A patient takes oral theophylline twice daily for chronic stable angina. After
developing an infection, the patient went to an after-hours clinic where
ciprofloxacin was prescribed. What action will the patient's primary provider
take when the patient follows up the next day?
Reduce the theophylline dose
A child with allergic rhinitis has used budesonide for several years. The
parents are concerned that the child's rate of growth has slowed. What
action will the provider take to address the parent's concerns?
Discuss changing to fluticasone with the parents.
A patient with seasonal and perennial rhinitis requests a prescription for the
most effective drug for treating the condition. Which medication will the
provider recommend?
Fluticasone propionate
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A patient with a cold used phenylephrine nasal spray, 2 sprays every 4 hours
for a week. Since then it has been impossible to discontinue the medication
because the nasal congestion has increased. What action will the provider
take?
Order an intranasal glucocorticoid to be used while the phenylephrine is
,withdrawn.
A patient requests medication for insomnia. The provider notes that the
patient is restless and anxious with a heart rate of 90 beats/minute, and
blood pressure of 130/85 mmHg. Current medications are the combination
product loratadine/pseudoephedrine every 12 hours for allergic rhinitis.
What action will the provider take?
Discuss changing to an intranasal glucocoricoid and loratidine
A patient with a cough has been advised to use guaifenesin. When the
patient asks why this particular drug, what response will the provider
provide?
It stimulates the flow of secretions so they are easier to cough up.
A child with perennial allergic rhinitis has been using an intranasal
glucocorticoid. After the child develops frequent nosebleeds, the provider
orders montelukast to replace the inhaler. What statement will the provider
include when teaching the child's parents about montelukast?
This drug will help prevent inflammation without causing nosebleeds.
A patient who recently recovered from acute bronchitis reports a lingering
dry cough that prevents sleep. Which over-the-counter medication will the
provider recommend to best manage the symptoms?
Diphenhydramine
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Which medication for asthma can a provider prescribe off-label to treat
allergic rhinitis?
, Omalizumab
A provider prescribes montelukast for a child with asthma. Which statement
by the child's parent indicates understanding of this medication?
I may noticde mood changes in my child.
A patient with asthma reports daily symptoms requiring a short-acting
B2-agonist for relief. The patient has used oral glucocorticoids three times in
the past three months and reports awakening at night with symptoms about
once a week. The patient's forced expiratory volume in 1 second (FEV1) is
75% of predicted values. Which regimen does the provider determine is best
for this patient?
Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed.
Which medication will a provider prescribe for an asthma patient as part of
step 1 management?
Short acting B2 agonists
A patient with stable COPD is prescribed a bronchodilator by the provider.
Which type of bronchodilator is preferred for this patient?
A long-acting inhaled B2 agonist (LABA)
A patient with severe, chronic COPD uses an inhaled long-acting inhaled B2
agonist (LABA)/glucocorticoid but continues to have frequent exacerbation
of symptoms. What change in therapy will the provider discuss with the
patient?
Adding roflumilast
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