Chapters 15, 16

Question 1

Which sympathomimetic cant be administered orally due to rapid metabolism from the GI tract and liver?

Answer 1

epinephrine

Question 2

What is an expected adverse reaction from epinephrine

Answer 2

tachycardia and palpitations. the sympathetic nervous system is being activated, so while this is ad adverse effect, it is expected and should be communicated to your patient

Question 3

Which enzymes deactivate norepinephrine

Answer 3

monoamine oxidase (MAO) and COMT

Question 4

What are important points of education to provide to your patient who has been diagnosed with hypertension, and will be starting an anti-hypertensive?

Answer 4

1. check BP before each dose and monitor your trend
2. do not suddenly stop med
3. rise slowly

Question 5

What is the neurotransmitter for the parasympathetic nervous system?

Answer 5

ACH

Question 6

What is the neurotransmitter for the sympathetic nervous system

Answer 6

norepinephrine

Question 7

This central-acting alpha agonist is selective to alpha 2 and can cause rebound hypertension if stopped abruptly

Answer 7

clonidine

Question 8

Why do you want to assess your patient’s heart rate before administering albuterol

Answer 8

this is a sympathomimetic, so while this will dilate the bronchioles, it will increase heart rate, too. if the patient is already tachycardic, this can be problematic

Question 9

Why is it important to know if the beta blocker you are administering is selective or non-selective?

Answer 9

if it is non-selective, that means we are blocking beta systemically, instead of a target organ. if your patient as COPD and you administer a non-selective beta blocker, this could cause respiratory distress

Question 10

What are the 4 major responses to anticholinergics

Answer 10

1. decreased GI motility - constipation
2. pupillary dilation -difficulty seeing
3. increased pulse rate
4. decrease in salivation - dry mouth

Question 11

If your parasympathetic response was initiated, what would your pupils do?

Answer 11

constrict

Question 12

If your sympathetic response was initiated, what would your pupils do?

Answer 12

dilate

Question 13

If you are taking an “olol” what category of drugs are you taking

Answer 13

beta blocker

Question 14

Which medication would you anticipate administering to your patient with a severely low heart rate

Answer 14

atropine sulfate

Question 15

what is essential to complete prior to administering atenolol

Answer 15

must check heart rate and BP.

Question 16

what are the effects of cholinergic overdose

Answer 16

1. dry as a bone
2. mad as a hatter
3. red as a beet
4. blind as a bat

Question 17

if your parasympathetic response was initiated, what would your heart do?

Answer 17

decrease

Question 18

if your sympathetic response was initiated, what would your heart rate do

Answer 18

increase

Question 19

how do indirect-acting cholinergic agonists work

Answer 19

by inactivating cholinesterase resulting in an increase in circulating levels of acetylcholine

Question 20

this drug works by reducing the sympathetic outflow from the central nervous system thereby causing vasodilation with resulting decrease in blood pressure

Answer 20

methyldopa

Question 21

if beta 1 receptors are activated, what effects can you anticipate observing

Answer 21

2. increased heart rate

2. increase force of contraction

Question 22

what is a unique feature of catecholamines

Answer 22

1. they cant cross BBB
2. can’t be taken orally
3. short duration of action
4. can be endogenous or exogenous

Question 23

what are the two divisions of the peripheral nervous system

Answer 23

somatic and autonomic

Question 24

what comprises the central nervous system

Answer 24

brain and spinal cord

Question 25

where do nicotinic receptors have an effect

Answer 25

skeletal muscles

Question 26

what is the function of muscarinic receptors

Answer 26

1. stimulation of smooth muscle

2. decreased heart rate

Question 27

if beta 2 receptors are activated, what effects can you anticipate observing

Answer 27

relaxation of bronchioles

Question 28

if alpha 1 receptors are activated, what effects can you anticipate seeing

Answer 28

arterioles constricted

2. increased vascular resistance and blood pressure

Question 29

If someone’s parasympathetic system was activated, would that have urinary incontinence or urinary retention

Answer 29

urinary retention- urinary incontinence would be from sympathetic activation

Question 30

what are the two divisions of the autonomic nervous system

Answer 30

sympathetic and parasympathetic