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SRNAPharmacology I > My Own Questions > Flashcards

My Own Questions Flashcards

1
Q

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

A

True

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2
Q

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 _____

A

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

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3
Q

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.

A

True

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4
Q

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.

A

True

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5
Q

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

A

False; It is via ALPHA receptor

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6
Q

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

A

norepinephrine

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7
Q

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

A

ISOPROTERENOL

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8
Q

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

A

Norepinephrine

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9
Q

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

A

Norepinephrine

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10
Q

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

A

ISOPROTERENOL

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11
Q

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

A

ISOPROTERENOL

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12
Q

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

A

ISOPROTERENOL

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13
Q

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

A

True

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14
Q

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

A

True

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15
Q

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.

A

True Both

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16
Q

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.

A

True

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17
Q

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

A

True both

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18
Q

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

A

True

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19
Q

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..
A

shorter

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20
Q

Associated with higher doses of epinephrine administered:

A

PVCs

Ventricular Arrhythmias

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21
Q

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

A

True

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22
Q

β-adrenergic, non-selective blocker.

A

propranolol

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23
Q

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.

A

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

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24
Q

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

A

Uterine Smooth muscle response to epinephrine

Epinephrine inhibits serotonin contraction during last month of pregnancy.

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25
Q

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

A
  • Detrusor muscle relaxation due to β-adrenergic receptor activation.
  • Contraction of trigone and sphincter muscle as a result of α-adrenergic receptor subtype activation.
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26
Q

Sympathetic effect is on radial muscle

A

Contraction

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27
Q

Autonomic effect: ciliary muscle of the eye:

A

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

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28
Q

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

A

True

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29
Q

The parasympathetic effect is the predominant action on which ORGAN

A

HEART

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30
Q

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

A

True

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31
Q

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
A

true

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32
Q

Inhibit insulins secretion

A

Alpha 2

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33
Q

Promote insulin secretion

A

Beta 2

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34
Q

T/F

A

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

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35
Q

T/F Epinephrine increases hematocrit

A

True

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36
Q

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

A

True

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37
Q

Epinephrine effect(s) on plasma potassium:

  • Epinephrine administration _______ plasma potassium.
  • Epinephrine effects on plasma potassium are likely mediated by ______________________________
A

decreases; activation of β2 adrenergic receptors.

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38
Q

Epinephrine administered SYSTEMATICALLY result in substantial _______ and ________ activity.

A

sweating and pilomotor activity.

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39
Q

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

A

ISOPROTERENOL

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40
Q

Sympathomimetic due to inhibition of transmitter uptake at noradrenergic synapses:

A

COCAINE

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41
Q

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

A

Albuterol

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42
Q

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

A

PHENTOLAMINE

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43
Q

Sympathomimetic drugs increase extracellular potassium

44
Q

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)

45
Q

Catecholamine effects

A

Gq – protein coupling between beta-receptors and phospholipase C

46
Q

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

47
Q

Rate-determining enzyme reaction in catecholamine biosynthesis

A

tyrosine hydroxylase

48
Q

anatomical site for integration of autonomic information

A

Hypothalamus

49
Q

Alpha receptor Blocker

A

PHENOXYBENZAMINE

50
Q

Treat organophosphate and muscarinic intoxication

51
Q

Cholinergic activity on stomach acid secretions

52
Q

DOMINANT AUTONOMIC TONE IN THE HEART

A

PARASYMPATHETIC

53
Q

MULTIPLE USE OF SYMPATHOMIMETIC MAY LEAD TO

A

TACHYPHYLAXIS

54
Q

NOREPINEPHRINE BLOCKER

55
Q

RATE LIMITING STEP IN CATECHLAMINE SYNTESIS

A

TYROXINE HYDROXYLASE

56
Q

ENZYME CONVERTING DOPAMINE TO NOREPINEPHRINE

A

DOPAMINE BETA HYDROZYLASE

57
Q

Norepinephrine to Epinephrine catalyzed by

A

Phenylethanolamine

N-Methyltransferase

58
Q

Mediating pupillary dilation is

59
Q

Primary receptor type at autonomic ganglia:

