Drugs For the Treatment of Respiratory Diseases: MCQs and answers

Drugs for the treatment of Respiratory Disease

Multiple Choice Question

(Bronchial asthma, Tuberculosis, Antihistaminic, and Cough therapy)

1) All of the following are selective β2-agonist, except:
a) Isoprenaline
b) Salbutamol
c) Terbutaline
d) Formoterol

2) All of the following combinations of drug and their mechanism of action is correct, except:
a) Salbutamol: stimulation of β2 receptor causing bronchodilation
b) Sodium cromoglicate: mast cell stabilization
c) Zafirlukast: leukotriene modulators
d) Theophylline: non-selective β2 receptor stimulation causing bronchodilation

3) Which of the following statement about Salmeterol is not true?
a) It acts by relaxing muscles in the airways to improve breathing
b) It is a short-acting selective β2 agonist
c) Salmeterol inhalation is used to prevent asthma attacks
d) Salmeterol inhalation is used to treat COPD including emphysema and chronic bronchitis

4) Which of the following inhibits acetylcholine-mediated bronchospasm?
a) Theophylline
b) Ephedrine
c) Ipratropium
d) Salmeterol

5) All of the following statements about the use of glucocorticoids in asthma is true, except:
a) Reduces bronchial inflammation and hyperactivity to stimuli
b) Have delayed onset of action
c) Given as prophylactic medications, used alone or combined with β-agonists
d) They are bronchodilators

6) Systemic corticosteroids are indicated in the following conditions, EXCEPT:
a) Mild episodic asthma
b) Severe chronic asthma
c) Status asthmaticus
d) To prevent neonatal respiratory distress syndrome

7) Which one of the following is not a side effect due to systemic corticosteroids?
a) Adrenal suppression
b) Fluid retention, weight gain, hypertension
c) Hyperglycemia
d) Sleep disorders

8) All of the following statements about histamine are true except:
a) Increases blood pressure
b) Stimulates gastric acid secretion
c) Causes dilatation of capillaries
d) Causes constriction of bronchial smooth muscles

9) Isoniazid-induced liver damage:
a) Occurs primarily in patients under 30 years of age
b) Occurs with increased frequency in patients receiving concomitant ethambutol therapy
c) is probably due to the formation of a toxic hydrazine metabolite that binds to liver protein
d) is frequently associated with allergic manifestations such as eosinophilia, fever, and rash.

10) Development of peripheral neuritis is associated with …………………....
a) Rifampin
b) Ethambutol
c) Streptomycin
d) Isoniazid

11) Which of the following is the drug of choice in the treatment of productive cough?
a) Dextromethorphan
b) Bromhexine
c) Pholcodine
d) Noscapine

12) Astemizole and terfenadine may cause fatal arrhythmia when used in combination with some macrolides or antifungal agents. They.............................................................................................
a) Lengthen QT interval via direct action on cardiac H2 receptors
b) Increase metabolism of macrolide antibiotics
c) Cause accumulation of these agents following inhibition of CYP3A4, a cytochrome p450 enzyme
d) Exacerbate histamine-induced hypotension causing increased cardiac oxygen demand during reflex tachycardia

13) Which one of the following statements about cough is correct?
a) Cough must always be treated with an anti-tussive regardless of its cause
b) Codeine is effective in the treatment of productive cough
c) Pentoxyverine is especially well suited to treat cough in infants
d) Angiotensin II receptor blockers can cause cough

14) Choose the correct statement about rifampin:
a) It is the most active drug on slow-growing tubercle bacilli
b) Its antitubercular efficacy is lower than that of isoniazid
c) It is active against many atypical mycobacteria
d) It does not effectively cross the blood-CSF barrier

15) What is a serious adverse reaction caused by ethambutol?
a) Stomach upset
b) Eye damage
c) Gout
d) Hepatotoxicity

