My Own Questions

Question 1

Potent… By IV administration, epinephrine induces peak response proportional to dose..

Answer 1

True

Question 2

Factor/factors associated with characterizing blood pressure increases secondary to epinephrine administration:
Increase in blood pressure is due in ____
Increase in blood pressure is due in _____

Answer 2

Increased ventricular contractility (also known as a positive inotropic effect)
due in part to increased heart rate (also known as positive chronotropic effect)

Question 3

T/FFollowing IV epinephrine administration,an increased blood pressure is observed in part because of drug-induced vasoconstriction, particularly in skin, mucosal, and renal precapillary resistance vessels.

Answer 3

True

Question 4

T/F Following IV epinephrine administration, the pulse rate is initially increased but may then be decreased as a result of a compensatory cholinergic, vagal effect triggered by the baroreceptor reflex.

Answer 4

True

Question 5

T/F Absorption of epinephrine following subcutaneous (s. c.) injection: slows result of local vasoconstrictor activity mediated by β receptor activation; if false why?

Answer 5

False; It is via ALPHA receptor

Question 6

Administration of this agent by the intravenous infusion route is likely to cause an immediate reduction in pulse rate _____

Answer 6

norepinephrine

Question 7

IV administration of this agent is LIKELY to result in an extended elevation in heart rate_______

Answer 7

ISOPROTERENOL

Question 8

IV administration of this agent is MOST likely to induce both in elevation in systolic and diastolic pressure_____

Answer 8

Norepinephrine

Question 9

IV administration of this agent is MOST likely to result in an extended elevation in vascular peripheral resistance_____

Answer 9

Norepinephrine

Question 10

IV administration of this agent is MOST likely to cause the most profound decrease in diastolic blood pressure.

Answer 10

ISOPROTERENOL

Question 11

IV administration of this agent is LEAST likely to cause an increase in systolic blood pressure

Answer 11

ISOPROTERENOL

Question 12

IV administration of this agent is most likely to result in the most profound decrease in peripheral resistance______

Answer 12

ISOPROTERENOL

Question 13

T/F At epinephrine doses that increased renal vascular resistance while having limited effects on mean arterial pressure renin secretion is increased.

Answer 13

True

Question 14

T/F Epinephrine administration tends to increase arterial and venous pulmonary pressures.

Answer 14

True

Question 15

T/F Factor(s) responsible for elevated pulmonary pressures due to epinephrine:

Direct pulmonary vasoconstriction
Redistribution of blood from the systemic circulation as a result of systemic vasoconstriction to the pulmonary circulation.

Answer 15

True Both

Question 16

T/F Administration of high epinephrine concentrations may induce pulmonary edema secondary to high pulmonary capillary filtration pressure as well as possible effects on capillaries.

Answer 16

True

Question 17

T/F Usually, under physiological circumstances, coronary blood flow:
Increased by epinephrine
Increased by cardiac sympathetic stimulation

Answer 17

True both

Question 18

T/ F Epinephrine increases the slope of phase 4 depolarization, thus increasing heart rate.

Answer 18

True

Question 19

Epinephrine on MYOCARDIAL SYSTOLE

• Systole is shorter/longer ?
• Systole exhibits increased contractility (more power)
• Cardiac output is increased
• Cardiac efficiency, described as work performed relative to oxygen consumed, is reduced..

Answer 19

shorter

Question 20

Associated with higher doses of epinephrine administered:

Answer 20

PVCs

Ventricular Arrhythmias

Question 21

T/F Epinephrine administration usually shortens the human AV nodal refractory.

Answer 21

True

Question 22

β-adrenergic, non-selective blocker.

Answer 22

propranolol

Question 23

Epinephrine-induced in ventricular arrhythmias: The likelihood of these arrhythmias may be enhanced as a result of reduced sinus rate and AV conduction secondary to increased vagal nerve activity.

Answer 23

reduced sinus rate and AV conduction secondary to increased vagal nerve activity.

