Download 521 Pharmacology Exam 1 Questions and Answers Latest Update ( Frequently Examined Question and more Exams Nursing in PDF only on Docsity!
521 Pharmacology Exam 1 Questions
and Answers Latest Update ( Frequently
Examined Questions)
A drug that selectively stimulates muscarinic receptors is: - Answer -Bethanechol The side effect(s) of muscarinic agonists could be: - Answer -- diarrhea
- bronchospasm
- vasodilationc A drug that is topically used for treating glaucoma: - Answer -carbachol (T/F) A selective muscarinic agonist can stimulate skeletal muscle contraction. - Answer -False (T/F) A direct-acting cholinomimetic drug mimics the action of acetylcholine by inhibiting the activity of acetylcholinesterase (AchE). - Answer -False Drug Y is an antagonist for muscarinic receptors. An effect of drug Y on heart can be: - Answer -positive chronotropy Drug X blocks muscarinic receptors. An effect of drug X on eyes can be: - Answer -mydriasis
Drug Z is muscarinic blocker. The effects on most of the blood vessels can be: - Answer -no effect WRONG options: vasodilation, vasoconstriction, atherosclerosis The least favorite antimuscarinic drug used in COPD: - Answer -ipratropium A useful application for a muscarinic blocker can be: - Answer -minor diarrhea Atropine blocks: - Answer -all M1-M5 receptors The following muscarinic blocker can cross the blood brain barrier: - Answer -scopolamine A patient with narrow anterior chamber angle needs a mydriatic drug for eye examination, we can give: - Answer -tropicamide Darifenacin is effective in COPD because it: - Answer - causes bronchorelaxation and decrease secretion A crop duster pilot has been accidentally exposed to a high concentration of a highly toxic agricultural organophosphate insecticide. If untreated, the cause of death from such exposure would probably be: - Answer - respiratory failure
CORRECT options:
- leads to bronchodilation (opening of airways) when acting on beta 2
- causes vasoconstriction in blood vessels when acting on alpha 1
- action at alpha 1 causes pupil dilation Direct acting cholinomimetic agents act by: - Answer - activating both muscarinic and nicotinic receptors Which of the following is true about nicotinic receptors? - Answer -they are ligand-gated Na+ channels M2 receptor stimulation causes ________ effects - Answer -inhibitory Which of the following is true? - Answer -Bethanechol chloride only has action at muscarinic receptors INCORRECT options:
- Methacholine chloride has less muscarinic action than bethanechol chloride
- Acetylcholine chloride is not susceptible to cholinesterase
- Carbachol chloride has more muscarinic action than nicotinic action This drug is a direct-acting cholinoceptor stimulant and a non-choline ester - Answer -pilocarpine
Muscarinic agonists cause - Answer -increase in gastric motility Which of the following is true regarding muscarinic agonist effects in the bladder? - Answer -promotes voiding of bladder Which of the following is true regarding muscarinic agonist effects on the heart and blood vessels? - Answer - negative chronotropy Select all that apply: What is a clinical use of muscarinic agonist? - Answer -- atony of stomach following surgical manipulation
- smoking cessation Which statement is true about antimuscarinics in general?
- Answer -tertiary agents reach high levels in brain quickly (true, reach CNS within 30 minutes to 1 hour) INCORRECT options:
- all are well absorbed (not quaternary because they have low lipid solubility)
- most act like non-competitive antagonists (false, are competitive)
- they block receptors in variety of organs, including liver (false, liver does not have parasympathetic innervation) Select all that apply: Which of the following may be symptoms of atropine poisoning? - Answer -- mydriasis (blind as a bat)
CORRECT options:
- tachycardia
- block M2 activation in heart by acetylcholine
- increased conduction velocity Select all that apply: Antimuscarinics in the gastrointestinal tract... - Answer -- may be used to treat IBS and diarrhea
- include dicyclomine, glycopyrrolate, and hyoscyamine
- decrease saliva and stomach motility In the urinary tract, antimuscarinics can be used to treat: - Answer -- bladder spasm
- urge incontinence Which of the following is true about cholinergic poisoning (select all that apply)? - Answer -- atropine via parenteral route is preferred treatment
- may be caused by chemical warfare or nerve gasses Which drug is an irreversible organophosphate? - Answer -parathion Which is true about the pharmacokinetics of indirect-acting cholinomimetics? - Answer -Distribution of indirect-acting cholinomimetic is negligible in CNS Which is NOT an effect of indirect-acting cholinomimetics at the neuromuscular junction? - Answer -Paralysis will never occur with indirect-acting cholinomimetics
(depolarizing Nm blockade → paralysis with marked inhibition of acetylcholinesterase) CORRECT options:
- At low therapeutic doses, these agents cause muscle contraction
- At high concentrations, these agents may cause paralysis Match the drug with its correct application - Answer - Edrophonium is used as a diagnostic test for myasthenia gravis Select the drugs that are used for patients with Alzheimer's - Answer -- tacrine
- galantamine
- donepezil
- rivastigmine True or false: The cause of death from anticholinesterase agents is respiratory failure - Answer -True Which drug is used to treat anticholinesterase toxicity? - Answer -Pralidoxime (cholinesterase regenerator) Which of the following are clinical uses of neuromuscular blocking drugs? - Answer -- endotracheal intubation
- control of ventilation
- surgical relaxation
- treating convulsions
Increased intragastric pressure is a side effect of - Answer -succinylcholine Drugs used to induce local vasoconstriction include - Answer -- phenylephrine
- epinephrine
