Administration of fluticasone via a metered dose inhaler:

Correct Answer: A

Rationale: In the administration of fluticasone via a metered dose inhaler, option A is correct because it allows for a reduction in the maintenance dose of oral prednisolone in chronic asthma. Fluticasone is a potent inhaled corticosteroid that helps to reduce inflammation in the airways, thereby decreasing the need for systemic corticosteroids like prednisolone. Option B is incorrect because with proper inhaler technique, the majority of the dose should reach the lungs rather than being swallowed. Option C is incorrect because fluticasone can indeed cause hypothalamo-pituitary-adrenal suppression, especially at high doses. Option D is incorrect as fluticasone actually has a higher systemic bioavailability compared to beclomethasone. Educationally, understanding the correct administration and effects of respiratory drugs like fluticasone is crucial for healthcare providers managing patients with asthma and other respiratory conditions. Proper inhaler technique and knowledge of drug properties can significantly impact patient outcomes and reduce the need for systemic medications with potential side effects.

Correct Answer: A

Rationale: Inhalation of Beclomethasone can lead to moniliasis of the mouth due to its potential to suppress the immune response in the oral cavity, leading to overgrowth of yeast like Candida. Beclomethasone is a corticosteroid known to have local immunosuppressive effects. Formoterol is a long-acting beta-agonist used for bronchodilation and does not have direct immunosuppressive effects. Ipratropium is an anticholinergic bronchodilator that works by relaxing the muscles around the airways and does not affect the immune response in the oral cavity. Nedocromil is a mast cell stabilizer used for prevention of asthma symptoms and does not have significant immunosuppressive properties. Educationally, understanding the side effects of respiratory drugs is crucial for healthcare professionals to provide comprehensive care to patients. Knowing the specific adverse effects associated with each medication helps in identifying and managing potential complications effectively. This knowledge ensures safe medication administration and patient education regarding potential side effects.

Correct Answer: B

Rationale: In this case, the correct answer is B) It may produce bradycardia. Salbutamol, a beta-2 adrenergic agonist, primarily acts on beta-2 adrenoceptors present in the bronchial smooth muscle, leading to bronchodilation. Therefore, it is used as a reliever medication in asthma to alleviate bronchospasm and improve airflow. Option A is correct because salbutamol does indeed stimulate beta-2 adrenoceptors, leading to bronchodilation. Option C is also correct as the primary action of salbutamol is to relax bronchial smooth muscle. Option D is incorrect because salbutamol is primarily administered via inhalation to ensure direct delivery to the lungs and faster onset of action. Oral administration is less common and generally reserved for specific cases where inhalation is not feasible or effective. Understanding the correct administration and effects of respiratory medications like salbutamol is crucial for healthcare professionals, especially those working with patients with respiratory conditions like asthma. It is essential to know the correct pharmacological actions, indications, contraindications, and administration routes to ensure safe and effective patient care.

Correct Answer: D

Rationale: In the treatment of chronic bronchial asthma, long-term control medications play a crucial role in managing symptoms and preventing exacerbations. The correct answer is D) β-adrenergic antagonists like pindolol. The rationale behind this is that β-adrenergic antagonists can actually worsen asthma symptoms by blocking the action of β2 receptors in the bronchial smooth muscle, leading to bronchoconstriction. Option A, Selective long-acting B2-agonists (LABA) like salmeterol, is a valid long-term control medication as they stimulate β2 receptors, causing bronchodilation. Option B, Slow-release theophylline, is also a long-term control medication that helps relax the airway smooth muscles. Option C, Inhaled corticosteroids like budesonide, are essential in chronic asthma management as they reduce airway inflammation. Educationally, understanding the mechanism of action of each drug is vital for healthcare providers to appropriately select the most effective treatment for patients with chronic bronchial asthma. It is crucial to differentiate between medications that can provide long-term control and those that may exacerbate symptoms to optimize patient outcomes and quality of life.

Correct Answer: A

Rationale: In the case of managing glaucoma, muscarinic agonists like pilocarpine and beta blockers are commonly used. These drugs can pose risks for patients with asthma due to their potential to exacerbate asthma symptoms. Muscarinic agonists can lead to bronchoconstriction by stimulating smooth muscle contraction in the airways, worsening asthma symptoms. Beta blockers, on the other hand, can cause bronchoconstriction by blocking beta-2 receptors in the lungs, which are responsible for bronchodilation. Option A is correct because muscarinic agonists and beta blockers are contraindicated or pose great risks for individuals with asthma. It is crucial for healthcare providers to be aware of this interaction to avoid adverse effects in patients with both glaucoma and asthma. Options B, C, and D are incorrect. Option B incorrectly suggests that these drugs degranulate mast cells and cause bronchoconstriction. Option C is inaccurate as these drugs do not tend to raise intraocular pressure in patients with both glaucoma and asthma. Option D is also misleading as muscarinic agonists and beta blockers are not typically used for acute asthma management. Educationally, it is important for healthcare professionals to understand the potential cross-reactivity of drugs used in different conditions and how they can impact patients with comorbidities. This knowledge is essential for safe and effective patient care, highlighting the significance of considering individual patient profiles and medical history when prescribing medications.