Question 24

Dependent on state of gestation, phase of sexual cycle and dose

Answer 24

Uterine Smooth muscle response to epinephrine

Epinephrine inhibits serotonin contraction during last month of pregnancy.

Question 25

Epinephrine and bladder smooth muscle effect(s): Detrusor muscle _____ _due to _____ _______of trigone and sphincter due to ______receptor

Answer 25

- Detrusor muscle relaxation due to β-adrenergic receptor activation. - Contraction of trigone and sphincter muscle as a result of α-adrenergic receptor subtype activation.

Question 26

Sympathetic effect is on radial muscle

Answer 26

Contraction

Question 27

Autonomic effect: ciliary muscle of the eye:

Answer 27

Relaxation for far vision is the sympathetic-mediated response (β2) Parasympathetic effect is contraction for near vision (M2, M3 muscarinic receptor subtype mediated)

Question 28

T/F The parasympathetic action is to decrease conduction velocity and to promote blockade at the AV node.

Answer 28

True

Question 29

The parasympathetic effect is the predominant action on which ORGAN

Answer 29

HEART

Question 30

T/F The parasympathetic effect is to reduce contractility and decreased the action potential duration. With respect to contractility, the parasympathetic effect dominates.

Answer 30

True

Question 31

Epinephrine beneficial effect(s) in asthma: - Decreasing bronchial secretion - Decreasing mucosal congestion - Possible reduction in antigen-induced inflammatory mediator release from mast cells - Direct bronchodilator effects

Answer 31

true

Question 32

Inhibit insulins secretion

Answer 32

Alpha 2

Question 33

Promote insulin secretion

Answer 33

Beta 2

Question 34

T/F

Answer 34

The predominant effect of epinephrine with respect insulin secretion is mediated by activation of α2 receptors the activation of which inhibits insulin secretion.

Question 35

T/F Epinephrine increases hematocrit

Answer 35

True

Question 36

T/F Administration of epinephrine and selective β2 agonists tends increase physiological tremor.

Answer 36

True

Question 37

Epinephrine effect(s) on plasma potassium: - Epinephrine administration _______ plasma potassium. - Epinephrine effects on plasma potassium are likely mediated by ______________________________

Answer 37

decreases; activation of β2 adrenergic receptors.

Question 38

Epinephrine administered SYSTEMATICALLY result in substantial _______ and ________ activity.

Answer 38

sweating and pilomotor activity.

Question 39

Very potent beta adrenergic receptor agonists with minimal effects on alpha adrenergic receptors:

Answer 39

ISOPROTERENOL

Question 40

Sympathomimetic due to inhibition of transmitter uptake at noradrenergic synapses:

Answer 40

COCAINE

Question 41

Beta-2 selective agonist-- typically administered by aerosol for asthma management:

Answer 41

Albuterol

Question 42

Beta-2 selective agonist-- typically administered by aerosol for asthma management:

Answer 42

PHENTOLAMINE

Question 43

Sympathomimetic drugs increase extracellular potassium

Answer 43

True

Question 44

Effects of sympathomimetic agents on the gastrointestinal tract: alpha -adrenergic receptor activation relaxes gastrointestinal smooth muscle beta-adrenergic receptor activation relaxes gastrointestinal smooth muscle alpha-2 agonists act indirectly by reducing acetylcholine release (presynaptic effect)

Answer 44

true

Question 45

Catecholamine effects

Answer 45

Gq -- protein coupling between beta-receptors and phospholipase C

Question 46

alpha 1:most innervated vascular smooth muscle: contraction ? alpha 2:platelets: aggregation ? beta 2:uterine smooth muscle: smooth muscle relaxation

