Which statement describes a pharmacodynamic difference between albuterol and salmeterol?

Choice A reason: Protamine sulfate is the antidote for heparin overdose, neutralizing heparin’s anticoagulant effect by binding to it, forming an inactive complex. This reverses excessive anticoagulation, reducing bleeding risk in patients with prolonged aPTT (e.g., 90 seconds), making it the appropriate treatment for heparin-induced bleeding.

Choice B reason: Vitamin E has no role in reversing heparin-induced bleeding. It is an antioxidant with potential antiplatelet effects, which could worsen bleeding. Heparin’s action, enhancing antithrombin to inhibit thrombin and factor Xa, is specifically countered by protamine sulfate, not vitamin E.

Choice C reason: Vitamin K reverses warfarin, not heparin, by restoring vitamin K-dependent clotting factors. Heparin acts via antithrombin, independent of vitamin K, and its overdose causes bleeding correctable by protamine sulfate. Vitamin K is ineffective for heparin-related bleeding, making this incorrect.

Choice D reason: Potassium chloride treats hypokalemia, not heparin-induced bleeding. Heparin’s anticoagulant effect, prolonging aPTT, is unrelated to potassium levels. Administering potassium chloride would not address excessive anticoagulation or bleeding, making it irrelevant for managing heparin overdose complications.

Choice A reason: The 1 to 5 mcg/mL range is too low for theophylline’s therapeutic effect. Theophylline, a methylxanthine, requires 10-20 mcg/mL to achieve bronchodilation by inhibiting phosphodiesterase and increasing cyclic AMP. Levels below this range are ineffective for asthma or COPD management, risking suboptimal control.

Choice B reason: The 30 to 40 mcg/mL range is toxic for theophylline. Levels above 20 mcg/mL can cause serious side effects like seizures, arrhythmias, or nausea due to its narrow therapeutic index. Therapeutic monitoring ensures levels stay within 10-20 mcg/mL for safe and effective bronchodilation.

Choice C reason: The 50 to 60 mcg/mL range is far above theophylline’s therapeutic range, leading to severe toxicity, including life-threatening arrhythmias or convulsions. Theophylline’s efficacy for airway relaxation occurs at 10-20 mcg/mL, and such high levels are dangerous, requiring immediate intervention to reduce toxicity risks.

Choice D reason: The 10 to 20 mcg/mL range is the targeted therapeutic range for theophylline in adults. Within this range, theophylline inhibits phosphodiesterase, increasing cyclic AMP, promoting bronchodilation, and relieving asthma or COPD symptoms. Monitoring ensures efficacy while minimizing toxicity risks like tachycardia or seizures.