A

cholinergic: nicotinic

60
Q

Preganglionic fibers terminating on adrenal medullary CHROMAFIN CELLS release

A

Acetylcholine

61
Q

Rate-limiting step in acetylcholine synthesis:

A

Choline reuptake

62
Q

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

63
Q

Enzyme responsible for acetylcholine synthesis:

A

Choline acetyltransferase

64
Q

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

A

M2-muscarinic

65
Q

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

A

edrophonium
neostigmine
pyridostigmine

66
Q

Muscarinic receptor activation: effects on cardiac currents

A

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

67
Q

Cardiac muscarinic Type M2 receptor effects:

A

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

68
Q

Major of route of elimination for anticholinesterase drugs:

A

Answer: (C) renal

69
Q

Quaternary ammonium compound; anticholinesterase – permanently positively charged:

A

NEOSTIGMINE

70
Q

Dominant autonomic tone in the ventricle:

A

Adrenergic

71
Q

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

72
Q

T/F Anesthetic that probably increases central venous tone:

73
Q

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

A

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

74
Q

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

A

glycopyrrolate

75
Q

Anticholinesterase better for reversing atracurium blockade:

A

NEogstigmine

76
Q

Effect of antimuscarinic agents on bronchiolar smooth muscle:

A

BRONCHORELAXATION

77
Q

Arterioles – sympathetic: adrenergic

(C) gastrointestinal tract – parasympathetic: cholinergic

(D) veins – sympathetic: adrenergic

78
Q

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

A

isoproterenol, epinephrine, norepinephrine

79
Q

lpha receptor class activated by drugs such as clonidine:

80
Q

Enzyme(s) that degrade catecholamines:

A

(A) MAO (monoamine oxidase)

E) COMT (catechol-O-methyltransferase

81
Q

Termination of norepinephrine effect is mainly due to:

A

reuptake into presynaptic nerve terminals

82
Q

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

A

Phentolamine

83
Q

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

84
Q

Most abundant catecholamine in the adrenal medulla:

A

Epinephrine

85
Q

Physiological consequences alpha-2 receptor activation:

A

increased vagal tone

decreased sympathetic outflow

Decreased insulin release

86
Q

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

A

Epinephrine, norepinephrine, isoproterenol

87
Q

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

A

Tyrosine hydroxylase

88
Q

Alpha-adrenergic receptors found primarily postsynaptically:

89
Q

Miosis

A

Pilocarpine

90
Q

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

91
Q

Cholinergic receptor type primarily localized at skeletal muscle neuromuscular junctions:

92
Q

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

A

Decreased atrial and ventricular contractility

93
Q

Ligand-gated ion channels:

94
Q

Tends to cause fast responses:

A

MUSCARINIC

95
Q

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

96
Q

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

97
Q

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

A

Decrease in Calcium current in the AV node

98
Q

Dominating autonomic tone in the ventricle:

A

SYMPATHETIC

99
Q

Mechanisms by which muscarinic stimulation reduces ventricular contractility:

  • reduces ventricular responds to norepinephrine
  • reduces norepinephrine release from adrenergic terminals
100
Q

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

A

Increased intestinal peristalsis
increased tone
increased contraction amplitude
increase ureteral peristalsis

101
Q

Substances that increase NO production

A

Substance P
Acetylcholine
Bradykinin

102
Q

Major contraindications – muscarinic agonists

A
  • asthma
  • hyperthyroidism
  • peptic ulcer
  • coronary vascular disease
103
Q

Probable cause of myasthenia gravis:

A

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

104
Q

Drugs used for antagonist-assisted neuromuscular-blockade reversal

105
Q

__________Produces postoperative analgesia without respiratory depression:

A

Intrathecal neostigmine (Prostigmin)

106
Q

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

A

SCOPALAMINE

107
Q

Mydriasis without loss of accommodation

A

SYMPATHOMIMETIC

SRNAPharmacology I (29 decks)

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