NAECB Asthma Medication 5

Question 1

Which inhaled corticosteroid is a prodrug activated by esterases in the lung, designed to minimize systemic bioavailability?

Accepted Answer

Ciclesonide

Answer

Ciclesonide is an ICS prodrug converted to active des-ciclesonide by airway esterases, reducing oropharyngeal deposition and systemic effects.

Question 2

A patient develops oropharyngeal candidiasis after starting ICS therapy. What is the FIRST recommended intervention?

Accepted Answer

Use a spacer/valved holding chamber and rinse mouth after each dose

Answer

Using a spacer reduces oropharyngeal drug deposition, and rinsing the mouth after use removes residual ICS to prevent candidiasis.

Question 3

Benralizumab (Fasenra) reduces eosinophils more rapidly than mepolizumab. What is its mechanism compared to anti-IL-5 agents?

Accepted Answer

It binds IL-5 receptor alpha (IL-5Rα) and induces ADCC of eosinophils

Answer

Benralizumab binds IL-5Rα directly on eosinophils and triggers antibody-dependent cell-mediated cytotoxicity (ADCC), rapidly depleting eosinophils.

Question 4

Exercise-induced bronchoconstriction (EIB) prophylaxis with a SABA should be administered how long before exercise?

Accepted Answer

15–30 minutes before exercise

Answer

Albuterol MDI taken 15–30 minutes before exercise provides effective prophylaxis against EIB for approximately 2–3 hours.

Question 5

Which asthma medication class is CONTRAINDICATED in patients with a known hypersensitivity to aspirin who have asthma and nasal polyps (Samter's triad)?

Accepted Answer

Ketorolac or NSAIDs used as adjunct anti-inflammatory agents

Answer

In Samter's triad (AERD), NSAIDs including ketorolac trigger severe bronchoconstriction by diverting arachidonic acid to leukotriene synthesis.

NAECB Exam Practice Test

NAECB Exam Practice Test

NAECB Asthma Medication 5