Adrenergics and Antiadrenergics

Question 1

Which receptors do the autonomic nervous system parasympathetic and sympathetic innervation of the HEART act on?

Answer 1

Parasympathetic: M2 receptors
Sympathetic: Beta-1 receptors

Question 2

Which receptors do the autonomic nervous system parasympathetic and sympathetic innervation of the LUNGS act on?

Answer 2

Parasympathetic: M3 receptors
Sympathetic: Beta-2 receptors

Question 3

Name a drug that would have a direct sympatholytic effect on eccrine sweat glands?

Answer 3

Atropine or any other drug acting as an antagonist at M3 receptors

Question 4

Which subtype of dopamine receptors is important on renal blood vessels?

Answer 4

D1

Question 5

What is the major renal effect of dopamine?

Answer 5

Increased diuresis

Question 6

Why is propranolol is not suitable for treatment of glaucoma?

Answer 6

Propranolol has local anaesthetic-like direct membrane effects which block the protective blink reflex.

Question 7

Beta blockers selected for ophthalmic use for the treatment of glaucoma have little or no….

Answer 7

Low lipophilicity and hence low local anaesthetic-like direct membrane effect

Question 8

When is postural hypotension in a patient prescribed an alpha-1 adrenoceptor antagonist is likely to be worst?

Answer 8

After the first dose

Question 9

What is a common adverse effect of all alpha-2 adrenoceptor agonists?

Answer 9

Dry mouth

Question 10

What adverse effect is commonly caused by alpha adrenoceptor antagonists that cross the blood brain barrier?

Answer 10

Drowsiness

Question 11

Classify the prazosin according to the nature of its adrenergic/antiadrenergic activity.

Answer 11

Direct sympatholytic alpha-1 adrenoceptor antagonist

Question 12

Classify the betaxolol according to the nature of its adrenergic/antiadrenergic activity.

Answer 12

Direct sympatholytic beta-1 adrenoceptor antagonist

Question 13

Ephedrine is a/an

Answer 13

Indirect sympathomimetic increasing availability of norepinephrine through competing with norepinephrine for reuptake and vesicular reuptake while competitively inhibiting monoamine oxidase A (MAO-A). It also has direct alpha and beta-adrenoceptor agonist activity.

Question 14

A direct antiadrenergic prescribed for patients with angina pectoris?

Answer 14

Propranolol (or other beta-blockers)

Question 15

Nonselective beta-adrenoceptor antagonist used for the treatment of
glaucoma?

Answer 15

Timolol

Question 16

Selective beta-1 adrenoceptor antagonist used for the treatment of
glaucoma?

Answer 16

Betaxolol

Question 17

Non-selective direct alpha-adrenoceptor agonist used as a decongestant?

Answer 17

Oxymetazoline

Question 18

An indirect sympathomimetic drug that blocks presynaptic reuptake of noradrenaline

Answer 18

Tricyclic antidepressant

Question 19

Effect of activation of the sympathetic nervous system on airways?

Answer 19

Bronchodilation and increase mucociliary clearance

Question 20

Precursor of norepinephrine in the postganglionic sympathetic nervous system

Answer 20

Dopamine

Question 21

Rate limiting enzyme in epinephrine synthesis

Answer 21

Tyrosine hydroxylase

Question 22

List the receptors activated in effector organs by the sympathetic nervous system

Answer 22

Alpha-1 and -2 adrenoceptors, beta-1, -2, and -3 adrenoceptors , D1, M3

Question 23

Effect of activation of alpha-1 adrenoceptors on the pupil of the eye?

Answer 23

Dilation of the pupil (mydriasis)

Question 24

Activation of alpha-1 and beta adrenoceptors in the eye BLURS…

Answer 24

Accommodation for near vision

Question 25

What is the effect of ANTAGONISM of beta-1 adrenoceptors in the ciliary body of the eye on intraocular pressure (IOP)

Answer 25

Reduces intraocular pressure

Question 26

Activation of alpha-1 and alpha-2 adrenoceptors generally shuts down...

Answer 26

GIT & visceral functions

Question 27

Effect of activation of alpha-1 and alpha-2 receptors on visceral blood vessels?

Answer 27

Vasoconstriction

Question 28

Effect of activation of alpha-2 adrenoceptors in the salivary glands?

Answer 28

Inhibits salivation

Question 29

Effect of activation of beta-3 adrenoceptors on the bladder?

Answer 29

Relaxation

Question 30

Activation of which adrenoceptor subtype induces bronchodilation in the lungs?

