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CNS Drugs_Exam 4 > Broad Questions > Flashcards

Broad Questions Flashcards

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1
Q

What action would increase the levels of acetylcholine in the synaptic cleft?

A

Inhibition of acetylcholinesterase

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2
Q

What are the effects of Ephedrine?

A

Mild CNS stimulation (cross BBB), increase BP, and treats HTN

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3
Q

When xerostomia is cause by hypoactivity of the parasympathetic nervous system, which cholinergic drug could be used to increase the volume of salivary secretion?

A

Pilocarpine

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4
Q

Which type of drug would increase secretion of digestive enzymes, HCl and saliva

A

M3 Agonist

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5
Q

Which type of cholinergic receptor acts on the heart by decreasing HR and results in bradycardia

A

M2 Receptors

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6
Q

What are the general cholinergic side effects caused by general cholinergic stimulation

A

sweating, salivation, flushing, decrease in BP with reflexive tachycardia, nausea, abdominal pain/diarrhea, and bronchospasm

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7
Q

Which of the following conducting passages are most affected by the action of ipratropium?

A

Large-diameter central bronchiols

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8
Q

You need to intubate a patient in shock but you don’t want the pre-intubation drug to cross the BBB and effect the small respiratory first, which drug do you choose

A

Recuronium/Vecuronium

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9
Q

What drug is used in rapid intubations

A

Succinylcholine

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10
Q

Alpha 1 receptors generally produce which outcome to vasculature

A

Vasoconstriction, increase blood flow, and increase BP

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11
Q

What are the effects of alpha 2 receptors being agonized

A

Inhibit NE release
Inhibit Ach release
Inhibit insulin release

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12
Q

What are the effects of Beta 1 receptor agonists

A

Increase in HR
Increase in lipolysis
Increase myocardial contractility
Increase renin

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13
Q

What are the effects of Beta 2 receptor agonists

A

Vasodilation
Decrease periferal resistance
Bronchodilation
Increase glycogenolysis
Relax uterine smooth muscles

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14
Q

What do D1 receptors act upon

A

Smooth muscle, dilates renal blood vessels

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15
Q

What do D2 receptors act upon

A

Nerve endings, modulates transmitter release

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16
Q

What do you give people who are dry as fuck (Sjogrens)

A

Pilocarpine

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17
Q

What is pilocarpine used in an emergency for

A

Reduce opthalmatic pressure in glaucoma (fast acting)

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18
Q

What receptors does Acetylcholine act

A

M3, M, and N

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19
Q

What selective adrenergic antagonist used for pregnancy induced HTN and brings about hypertension without less significant tachycardia

A

Lebetalol (acts on alpha 1, beta 1, beta 2)

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20
Q

What are the simplified muscarinic agonist side effects

A

Diarrhea, diaphoresis, miosis, nausea, urinary urgency

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21
Q

In addition to supportive therapy, a victim of antimuscarinic poisoning would be given drugs to abolish delirium and coma. Which of the following is the best choice for such treatment?

A

Physostigmine

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22
Q

Tracheobronchial gland hypersecretion can be suppressed by
Atropine
Succinylcholine
Recuronium
Histamine

A

Atropine

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23
Q

Which of the following drugs used in glaucoma therapy has a prolonged longest duration of action and can be administered relatively infrequently?
Timolol
Albuterol
Echothiophate
Epinephrine

A

Echothiophate

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24
Q

What is the only clinical use of Echothiophate?

A

Treatment of occular hypertension in chronic glaucoma

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25
Q

Release of vesicular norepinephrine requires an increase in the concentration of which of the following cations near the inner surface of the presynaptic membrane?

A

Calcium

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26
Q

A drug that is an agonist both of β1- and β2-adrenoceptors can be expected to cause

A

A decrease in total peripheral vascular resistance

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27
Q

What is the mechanism and medical effects of Phenylephrine

A

Is a direct adrenergic agonist acting on alpha 1 receptors that results in increased BP and reflexive bradycardia

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28
Q

What are the adverse effects of albuterol?

A

Tremor and tachycardia

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29
Q

Medication used in treatment of nonobstructive urinary retention and neurogenic atony of the urinary bladder?

A

Bethanecol

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30
Q

What is the MOA of Physotigmine?

A

binds with acetylcholinesterase, making it reversibly inactivated.

Stimulates M, N in the CNS and N in NMJ

31
Q

What is the clinical indication of oxybutinin/solifecin/tolteradine

A

overactive bladder and incontinence

32
Q

What is the MOA of oxybutinin/solifecin/tolteradine

A

Is an antimuscarinic cholinergic antagonist that competatively binds to M3 receptors that results in decreased bladder pressure and capacity

33
Q

Which type of drugs can increase both sympathetic and parasympathetic symptoms through the same mechanism?

