Bronchodilators: Types, Mechanisms, and Clinical Uses

Question 1

Describe the mechanism of action of long-acting beta2-agonists (LABAs) and explain how it differs from that of short-acting beta2-agonists (SABAs).

Accepted Answer

LABAs bind to beta2-receptors with higher affinity and dissociate more slowly than SABAs.

Answer

SABAs have a higher binding affinity for beta2-receptors than LABAs.

Answer

LABAs bind to both beta1- and beta2-receptors, while SABAs only bind to beta2-receptors.

Question 2

Which of the following is not an anticholinergic bronchodilator?

Accepted Answer

Salmeterol

Answer

Ipratropium bromide

Answer

Tiotropium bromide

Answer

Glycopyrronium bromide

Question 3

Which bronchodilator class includes Tiotropium bromide?

Accepted Answer

Long-acting muscarinic antagonists (LAMAs)

Answer

Short-acting β2-agonists

Answer

Long-acting β2-agonists

Answer

Short-acting muscarinic antagonists (SAMAs)

Question 4

For acute asthma, what is the recommended route of administration for salbutamol?

Accepted Answer

Inhaled, via a nebulizer or inhaler

Answer

Orally, in tablet form

Answer

Intravenously, through an injection

Answer

Subcutaneously, beneath the skin

Question 5

Which of the following is not a potential drug interaction with theophylline?

Accepted Answer

Salmeterol, a long-acting β2-agonist

Answer

Erythromycin, an antibiotic

Answer

Cimetidine, an anti-ulcer medication

Answer

Warfarin, an anticoagulant

Question 6

Which of these is the most common adverse effect associated with inhaled corticosteroids?

Accepted Answer

Oral candidiasis, a fungal infection in the mouth

Answer

Hoarseness, a change in voice quality

Answer

Tachycardia, a rapid heart rate

Answer

Tremor, involuntary shaking

Question 7

What is the primary mechanism of action by which bronchodilators exert their therapeutic effects?

Accepted Answer

Relax smooth muscles in the airways

Answer

Increase airway resistance

Answer

Stimulate mucus production

Answer

Inhibit inflammatory mediators

Question 8

Which class of bronchodilators primarily activates β2-adrenoceptors, leading to bronchodilation?

Accepted Answer

β-agonists

Answer

Anticholinergics

Answer

Methylxanthines

Answer

Cromones

Question 9

Which of the following is a potential adverse effect associated with the use of β-agonist bronchodilators?

Accepted Answer

Tachycardia

Answer

Hypoglycaemia

Answer

Blurred vision

Answer

Nausea

Question 10

In the management of severe asthma, what is the recommended route of administration for inhaled bronchodilators?

Accepted Answer

Nebulizer

Answer

Oral

Answer

Intravenous

Answer

Transdermal

Question 11

What is the primary mechanism of action by which methylxanthine bronchodilators achieve their effects?

Accepted Answer

Inhibition of phosphodiesterase

Answer

Stimulation of β-adrenoceptors

Answer

Blockade of muscarinic receptors

Answer

Reduction of airway inflammation

Question 12

A patient with asthma uses a bronchodilator, resulting in a 250 mL increase in their forced expiratory volume in 1 second (FEV1). What does this change in FEV1 suggest about the bronchodilator's effectiveness?

Accepted Answer

Improved airway diameter

Answer

Increased total lung capacity

Answer

Reduced airway inflammation

Answer

Prevented bronchospasm

Question 13

Which of the following is the primary mechanism of action of β2-agonists?

Accepted Answer

Stimulation of β2-adrenoreceptors, leading to relaxation of airway smooth muscle.

Answer

Inhibition of phosphodiesterase enzymes, leading to increased intracellular cAMP levels.

Answer

Inhibition of acetylcholinesterase, leading to increased levels of acetylcholine in the airway.

Answer

Blockade of muscarinic receptors, leading to decreased airway secretions.

Question 14

Of the following, which drug is a combination of a β2-agonist and a muscarinic antagonist?

Accepted Answer

Formoterol + Budesonide

Answer

Salbutamol

Answer

Ipratropium

Answer

Tiotropium

Question 15

What is the key difference between salmeterol and formoterol?

Accepted Answer

Salmeterol has a longer duration of action, typically 12 hours compared to 6 hours for formoterol.

Answer

Formoterol has a faster onset of action, typically within 1 minute compared to 15 minutes for salmeterol.

Answer

Salmeterol is contraindicated in asthma, while formoterol is not.

Answer

Formoterol is more potent than salmeterol and requires a lower dose.

Question 16

Which of the following is NOT an adverse effect associated with inhaled β2-agonists?

Accepted Answer

Hypoglycemia

Answer

Tachycardia

Answer

Tremor

Answer

Bronchospasm

Question 17

In the treatment of acute asthma exacerbations, which of the following bronchodilators is considered the first-line choice?

Accepted Answer

Salbutamol

Answer

Ipratropium

Answer

Budesonide

Answer

Montelukast

Question 18

Which of the following is the main advantage of using inhaled corticosteroids (ICS) in COPD?

Accepted Answer

Reduction of airway inflammation, addressing the underlying cause of COPD.

Answer

Rapid bronchodilation, providing immediate relief from airway obstruction.

Answer

Prevention of bronchospasm, particularly during exercise or allergen exposure.

Answer

Improvement of mucociliary clearance, helping to remove mucus and improve airway hygiene.

Question 19

What is the difference between leukotriene modifiers and cromolyn sodium in terms of their mechanism of action?

Accepted Answer

Leukotriene modifiers inhibit mast cell degranulation, while cromolyn sodium does not.

Answer

Cromolyn sodium inhibits mast cell degranulation, while leukotriene modifiers do not.

Answer

Both leukotriene modifiers and cromolyn sodium inhibit mast cell degranulation.

Answer

Neither leukotriene modifiers nor cromolyn sodium inhibit mast cell degranulation.

Question 20

Which of the following is NOT a type of bronchodilator?

Accepted Answer

Mucolytics

Answer

Beta2-agonists

Answer

Methylxanthines

Answer

Anticholinergics

Question 21

What is the primary mechanism of action of beta2-agonists?

Accepted Answer

Activation of beta2-receptors in bronchial smooth muscle, leading to relaxation

Answer

Elevation of intracellular cAMP levels

Answer

Inhibition of acetylcholinesterase

Question 22

What is the mechanism of action of anticholinergics?

Accepted Answer

Competitive antagonism of muscarinic acetylcholine receptors in bronchial smooth muscle

Answer

Inhibition of phosphodiesterase enzymes

Answer

Stimulation of beta2-receptors

Question 23

Which of the following is a long-acting anticholinergic bronchodilator?

Accepted Answer

Tiotropium

Answer

Albuterol

Answer

Ipratropium

Answer

Salmeterol

Question 24

What is the most common indication for use of bronchodilators?

Accepted Answer

Asthma

Answer

Cystic fibrosis

Answer

Pulmonary fibrosis

Answer

Pneumonia

Question 25

Which of the following is a contraindication for use of beta2-agonists?

Accepted Answer

Uncontrolled cardiac arrhythmias

Answer

Thyrotoxicosis

Answer

Hypertension

Answer

Glaucoma

Question 26

What is the preferred route of administration for bronchodilators in acute asthma?

Accepted Answer

Nebulized

Answer

Oral

Answer

Rectal

Answer

Intravenous