Examl 2:l NU641/l NUl 641l (NEWl 2025/l
2026l Update)l Advancedl Clinicall
Pharmacologyl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Regis
QUESTION
Leukotrienel modifiers
Answer:
Leukotrienel receptorl antagoinistsl (LTRAs)l andl 5l lipoxygenasael pathwayl inhibitorsl
developedl basedl onl thel theoryl thatl cysteinyll leukotrienesl playl al significantl rolel inl thel
chronicl inflammationl associatedl withl asthmal andl allergy
->l Thisl causesl airwayl ededmal smoothl musclel constriction,l andl cellularl changesl
associatedl withl thel inflammatoryl process
->Originallyl al lotl ofl excitementl whenl thesel camel tol thel marketl butl nowl actuallyl onlyl
typicallyl usedl asl secondl line
->Canl bel orall whichl mightl helpl withl compliance
QUESTION
Leukotrienel modifiersl PK
Answer:
-leukotienel receptorl antagonistsl =l zafirlukast,l montelukast
-5l lipoxygenasel pathwayl inhibitors=l zileuton
-typicallyl welll absorbed,l 3-5l hrl halfl lie
-extensivel hepaticl metabolism,l cautionl forl liverl disease
QUESTION
Leukotrienel modifersl precautions
Answer:
,-avoidl zileutonl inl severel liverl diease
***dol notl usel forl primaryl treatmentl ofl anl acutel asthmal attackl (longerl terml affects)
-chewablel montelukastl containsl phenylalanine-l don'tl takel ifl youl havel PKU
-cautionl ifl systemicl corticosteroidl dosel isl reducedl orl substitutedl canl leadl tol
eosinophilia,l vascularl rash,l worseningl pulm,l cardiacl complicationsl andl neuropathy
-reportsl ofl neuropsychiatricl events
Zileuton=l pregl c
LTRASl generally=l pregl b
Zafirlukastl goodl forl kidsl agel 5+,l Montelukastl >l 12l m
Leukotrinel modifiersl s/e
-zileutonl rare=l hepaticl injury
Drugl interactions:l increasel theophyllinel levelsl sol mustl decreasel theophyllinel dose
Canl increasel PTl withl Warfarin
QUESTION
LTRA'sl clinicall usel andl ptl education
Answer:
-treatmentl ofl CHRONICl ASTHMA
-montelukast=l preventl ofl exercisel inducedl bronchoconstrictionl inl agel >15,l allergicl
rhinitisl >6l months
-mustl bel takenl dailyl evenl ifl symptoml free-l notl forl acutel episodes,l mustl continuel
bronchodilatorl inhaledl forl acutel episodesl ofl bronchospasm
QUESTION
Inhaledl corticosteroidsl (ICS)
Answer:
-beclomethasone,l triamcinolone,l budesonidel (Pulmicort),l fluticasonel (Flovent)
-PD:l suppressesl airwayl inflammationl byl activatingl anti-inflaml genes,l switchingl offl
inflammatoryl genel expressionl andl inhibitingl inflammatoryl cells
->l reductionl inl thel severityl ofl asthmal symptoms,l increasedl peakl flowl readings,l andl
decreasedl airwayl hyperl responsiveness
-inl general,l safel andl welll toleratedl forl childrenl andl adults
-corticosteroidsl canl alsol bel usedl intranasallyl forl allergicl rhinitis
QUESTION
,Inhaledl corticosteroidsl PK
Answer:
-onlyl 10-30%l systemicallyl absorbed,l spacersl increasel overalll absorption
-asthma=l preferredl longl terml controll medicationsl forl managingl thel inflammaotryl processl
withl asthma
-willl startl onl alll patientsl withl mildl persistentl asthmal orl wrose
Or
-allergicl rhinitis=l nasall cortico
QUESTION
Corticol pearlsl andl precautions
Answer:
-***notl indicatedl alonel forl acutel asthmal attackl orl usel forl reliefl ofl acutel bronchospasm
-ifl takingl withl orall steroids,l increasel riskl forl hypothalamicl pituitaryl adrenall suppressionl
(HPA)\
-avoidl inl ptsl withl Cushings
-pregl C,l budesonidel DOCl inl preg*