Answer 46

true

Question 47

Rate-determining enzyme reaction in catecholamine biosynthesis

Answer 47

tyrosine hydroxylase

Question 48

anatomical site for integration of autonomic information

Answer 48

Hypothalamus

Question 49

Alpha receptor Blocker

Answer 49

PHENOXYBENZAMINE

Question 50

Treat organophosphate and muscarinic intoxication

Answer 50

ATROPINE

Question 51

Cholinergic activity on stomach acid secretions

Answer 51

INCREASED

Question 52

DOMINANT AUTONOMIC TONE IN THE HEART

Answer 52

PARASYMPATHETIC

Question 53

MULTIPLE USE OF SYMPATHOMIMETIC MAY LEAD TO

Answer 53

TACHYPHYLAXIS

Question 54

NOREPINEPHRINE BLOCKER

Answer 54

PRAZOSIN

Question 55

RATE LIMITING STEP IN CATECHLAMINE SYNTESIS

Answer 55

TYROXINE HYDROXYLASE

Question 56

ENZYME CONVERTING DOPAMINE TO NOREPINEPHRINE

Answer 56

DOPAMINE BETA HYDROZYLASE

Question 57

Norepinephrine to Epinephrine catalyzed by

Answer 57

Phenylethanolamine | N-Methyltransferase

Question 58

Mediating pupillary dilation is

Answer 58

ALPHA-1

Question 59

Primary receptor type at autonomic ganglia:

Answer 59

cholinergic: nicotinic

Question 60

Preganglionic fibers terminating on adrenal medullary CHROMAFIN CELLS release

Answer 60

Acetylcholine

Question 61

Rate-limiting step in acetylcholine synthesis:

Answer 61

Choline reuptake

Question 62

Influx of this ion promotes fusion between axoplasmic membrane and nearby vesicles.

Answer 62

Calcium

Question 63

Enzyme responsible for acetylcholine synthesis:

Answer 63

Choline acetyltransferase

Question 64

Cholinergic receptor type that mediates the decrease in heart rate by activating potassium channels:

Answer 64

M2-muscarinic

Question 65

Anticholinesterase agents used in antagonist-assisted neuromuscular-blockade reversal:

Answer 65

edrophonium neostigmine pyridostigmine

Question 66

Muscarinic receptor activation: effects on cardiac currents

Answer 66

increase potassium conductance in atrial muscle, S.A., AV nodal tissue (B) decreased inward calcium current

Question 67

Cardiac muscarinic Type M2 receptor effects:

Answer 67

decreased phase 4 depolarization B) decreased atrial contractility C) decreased conduction velocity through the AV node D) decreased ventricular contractility

Question 68

Major of route of elimination for anticholinesterase drugs:

Answer 68

Answer: (C) renal

Question 69

Quaternary ammonium compound; anticholinesterase -- permanently positively charged:

Answer 69

NEOSTIGMINE

Question 70

Dominant autonomic tone in the ventricle:

Answer 70

Adrenergic

Question 71

T/F Atropine has limited effects on circulation because most vascular beds lack significant cholinergic innervation

Answer 71

True

Question 72

T/F Anesthetic that probably increases central venous tone:

Answer 72

halothane

Question 73

Factors influencing the speed and extent of neuromuscular-blockade reversal by anticholinesterases

Answer 73

Intensity of neuromuscular-blockade when reversal is initiated (B) which nondepolarizing neuromuscular-blocking drug is being reversed (C) hypothermia (D) hypokalemia (E) respiratory acidosis

Question 74

Least effect on pupil size of all anticholinergic drugs used in preoperative medication:

Answer 74

glycopyrrolate

Question 75

Anticholinesterase better for reversing atracurium blockade:

Answer 75

NEogstigmine

Question 76

Effect of antimuscarinic agents on bronchiolar smooth muscle:

Answer 76

BRONCHORELAXATION

Question 77

Arterioles -- sympathetic: adrenergic (C) gastrointestinal tract -- parasympathetic: cholinergic (D) veins -- sympathetic: adrenergic

Answer 77

True

Question 78

Correct order of adrenergic beta-agonist potency (greatest to least)