16) Choose the correct drug and its mechanism of action combination:
a) Rifampicin: inhibits bacterial DNA-dependent RNA polymerase
b) Pyrazinamide: interferes with mycobacteria fatty acid synthesis and inactivates mycobacteria at alkaline pH
c) Ethambutol: Interferes with mycolic acid synthesis
d) Isoniazid: Inhibits arabinosyl transferases involved in cell wall biosynthesis

17) The following anti-tubercular drug is a potent CYP-P450 enzyme inducer:
a) Isoniazid
b) Ethambutol
c) Rifampicin
d) Pyrazinamide

18) Which of the following pharmacologic agents antagonizes adenosine?
a) Terbutaline
b) Glucocorticoids
c) Cromolyn sodium
d) Theophylline

19) All of the following statements about antihistaminics are correct, EXCEPT:
a) Some histamine H1 receptor antagonists are used in the prophylaxis and treatment of motion sickness
b) Promethazine possesses anti-emetic, sedative, and anti-muscarinic activity
c) Histamine H1 receptor antagonists inhibit the release of histamine
d) Histamine H1 receptor antagonists are effective in the treatment of hay fever

20) An anti-tubercular drug that is bacteriostatic to resting organisms is…………..................
a) Pyrazinamide
b) Isoniazid
c) Ethambutol
d) Rifampicin

Multiple Choice Answers:
1-a) Isoprenaline

Beta-2 agonists, also known as beta-2 adrenergic agonists, are a class of medications that specifically target and activate beta-2 adrenergic receptors in the body. These receptors are primarily found in the smooth muscles of the airways, blood vessels, and certain organs.

The main therapeutic use of beta-2 agonists is in the management of respiratory conditions, particularly asthma and chronic obstructive pulmonary disease (COPD). When inhaled, beta-2 agonists selectively bind to and stimulate the beta-2 adrenergic receptors in the smooth muscles lining the airways. This stimulation causes the muscles to relax, leading to bronchodilation and improved airflow in the lungs. As a result, beta-2 agonists can provide quick relief from bronchospasm, alleviate wheezing, and help restore normal breathing.

Beta-2 agonists can be classified into two categories based on their duration of action: short-acting and long-acting.

Short-acting beta-2 agonists (SABAs): Examples include albuterol (salbutamol), levalbuterol, and terbutaline. SABAs are used as rescue medications to provide immediate relief during acute episodes of bronchospasm. They are typically inhaled using a metered-dose inhaler (MDI) or a nebulizer.

Long-acting beta-2 agonists (LABAs): Examples include formoterol, salmeterol, and vilanterol. LABAs have a prolonged duration of action and are used as maintenance therapies to prevent bronchospasm and maintain open airways over an extended period. They are typically prescribed in combination with inhaled corticosteroids for better asthma or COPD control.

Isoprenaline stimulates both beta-1 and beta-2 adrenergic receptors. By activating beta-1 receptors in the heart, it increases heart rate, contractility, and cardiac output. These effects make it useful in certain cardiac conditions such as bradycardia (slow heart rate), heart block, and cardiac arrest. Isoprenaline can be administered intravenously or intramuscularly to achieve these cardiovascular effects.

2-d)Theophylline: non-selective β2 receptor stimulation causing bronchodilation
3-b) It is a short-acting selective β2 agonist
4-c) Ipratropium
5-d) They are bronchodilators
6-a) Mild episodic asthma
7-d) Sleep disorders
8-a) Increases blood pressure
9-c) is probably due to the formation of a toxic hydrazine metabolite that binds to liver protein
10-d) Isoniazid
11-b) Bromhexine
12-c) cause accumulation of these agents following inhibition of CYP3A4, a cytochrome p450 enzyme
13-d) Angiotensin II receptor blockers can cause cough
14-c) It is active against many atypical mycobacteria
15-b) Eye damage
16-a) Rifampicin: inhibits bacterial DNA-dependent RNA polymerase
17-c) Rifampicin
18-d) Theophylline
19-c) Histamine H1 receptor antagonists inhibit the release of histamine
20-b) Isoniazid

Author: Ronak Shrestha