-**highl dosel inhaledl steroidsl inl childrenl mayl inhibitl growth
QUESTION
Inhaledl corticosteroidsl drugl interactionl andl s/e
Answer:
-s/e:l dryl mouth,l hoareness,l toungel andl mouthl irritation,l flushing,l alteredl taste
-orall candidiasis-l rinsel mouth
-l nol majorl drugl interactions
QUESTION
inhaledl corticosteroidl patientl education
Answer:
-ifl separatel bronchodilator:l administerl bronchodilatorl dirstl andl waitl severall minutesl
beforel inhaledl corticosteroidl (onlyl timel youl usel theml separatelyl isl usuallyl IP,l OPl
usuallyl together)l ->l enhancesl absorptionl ofl steroid
, -rinsel mouth,l usel peakl flowl monitor,l quitl smoking,l spacers,l mouthl rinse,l avoidl
environementall triggers,l avoidl infectionsl whenl possible
QUESTION
Dryl vsl meteredl dose
Answer:
Dryl powderl inhaler=l onlyl appropriatel ifl thel patientl canl makel al forcefull andl deepl
inhalation
Meteredl dosel inhaler=l (andl tol al lesserl extentl softl mistl inhalers)l requirel coordinationl
betweenl devicel triggeringl andl inhalationl andl patientl canl inhalel slowlyl andl deeplyl froml
thel device-l ifl therel isl doubtl considerl addingl al spacer
QUESTION
reviewl inhalerl thingl inl moodle
Answer:
QUESTION
Asthmal pathophysiology
Answer:
-chronicl inflammationl disorderl ofl thel airways
-airwayl inflammationl presentl evenl betweenl flareupsl andl canl significantlyl alterl lungl
function
-recurrentl episodesl ofl wheezing,l breathlessnessl andl chestl tightness
-airflowl obstructionl isl reversible
LOOKl ATl GINAl GUIDELINES
QUESTION
Asthma-l howl tol determinel treatment?l Andl goals
Answer:
-4l classesl ofl severity
->l needl forl medicationl tol relievel symptomsl (howl muchl rescuel medication)
2026l Update)l Advancedl Clinicall
Pharmacologyl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Regis
QUESTION
Leukotrienel modifiers
Answer:
Leukotrienel receptorl antagoinistsl (LTRAs)l andl 5l lipoxygenasael pathwayl inhibitorsl
developedl basedl onl thel theoryl thatl cysteinyll leukotrienesl playl al significantl rolel inl thel
chronicl inflammationl associatedl withl asthmal andl allergy
->l Thisl causesl airwayl ededmal smoothl musclel constriction,l andl cellularl changesl
associatedl withl thel inflammatoryl process
->Originallyl al lotl ofl excitementl whenl thesel camel tol thel marketl butl nowl actuallyl onlyl
typicallyl usedl asl secondl line
->Canl bel orall whichl mightl helpl withl compliance
QUESTION
Leukotrienel modifiersl PK
Answer:
-leukotienel receptorl antagonistsl =l zafirlukast,l montelukast
-5l lipoxygenasel pathwayl inhibitors=l zileuton
-typicallyl welll absorbed,l 3-5l hrl halfl lie
-extensivel hepaticl metabolism,l cautionl forl liverl disease
QUESTION
Leukotrienel modifersl precautions
Answer:
,-avoidl zileutonl inl severel liverl diease
***dol notl usel forl primaryl treatmentl ofl anl acutel asthmal attackl (longerl terml affects)
-chewablel montelukastl containsl phenylalanine-l don'tl takel ifl youl havel PKU
-cautionl ifl systemicl corticosteroidl dosel isl reducedl orl substitutedl canl leadl tol
eosinophilia,l vascularl rash,l worseningl pulm,l cardiacl complicationsl andl neuropathy
-reportsl ofl neuropsychiatricl events
Zileuton=l pregl c
LTRASl generally=l pregl b
Zafirlukastl goodl forl kidsl agel 5+,l Montelukastl >l 12l m
Leukotrinel modifiersl s/e
-zileutonl rare=l hepaticl injury
