Brand/generic
Generic name for Breo Ellipta
a. fluticasone/vilanterol
b. fluticasone
c. Umeclidinium
d. Umeclidinium/Vilanterol
A. fluticasone/vilanterol
What drug class does umeclidinium belong to?
A. LABA
B. SABA
C. LAMA
D. SAMA
C. LAMA
rationale: umeclidinium (incruse Ellipta) is a long acting anticholinergic. It is dosed ONCE daily, every 24 hours
A 74-year-old male patient comes to the pharmacy and asks about a proper technique and cleaning his inhaler. He says that the name of the inhaler is Atrovent HFA. Which of the following counseling points is/are true for this patient?
A. Always shake your inhaler before using it
B. Prime the inhaler by spraying 2 times away from the face. Prime again if >3 days from the last use
C. To prevent medication buildup, wash the metal cannister with warm water for 30 seconds at least once a week
D. All of the above
B. Prime the inhaler by spraying 2 times away from the face. Prime again if >3 days from the last use
Rationale: You do not have to shake Atrovent HFA. In order to clean the inhaler, remove the metal cannister- DO NOT let this get wet and rinse the mouthpiece only under warm running water for 30 seconds.
How is FEV1 assessed using the GOLD guidelines?
a. heart rate
b. blood pressure
c. O2 sat
d. spirometry
D. Spirometry
rationale: FEV1 is assessed by spirometry to calculate the GOLD score for a patient.
First line treatment: Bronchodilators used for vs. inhaled corticosteroids used for:
a. Asthma, COPD
b. COPD, Asthma
c. COPD only
d. Asthma only
b. COPD, Asthma
Rationale: The first line treatment for COPD is bronchodilators and ICS for Asthma.
Brand name for salmeterol/fluticasone
a. Advair diskus
b. Symbicort
c. Brovana
d. Spiriva
A. Advair Diskus
What drug class does olodaterol belong to?
A. LAMA
B. LABA
C. SABA
D. SAMA
B. LABA
rationale: olodaterol (Striverdi) is ultra-long acting LABA. It is also available in combination with tiotropium (Stiolto Respimat) Dose: TWO inhalations ONCE daily
RM is a 50-year-old patient with a past medical history of COPD, CHF, HTN and dyslipidemia. He is currently taking furosemide, lisinopril, atorvastatin, fish oil, and a LAMA. He is admitted to the hospital for his first COPD exacerbation. He has no prior history of COPD exacerbations. The physician asks you for a recommendation on his COPD management. He has a CAT score of 9 and mMRC 1. Which one of the following would be the best recommendation for RM at this point?
A. RM is in Group A and bronchodilator such as SABA or SAMA need to be added
B. RM is in Group C and LABA is preferred over LAMA
C. RM is in Group C and LAMA is preferred over LABA
D. None of the above
C. RM is in Group C and LAMA is preferred over LABA
Rationale: see grouping chart
A 60-year-old male with FEV1 FVC <70 and FEV1 50% predicted. CAT score is 20 and he had 3 exacerbations in the past year. What is the assessment for this patient?
a. GOLD 1 grade, group D
b.GOLD 2 grade, group D
c. GOLD 2 grade, group B
d. GOLD 1 grade, group B
B.GOLD 2 grade, group D
Rationale: see GOLD scaling chart
Exacerbations are common complications of:
a. Asthma
b. COPD
c. Asthma and COPD
d. None of the above
c. Asthma and COPD
Rationale: Exacerbations are commonly seen in both diseases
Generic name for Arcapta
a. salmeterol
b. olodaterol
c. indacterol
d. arformoterol
C. Indacterol
What class is Combivent Respimat in?
A. LAMA
B. SABA
C. SAMA
D. LABA
C. SAMA
rationale: Combivent is ipratropium/albuterol and is a short acting muscarinic agonist
MD is a 67 year old patient with mild COPD. They are currently managing their treatments well, but they want some tips on how to prevent and exacerbation. As their pharmacist, what non-pharm technique would you recommend?
A. Continue smoking as it does not affect COPD
B. Do intense exercise daily
C. Get all vaccinations recommended
D. Only take your maintenance inhaler when you are feeling short of breath
C. Get all vaccinations recommended
Rationale: it is very important for COPD patients to get their annual influenza vaccine as well as their pneumonia vaccine.
A GOLD score for a patient with an FEV1 of 35% would be...
a. GOLD 1-mild
b. GOLD 2- moderate
c. GOLD 3- severe
d. GOLD 4-very severe
D. GOLD 3- severe
Rationale: see GOLD chart
Sputum production occurs most commonly in:
a. Asthma
b. COPD
c. Both
d. None
b. COPD
Rationale: Sputum production commonly occurs in COPD
What is the generic name for Combivent Respimat?
a. tiotropium
b. fluticasone/salmeterol
c. ipratropium bromide
d. ipratropium/albuterol
D. ipratropium/albuterol
What class is Spiriva Handihaler in?
A. SAMA
B. LAMA
C. SABA
D. PDE-4 inhibitor
B. LAMA
rationale: Spiriva Handihaler is tiotropium and is a long acting muscarinic antagonist
a. Add Advair Diskus
b. Add Spiriva
c. discontinue SABA
d. Add Combivent
a. Add Advair Diskus
rationale: because JB already has a LAMA on board, adding on a LABA will be beneficial.
A 90 year old patient with a FEV1 >80% is considered to be...
a. GOLD 1-mild
b. GOLD 2-moderate
c. GOLD 3-severe
d. GOLD 4- very severe
a. GOLD 1-mild
rationale: see GOLD scaling chart
PT is a 23 year old patient experiencing SOB. What will PT most likely be diagnosed with?
a. COPD
b. Asthma
c. Both
B. asthma
rationale: PT is 23 years old which correlates more with asthma. COPD is seen in patients >40 years old
What is the brand name for rolflumilast?
a. Arcapta
d. Stiolto Respimat
c. Daliresp
d. Tudorza Pressair
c. Daliresp
What class is roflumlilast in?
A. SAMA
B. LAMA
C. PDE-4 inhibitor
D. LABA
C. PDE-4 inhibitor
rationale: roflumilast (Daliresp) is a PDE-4 inhibitor that reduces lung inflammation
JP is a 83 year old COPD patient that comes into the clinic with a case of thrush (fungal mouth infection). Which medication may have caused this infection?
a. Wixela
b. Spiriva
C. Atrovent
D. Combivent
A. Wixela
Rationale: Wixela (salmeterol/fluticasone) contains fluticasone which is an ICS. All ICS products require rinsing the mouth out after use due to the chance of fungal infection.
A 42-year-old female with FEV1 FVC <70 and FEV1 20% predicted. What is the assessment for this patient?
a. GOLD grade 1, mild
b. GOLD grade 2, moderate
c. GOLD grade 3, severe
d. GOLD grade 4, very severe
D. GOLD grade 4, very severe
Rationale: see GOLD scaling chart
Allergies are associated more with...
a. asthma
b. COPD
c. both
d. neither
a. asthma
rationale: Allergies are uncommonly related to COPD