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Pharmacology MCQ practice
Review asthma, COPD, inhaled therapy, cough and cold medicines, respiratory counselling, and prevention scenarios.
Therapeutic optimisation
Answer: Frequent reliever use most days
Frequent salbutamol use suggests uncontrolled airway disease.
Occasional use, known tremor, or using a spacer does not by itself show poor control.
Cough and cold
Answer: Sedation & confusion
Codeine can cause sedation and confusion in older adults, increasing fall and cognitive risk.
Hypertension, hypoglycaemia and excitation are less typical as opioid effects of codeine.
Asthma
Answer: Fluticasone
High-dose fluticasone can suppress the hypothalamic-pituitary-adrenal axis, especially with prolonged use or interacting CYP3A4 inhibitors.
Budesonide and beclomethasone can also cause systemic corticosteroid effects, but risk varies by dose, formulation, and exposure.
Cough and cold
Answer: Diphenhydramine
Diphenhydramine has significant anticholinergic activity and may precipitate acute angle-closure glaucoma by causing mydriasis.
Dextromethorphan, guaifenesin, and acetylcysteine are not strongly associated with precipitating angle-closure glaucoma.
Cough and cold
Answer: Confusion
Confusion is an important adverse effect of first-generation antihistamines in older adults because of central anticholinergic and sedating effects.
Fever is not typical, cough is the treated symptom, and urinary incontinence is less characteristic than urinary retention from anticholinergic effects.
Asthma
Answer: Eosinophil major basic protein
Eosinophil major basic protein is released in the late allergic response, promoting airway inflammation and hyperresponsiveness.
Histamine and leukotrienes are early mediators; acetylcholine can bronchoconstrict but is not a classic late-phase mediator.
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