Answer 30

Beta-2

Question 31

Activation of which adrenoceptor subtype has positive chronotropic and inotropic cardiac effects?

Answer 31

Beta-1

Question 32

Activation of which adrenoceptor subtype vasodilates blood vessels supplying skeletal muscle?

Answer 32

Beta-2

Question 33

Effect of activation of alpha adrenoceptors on visceral blood vessels on blood pressure?

Answer 33

Vasoconstricts increasing systemic blood pressure

Question 34

Major adrenoceptors involved in increasing GLYCOGENOLYSIS ( | breakdown of glycogen stored in the liver to release glucose)

Answer 34

Beta-2 and Alpha-1

Question 35

Activation of beta-3 adrenoceptors on fat cells...

Answer 35

Increases lipolysis

Question 36

Which adrenoceptor is important for the contraction of gastrointestinal and urinary tract sphincters?

Answer 36

Alpha-1

Question 37

Which adrenoceptors are important for secretions and motility along the gastrointestinal tract?

Answer 37

Alpha-1, Alpha-2 & Beta-2

Question 38

Relaxation of bladder muscle inhibits urination. Activation of which adrenoceptor relaxes bladder muscle?

Answer 38

Beta-3

Question 39

During late pregnancy activation of which adrenoceptor can relax the uterus and delay childbirth?

Answer 39

Beta-2

Question 40

Antagonism of alpha-1 adrenoceptors in the male reproductive system blocks...

Answer 40

Ejaculation

Question 41

Sympathomimetic especially useful for cardiac resuscitation in patients renal failure due to insufficient renal blood flow?

Answer 41

Dopamine

Question 42

Beta-3 selective adrenergic agonist used to treat overactive bladder?

Answer 42

Mirabegron

Question 43

Alpha-1 selective agonist used as a nasal decongestant?

Answer 43

Phenylephrine

Question 44

Beta-1 selective agonist used to treat congestive heart failure?

Answer 44

Dobutamine

Question 45

The major clinical use of norepinephrine is in the treatment of...

Answer 45

Severe hypotension

Question 46

A patient presenting with severe anaphylactic shock would be treated with...

Answer 46

Epinephrine

Question 47

Tocolysis is the prevention of labour contractions. Select a short-acting tocolytic drug that can be given to prevent premature labour?

Answer 47

Terbutaline, salbutamol

Question 48

Beta-2 agonists used to treat asthma can also be used to treat pregnant patients presenting with...

Answer 48

Preterm labour

Question 49

In presynaptic nerve terminals, noradrenaline is primarily broken down by...

Answer 49

Monoamine oxidase A

Question 50

Noradrenergic synaptic signals are terminated by

Answer 50

Presynaptic uptake 1

Question 51

Moclobemide is an MAO-A inhibitor. Clinically, moclobemide used as a/an...

Answer 51

Antidepressant

Question 52

Moclobemide is a/an...

Answer 52

Reversible monoamine oxidase A (MAO-A) inhibitor indirect sympathomimetic antidepressant

Question 53

Tricyclic antidepressants block...

Answer 53

Synaptic norepinephrine reuptake

Question 54

Brimonidine is a/an...

Answer 54

Alpha-2 agonist used to treat glaucoma

Question 55

In addition to reducing intraocular pressure, brimonidine is thought to help in treatment in glaucoma because it...

Answer 55

Is neuroprotective

Question 56

Which group of drugs is used to treat delay in initiating urination due to benign prostatic hyperplasia?

Answer 56

Alpha-1 antagonists

Question 57

Prazosin is used to treat

Answer 57

Chronic hypertension, urinary symptoms of benign prostatic hyperplasia (BPH)

Question 58

Which group of drugs is used to treat delay in initiating urination due to benign prostatic hyperplasia?

Answer 58

Alpha-1 antagonists

Question 59

An elderly patient with benign prostatic hyperplasia has difficulty in initiating urination. He could be prescribed...

Answer 59

Tamsulosin, prazosin, any other alpha-1 antagonists

Question 60

Methyldopa results in the formation of methylnoradrenaline which is a...

Answer 60

False transmitter

Question 61

Methyldopa is a competitive inhibitor of...

Answer 61

Tyrosine hydroxylase

Question 62

Alpha-2 agonists act at presynaptic autoreceptors to...

Answer 62

Decrease norepinephrine release

Question 63

A rare but severe adverse effect of methyldopa, which increases the cost of treatment with methyldopa as it often requires monitoring?

Answer 63

Haemolytic anaemia