Answer 78

isoproterenol, epinephrine, norepinephrine

Question 79

lpha receptor class activated by drugs such as clonidine:

Answer 79

alpha2

Question 80

Enzyme(s) that degrade catecholamines:

Answer 80

(A) MAO (monoamine oxidase) | E) COMT (catechol-O-methyltransferase

Question 81

Termination of norepinephrine effect is mainly due to:

Answer 81

reuptake into presynaptic nerve terminals

Question 82

Competitive antagonist in both alpha1 and alpha2 receptor sites; also block serotonin receptors

Answer 82

Phentolamine

Question 83

Alpha adrenergic antagonist more potent at alpha2 compared alpha1 adrenergic receptors:

Answer 83

yohimbine

Question 84

Most abundant catecholamine in the adrenal medulla:

Answer 84

Epinephrine

Question 85

Physiological consequences alpha-2 receptor activation:

Answer 85

increased vagal tone decreased sympathetic outflow Decreased insulin release

Question 86

Order of alpha-adrenergic agonist potency (greatest to least):

Answer 86

Epinephrine, norepinephrine, isoproterenol

Question 87

Rate-limiting step been catecholamine biosynthesis is catalyzed by this enzyme:

Answer 87

Tyrosine hydroxylase

Question 88

Alpha-adrenergic receptors found primarily postsynaptically:

Answer 88

Alpha1

Question 89

Miosis

Answer 89

Pilocarpine

Question 90

Muscarinic agent: enhances transmission through the A-V node:

Answer 90

ATROPINE

Question 91

Cholinergic receptor type primarily localized at skeletal muscle neuromuscular junctions:

Answer 91

Nicotinic

Question 92

Cardiac muscarinic Type M2-receptor mediated action(s):

Answer 92

Decreased atrial and ventricular contractility

Question 93

Ligand-gated ion channels:

Answer 93

NICOTINIC

Question 94

Tends to cause fast responses:

Answer 94

MUSCARINIC

Question 95

Cholinergic-receptor-mediated vasodilation -- changes in intracellular concentration of this ion is principally responsible:

Answer 95

CALCIUM

Question 96

Mechanism(s) of vasodilation mediated by the cholinergic system: cholinergic activation promotes nitric oxide release from endothelial cells ? acetylcholine inhibits norepinephrine release from postganglionic sympathetic fibers

Answer 96

True

Question 97

Major mechanism responsible for decreased AV nodal conduction following increased vagal tone:

Answer 97

Decrease in Calcium current in the AV node

Question 98

Dominating autonomic tone in the ventricle:

Answer 98

SYMPATHETIC

Question 99

Mechanisms by which muscarinic stimulation reduces ventricular contractility: - reduces ventricular responds to norepinephrine - reduces norepinephrine release from adrenergic terminals

Answer 99

True

Question 100

Effect(s) of muscarinic agonists on the gastrointestinal and urinary tracts:

Answer 100

Increased intestinal peristalsis increased tone increased contraction amplitude increase ureteral peristalsis

Question 101

Substances that increase NO production

Answer 101

Substance P Acetylcholine Bradykinin

Question 102

Major contraindications -- muscarinic agonists

Answer 102

- asthma - hyperthyroidism - peptic ulcer - coronary vascular disease

Question 103

Probable cause of myasthenia gravis:

Answer 103

binding of anti-nicotinic receptor antibodies to the nicotinic cholinergic receptor

Question 104

Drugs used for antagonist-assisted neuromuscular-blockade reversal

Answer 104

Tensilon

Question 105

__________Produces postoperative analgesia without respiratory depression:

Answer 105

Intrathecal neostigmine (Prostigmin)

Question 106

Preferred anticholinergic drug when sedation is the principal objective, preoperatively:

Answer 106

SCOPALAMINE

Question 107

Mydriasis without loss of accommodation

Answer 107

SYMPATHOMIMETIC