In the emergency department, the preferred first-line therapy for asthma exacerbation is

Correct Answer: B

Rationale: In the context of managing asthma exacerbations in the emergency department, the preferred first-line therapy is a β-agonist, making option B the correct answer. β-agonists, such as albuterol, work rapidly to dilate bronchial smooth muscle, providing quick relief of bronchoconstriction and improving airflow. This is crucial during an acute asthma attack to alleviate symptoms and prevent respiratory distress. Option A, Theophylline, is not the preferred first-line therapy for acute asthma exacerbations due to its slower onset of action compared to β-agonists. Using Theophylline in this scenario may delay symptom relief and exacerbate the patient's condition. Corticosteroids, as in option C, play a crucial role in managing asthma by reducing airway inflammation. However, they are typically used as an adjunct therapy in the acute setting and are not as effective as β-agonists for rapid bronchodilation. Cromolyn sodium, listed in option D, is an anti-inflammatory agent that is more commonly used for the prevention of asthma symptoms rather than for acute exacerbations. It is not the preferred first-line therapy for managing acute asthma attacks in the emergency department. Educationally, understanding the rationale behind using β-agonists as the preferred initial treatment for asthma exacerbations helps healthcare professionals prioritize interventions based on evidence-based practices. This knowledge ensures timely and appropriate management of acute respiratory distress, ultimately improving patient outcomes and safety.

Correct Answer: D

Rationale: In this question, the correct answer is D) Both (b) and (c). Antitussives are medications used to suppress or relieve coughing. Antitussives work by raising the threshold of the cough center in the brainstem (option B) and by reducing the cough-inducing impulses from the lungs (option C). Option A, liquifying bronchial secretions, is incorrect because medications that liquify bronchial secretions are known as expectorants, not antitussives. Expectorants help to make coughing more productive by thinning and loosening mucus in the airways, facilitating its removal. Understanding the mechanism of action of antitussives is essential for healthcare professionals, especially those working in respiratory care or pharmacology. By knowing how antitussives work, healthcare providers can make informed decisions when selecting the appropriate medication for patients with cough. This knowledge also helps in patient education, as individuals can understand how the medication is intended to alleviate their symptoms.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Cardiac stimulation. Caffeine is more powerful than theophylline in exerting cardiac stimulation because caffeine is a central nervous system stimulant that can increase heart rate and blood pressure more significantly compared to theophylline. Option A) Bronchodilation is a common action of theophylline, not caffeine. Theophylline acts as a bronchodilator by relaxing the smooth muscles of the airways, making it easier to breathe. Option C) Diuresis is not a typical action of caffeine or theophylline. Diuresis is the increased production of urine by the kidneys, which is not a primary effect of these drugs. Option D) Augmentation of skeletal muscle contractility is also not a known action of caffeine or theophylline. These drugs do not directly impact skeletal muscle contractility. In an educational context, understanding the differences in the actions of caffeine and theophylline is crucial for healthcare professionals, especially when managing patients with respiratory conditions such as asthma or COPD. Knowing the specific effects of each drug helps in making informed decisions regarding drug selection and monitoring for potential side effects. It also highlights the importance of pharmacological knowledge in providing safe and effective patient care.

Correct Answer: B

Rationale: In patients with bronchial asthma, inhaled corticosteroids are primarily used for their anti-inflammatory effects, which help to reduce airway inflammation and prevent exacerbations of asthma symptoms. The correct answer, option B, states that inhaled corticosteroids control an attack of refractory asthma. This is incorrect because inhaled corticosteroids are not typically used to quickly relieve or control acute asthma attacks. Instead, they are used as a maintenance therapy to prevent exacerbations and manage chronic asthma symptoms over the long term. Option A, reducing the need for bronchodilator medication, is a correct statement. Inhaled corticosteroids can help decrease airway inflammation, leading to better control of asthma symptoms and potentially reducing the need for rescue bronchodilators. Option C, reducing bronchial hyperreactivity, is also a correct statement. By reducing inflammation in the airways, inhaled corticosteroids can help decrease the hyperreactivity of the bronchi and improve overall lung function in patients with asthma. Option D, reversing diminished responsiveness to sympathomimetic bronchodilators, is incorrect. While inhaled corticosteroids can improve lung function and reduce inflammation, they do not directly reverse diminished responsiveness to bronchodilators. This is more related to the development of tolerance or reduced efficacy of bronchodilators over time, which may require adjustments in treatment rather than reliance solely on corticosteroids. Educationally, it is important for students to understand the specific mechanisms of action and therapeutic uses of different classes of respiratory medications to effectively manage asthma and other respiratory conditions. Understanding the appropriate indications for inhaled corticosteroids can help ensure optimal treatment outcomes and patient safety.

Correct Answer: B

Rationale: The correct answer is B) Pentoxifylline because it is not a xanthine derivative used in the treatment of asthma. Pentoxifylline is primarily used to improve blood flow in patients with peripheral vascular disease, not for respiratory conditions like asthma. A) Theophylline is a xanthine derivative that is commonly used in the treatment of asthma and other respiratory conditions. It works by relaxing the muscles in the airways, making it easier to breathe. C) Enprofylline is another xanthine derivative that has been studied for its potential use in treating respiratory conditions like asthma. While not as commonly used as theophylline, it still has a function in the management of asthma. D) "None of the above" is incorrect because, as explained above, Pentoxifylline is not a xanthine derivative typically used in asthma treatment, making it the correct answer in this context. In an educational context, understanding the different classes of drugs used in respiratory conditions like asthma is crucial for healthcare professionals. Knowing which medications are effective and appropriate for specific conditions ensures safe and effective patient care. This question reinforces the importance of recognizing the differences between xanthine derivatives and their respective uses in respiratory pharmacology.