Drugl interactions:l increasel theophyllinel levelsl sol mustl decreasel theophyllinel dose
Canl increasel PTl withl Warfarin
QUESTION
LTRA'sl clinicall usel andl ptl education
Answer:
-treatmentl ofl CHRONICl ASTHMA
-montelukast=l preventl ofl exercisel inducedl bronchoconstrictionl inl agel >15,l allergicl
rhinitisl >6l months
-mustl bel takenl dailyl evenl ifl symptoml free-l notl forl acutel episodes,l mustl continuel
bronchodilatorl inhaledl forl acutel episodesl ofl bronchospasm
QUESTION
Inhaledl corticosteroidsl (ICS)
Answer:
-beclomethasone,l triamcinolone,l budesonidel (Pulmicort),l fluticasonel (Flovent)
-PD:l suppressesl airwayl inflammationl byl activatingl anti-inflaml genes,l switchingl offl
inflammatoryl genel expressionl andl inhibitingl inflammatoryl cells
->l reductionl inl thel severityl ofl asthmal symptoms,l increasedl peakl flowl readings,l andl
decreasedl airwayl hyperl responsiveness
-inl general,l safel andl welll toleratedl forl childrenl andl adults
-corticosteroidsl canl alsol bel usedl intranasallyl forl allergicl rhinitis
QUESTION
,Inhaledl corticosteroidsl PK
Answer:
-onlyl 10-30%l systemicallyl absorbed,l spacersl increasel overalll absorption
-asthma=l preferredl longl terml controll medicationsl forl managingl thel inflammaotryl processl
withl asthma
-willl startl onl alll patientsl withl mildl persistentl asthmal orl wrose
Or
-allergicl rhinitis=l nasall cortico
QUESTION
Corticol pearlsl andl precautions
Answer:
-***notl indicatedl alonel forl acutel asthmal attackl orl usel forl reliefl ofl acutel bronchospasm
-ifl takingl withl orall steroids,l increasel riskl forl hypothalamicl pituitaryl adrenall suppressionl
(HPA)\
-avoidl inl ptsl withl Cushings
-pregl C,l budesonidel DOCl inl preg*
-**highl dosel inhaledl steroidsl inl childrenl mayl inhibitl growth
QUESTION
Inhaledl corticosteroidsl drugl interactionl andl s/e
Answer:
-s/e:l dryl mouth,l hoareness,l toungel andl mouthl irritation,l flushing,l alteredl taste
-orall candidiasis-l rinsel mouth
-l nol majorl drugl interactions
QUESTION
inhaledl corticosteroidl patientl education
Answer:
-ifl separatel bronchodilator:l administerl bronchodilatorl dirstl andl waitl severall minutesl
beforel inhaledl corticosteroidl (onlyl timel youl usel theml separatelyl isl usuallyl IP,l OPl
usuallyl together)l ->l enhancesl absorptionl ofl steroid
, -rinsel mouth,l usel peakl flowl monitor,l quitl smoking,l spacers,l mouthl rinse,l avoidl
environementall triggers,l avoidl infectionsl whenl possible
QUESTION
Dryl vsl meteredl dose
Answer:
Dryl powderl inhaler=l onlyl appropriatel ifl thel patientl canl makel al forcefull andl deepl
inhalation
Meteredl dosel inhaler=l (andl tol al lesserl extentl softl mistl inhalers)l requirel coordinationl
betweenl devicel triggeringl andl inhalationl andl patientl canl inhalel slowlyl andl deeplyl froml
thel device-l ifl therel isl doubtl considerl addingl al spacer
QUESTION
reviewl inhalerl thingl inl moodle
Answer:
QUESTION
Asthmal pathophysiology
Answer:
-chronicl inflammationl disorderl ofl thel airways
-airwayl inflammationl presentl evenl betweenl flareupsl andl canl significantlyl alterl lungl
function
-recurrentl episodesl ofl wheezing,l breathlessnessl andl chestl tightness
-airflowl obstructionl isl reversible
LOOKl ATl GINAl GUIDELINES
QUESTION
Asthma-l howl tol determinel treatment?l Andl goals
Answer:
-4l classesl ofl severity
->l needl forl medicationl tol relievel symptomsl (howl muchl rescuel medication)
