NBRC Pharmacology and Therapeutics 1 — Questions and Answers
Question 1: Which bronchodilator class acts primarily on beta-2 adrenergic receptors to cause bronchodilation?
- Short-acting muscarinic antagonists
- Short-acting beta-2 agonists (Correct answer)
- Methylxanthines
- Leukotriene modifiers
Correct answer: Short-acting beta-2 agonists
Short-acting beta-2 agonists (SABAs) such as albuterol selectively stimulate beta-2 adrenergic receptors in airway smooth muscle, causing relaxation and bronchodilation.
Question 2: What is the primary mechanism of action of ipratropium bromide?
- Beta-2 receptor stimulation
- Mast cell stabilization
- Muscarinic receptor blockade (Correct answer)
- Phosphodiesterase inhibition
Correct answer: Muscarinic receptor blockade
Ipratropium bromide is an anticholinergic agent that blocks muscarinic receptors, reducing bronchoconstriction and secretions by inhibiting acetylcholine binding.
Question 3: A patient with status asthmaticus is receiving continuous albuterol nebulization. Which adverse effect must be monitored most closely?
- Hypokalemia (Correct answer)
- Hypernatremia
- Metabolic acidosis
- Hyperglycemia
Correct answer: Hypokalemia
Beta-2 agonists like albuterol stimulate Na+/K+-ATPase, shifting potassium intracellularly and potentially causing hypokalemia, which can lead to cardiac dysrhythmias.
Question 4: Which inhaled corticosteroid is most commonly used as maintenance therapy for persistent asthma?
- Prednisone
- Fluticasone (Correct answer)
- Methylprednisolone
- Hydrocortisone
Correct answer: Fluticasone
Fluticasone (and other inhaled corticosteroids like budesonide and beclomethasone) is used as daily maintenance therapy for persistent asthma to reduce airway inflammation.
Question 5: What is the therapeutic serum level range for theophylline in adults?
- 1–5 mcg/mL
- 5–10 mcg/mL
- 10–20 mcg/mL (Correct answer)
- 20–30 mcg/mL
Correct answer: 10–20 mcg/mL
The therapeutic range for theophylline is 10–20 mcg/mL; levels above 20 mcg/mL are associated with toxicity including seizures, tachycardia, and nausea.
Question 6: Dornase alfa (Pulmozyme) is primarily indicated for which condition?
- Asthma exacerbations
- COPD with chronic bronchitis
- Cystic fibrosis (Correct answer)
- Pulmonary hypertension
Correct answer: Cystic fibrosis
Dornase alfa is a recombinant human DNase that cleaves extracellular DNA in mucus, reducing viscosity and improving airway clearance in patients with cystic fibrosis.
Question 7: Which medication is classified as a long-acting beta-2 agonist (LABA)?
- Albuterol
- Levalbuterol
- Salmeterol (Correct answer)
- Metaproterenol
Correct answer: Salmeterol
Salmeterol is a LABA with a duration of action of approximately 12 hours, making it suitable for twice-daily maintenance dosing rather than acute rescue.
NBRC Pharmacology and Therapeutics 1
Which bronchodilator class acts primarily on beta-2 adrenergic receptors to cause bronchodilation?