Questions
[1] Zileuton is effective in treating asthma because it performs which of the following?
A. Antagonizes leukotriene receptors
B. Inhibits cyclooxygenase
C. Inhibits 5-lipoxygenase
D. Inhibits mast cell degranulation
[2] Which of the following drugs would be best for treatment of an acute attack of asthma?
A. Inhaled albuterol
B. Oral albuterol
C. Oral dexamethasone
D. Oral salmeterol
Match the following agents (A-H) to the described clinical situation
[3-5].
A. Anticholinergic inhaler
B. β-Agonist inhaler
C. Chromone agent
D. Glucocorticoid inhaler
E. IgE inhibitor
F. Leukotriene receptor antagonist
G. Lipoxygenase inhibitor
H. Methylxanthines
[3] A 21-year-old woman with moderately severe asthma on three-drug treatment has elevated liver function tests thought to be caused by one of her medications.
[4] A 25-year-old man has bronchospasm that is exercise induced, particularly in the cold weather. He takes his medication 15 minutes prior to anticipated exercise, which will help to prevent the asthmatic attack but does not produce bronchodilation.
[5] A 16-year-old female is placed on multiple medications. She has been taking her medications as instructed, but one of the medications is causing her to have tachycardia, nausea, and jitteriness. She has been informed of the need to measure serum levels of this medication.
Answers
[1] C. Zileuton diminishes the production of leukotrienes by inhibiting 5-lipoxygenase.
[2] A. Inhaled albuterol would provide the fastest acting and most localized therapy for an acute attack.
[3] G. Zileuton is an inhibitor of 5-lipoxygenase, thereby decreases the biosynthesis of leukotrienes; it is associated with liver toxicity.
[4] C. Chromones are prophylactic agents, useful especially for exercise or cold-induced bronchospasm.
[5] H. The methylxanthine agents have a low therapeutic index and often can cause adverse effects.
Pharmacology pearls
Inhaled corticosteroids are the treatment of choice for the long-term management of persistent asthma.
Use of short-acting β2-agonists more than twice weekly indicates inadequate control, and examination of long-term treatment should be considered.
Albuterol
Epinephrine
Metaproterenol
Cortisone
Prednisone
He knows everything about medications – to which pharmacological group the drug belongs, what components are included in its composition, how it differs from its analogs, what indications, contraindications, and side effects remedy has. John is a real pro in his field, so he knows all these subtleties and wants to tell you about them.