- oxymetazoline Drugs used for treating mild to moderate hypertension include - Answer -alpha1 antagonist Side effect(s) of phenoxybenzamine include - Answer -- orthostatic hypotension
- miosis
- nasal stuffiness A drug that can be used to induce sedation before anesthesia - Answer -dexmedetomidine (T/F) The neuromuscular blockade by succinylcholine can be reversed by neostigmine. - Answer -False Which of the following is a mixed-acting adrenergic agonist? - Answer -ephedrine alpha1, alpha2, beta1, beta2 and releasing agent - both direct action and indirect action What receptor(s) does norepinephrine act at? - Answer -- alpha 1
- alpha 2
- beta 1
- beta 2 (some) Which sympathomimetic has the highest selectivity at beta receptors? - Answer -isoproterenol Which of the following is NOT an effect of alpha 1 adrenergic agonists? - Answer -prostate relaxation cause prostate CONSTRICTION (why we use alpha antagonists for BPH) Which of the following is a cardiovascular effect of alpha- selective agonists? - Answer -increase in blood pressure cause vasoconstriction --> increased peripherl arterial resistance --> dose dependent increase in BP used as hypotension treatment What is midodrine used for? - Answer -orthostatic hypotension Which drug can be used in local anesthetics? - Answer - epinephrine vasoconstricting effects that prolong duration of action of local anesthetics
What happens when the ALPHA 1 receptor is blocked? - Answer -- decreases blood pressure
- vasodilation
- reflex tachycardia baroreceptors are stimulated by drop in BP and causes reflex tachycardia and increase in contractility Which of the following is FALSE concerning the ALPHA 2 blockers? - Answer -block beta 1 receptors in heart beta 1 receptors are ACTIVATED by alpha 2 blockers --> increased heart rate, increased contractility, and increased cardiac output
- only example: yohimbine Which is not a BETA 1 selective blocker? - Answer - carvedilol nonselective (blocks alpha1 and beta) Which of the following describes the actions of BETA blockers? - Answer -- negative chronotropic agent
- decrease blood pressure
- treat heart disease and heart failure negative chronotropic, inotropic, and dromotropic --> DECREASE cardiac output --> decrease in BP
- useful in treating HTN, ischemic heart disease, arrhythmias, and heart failure
- also decrease RAAS system Which is matched to its indication incorrectly? - Answer - esmolol and hypothyroidism cardiac arrhythmias - esmolol (also hyperthyroidism symptoms Which medication should be avoided in a patient with severe asthma? - Answer -propranolol Which of the following is FALSE regarding BETA blockers in the eye? - Answer -a few examples include apraclonidine and brimonidine alpha 2 agonists, not beta blockers Which of the following statements are FALSE regarding ISA or intrinsic sympathomimetic activity? - Answer -non- selective third generation beta blockers like pindolol are partial agonists of ISA non-selective FIRST generation beta blocker and does NOT have ISA True or false: The autonomic nervous system is composed of two components - sympathetic (trophotropic) and parasympathetic (ergotropic). - Answer -FALSE sympathetic - ergotropic ("energy") parasympathetic - trophotropic ("growth")
Which of the following drugs may be used to treat Parkinson's tremors? - Answer -benztropine Parkinsonian tremor due to TOO MUCH acetylcholine or excess of cholinergic activity A patient has severe narrow angle glaucoma and needs their yearly retinal examination. Which eye drop would you recommend to the ophthalmologist? - Answer -tropicamide shortest duration of action (15-60 minutes) A patient has been diagnosed with COPD and requests an appropriate inhaler. Which is MOST appropriate? - Answer -aclidinium Which of the following is FALSE regarding antimuscarinics? - Answer -may be used to treat benign prostatic hyperplasia may CAUSE urinary retention Which statement is FALSE regarding cholinergic poisoning? - Answer -Pralidoxime can reach CNS very quickly does NOT enter CNS - atropine is preferred Which of the following are TRUE regarding the reversal of the nondepolarizing NMJ blockade? - Answer --
neostigmine and pyridostigmine may be used because they inhibit acetylcholinesterase
- sugammadex binds tightly to rocuronium and decreases its free plasma concentration Which of the following does NOT enhance the NMJ blockade? - Answer -severe burns RESISTANT to nondepolarizing muscle relaxants because of increased amount of receptors Which of the following are used more often in the clinical setting? - Answer -- vecuronium
- rocuronium
- cisatracurium intermediate acting muscle relaxants are more commonly used clinically than long-acting drugs Which of the following is NOT a clinical use of NMJ blockers? - Answer -GI bleed Which statement is FALSE regarding non-depolarizing and depolarizing NMJ blockers? - Answer -curarine is non- depolarizing agent and is widely sued in practice not used clinically due to side effects (not available in US) What is an effect of agonist action at nicotinic receptors? - Answer -increased sodium influx
Which drug can be used topically for acute close angle glaucoma? - Answer -physostigmine What is cevimeline used for? - Answer -treatment of dry mouth associated with Sjogren syndrome What is a possible side effect of muscarinic agonists? - Answer -urinary urgency excessive parasympathetic effects Which agent is a reversible carbamate anticholinesterase?
- Answer -physostigmine Which of the following is an effect of indirect-acting cholinomimetics/anticholinesterases? - Answer -at higher concentrations, indirect-acting cholinomimetics may cause muscle fibrillation (spasms) Which drug is matched correctly with its clinical application? - Answer -physostigmine - glaucoma Why is atropine used to treat anticholinesterase toxicity? - Answer -tertiary amine drug - preferred to treat effects of anticholinesterase toxicity What is galantamine used for? - Answer -Alzheimer's disease