A

Nn agonists

34
Q

Beta 1 receptors generally function to

A

Increase cardiac function

35
Q

What is the clinical indication of Esmolol

A

Used only for supra-ventricular tachycardia (SVT)

36
Q

What are the adverse effects of selective adrenergic antagonists

A

Bradycardia, reduced cardiac output, AV heart block

Safe to use in COPD/asthma because there is no blockage of B2

37
Q

In general what receptors do non-selective adrenergic antagonists act on

A

B1 and B2

38
Q

What is the MOA of amphetamines

A

release dopamine + NE (catecholamines) and has powerful CNS effect alpha 1, alpha 2, and beta 1

39
Q

What is dopamine useful for treating

A

treating both cardiac and septic shock

40
Q

What is the mechanism of action of cocaine

A

propagation of action on norepinephrine by inhibiting its active transport from the synapse

41
Q

What do all preganglionic neurons release

A

Acetylcholine

42
Q

What do acebutolol and metoprolol have in common

A

both are selective B-blockers and may be used in hypertensive patients with impaired pulmonary function

43
Q

The effects of bethanecol can be reversed by

A

Atropine

44
Q

What is the mechanism of action of botulinum toxin?

A

Inhibition of the release of acetylcholine

45
Q

Which of the following is a competitive muscarinic antagonist used to treat some symptoms of organophosphate poisoning?
Neostigmine
Atropine
Carbachol

A

Atropine

46
Q

What drug is used to conduct cardiac stress tests?

A

Dobutamine

47
Q

What receptors mimic the parasympathetic nervous system?

A

Muscarinic

48
Q

Sympathetic preganglionic neurons are located in

A

The thoracic and lumbar segments of the spinal cord

49
Q

Parasympathetic preganglionic neurons are located in and send signals through

A

the CNS through the cranial nerves (especially the third, seventh, ninth, and tenth).

50
Q

What are the primary acetylcholine subtypes

A

Muscarinic and Nicotinic receptors

51
Q

How do direct-acting cholinomimetic act

A

Bind to and activate muscarinic or nicotinic receptors

52
Q

How do indirect-acting agents produce their primary effects

A

by inhibiting acetylcholinesterase, which hydrolyzes acetylcholine to choline and acetic acid

53
Q

The nerve fibers that innervate the adrenal medulla are best described as

A

Cholinergic sympathetic

54
Q

The nerve fibers that innervate skeletal muscle are best described as

A

Somatic Cholinergic

55
Q

Sympathetic postganglionic fibers release

A

Acetylcholine

56
Q

What is the mechanism of action of an indirect-acting agonist like amphetamine

A

Interferes with the enzymatic breakdown of a neurotransmitter

57
Q

What are the Alpha Antagonist Drugs

A

Phenoxybenzamine
Prazosin/Terazosin
Tamsulosin

58
Q

What are the nonselective beta antagonists (B1 and B2 antagonists)

A

Propranolol
Nadolol
Pindolol (partial B1 agonistic activity)
Timolol

59
Q

What are the B1 Selective Antagonists

A

Metoprolol
Acebutolol (partial B1 agonistic activity)
Esmolol
Atenolol
Nebivolol (vasodilation effect)

60
Q

What are the A1, B1, and B2 selective antagonists (has vasodilation effect)

A

Carvedilol
Labetalol

61
Q

What are the direct adrenergic agonists

A

Epinephrine
Norepinephrine
Dopamine
Dobutamine
Isoproterenol
Phenylephrine
Albuterol

62
Q

What are the indirect adrenergic agonists

A

Cocaine
Amphetamine

63
Q

What are the direct and indirect agonists

A

Ephedrine
Pseudophedrine

64
Q

What are the direct cholinergic agonists

A

Acetylcholine
Bethanecol
Pilocarpine

65
Q

What are the Indirect cholinergic agonists

A

Edrophonium
Pyridostigmine/neostigmine
Physostigmine

66
Q

What are the Direct and Indirect cholinergic agonists

A

Echothiophate

67
Q

What are the antimuscarinic cholinergic antagonists

A

Atropine
Scopolamine
Ipratropium/Tiotropium
Oxybutinin/Solifecin/Tolteradine

68
Q

What are the neuromuscular cholinergic antagonists

A

Recuronium/Vecuronium
Succylcholine

69
Q

Selective adrenergic antagonists that can be given to lower blood pressure in HTN and increase exercise tolerance

A

Metropolol
Nebivolol
Atenolol

70
Q

What drug is useful in diagnosing mysthenia gravis

A

Edrophonium

71
Q

What are the clinical indications for Propranolol

A

Diminishes cardiac output and depresses SA/AV node
HTN and angina management
Performance anxiety

72
Q

Ganglionic antagonists

A

nicotine is rarely used, often used in research

73
Q

A drug that is a selective alpha 1 agonist that causes exaggerated orthostatic response and syncope​ with the first dose

A

Prazosin

CNS Drugs_Exam 4 (1 decks)

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