Pharmacology Quizzes Flashcards
1
Q
Hypertension treatment with the a 2 agonist, clonidine, works by _________.
A
acting at autoreceptors to decrease sympathetic outflow
2
Q
Direct-acting sympathomimetics ________________________.
A
bind to post- (or pre-) synaptic receptors
3
Q
___________ is an example of a non-selective sympathomimetic drug.
A
Epinephrine
4
Q
Vasoconstriction via epinephrine is a useful means to _____________________.
A
reduce bleeding surfaces
prolong actions of local anesthetics
shrink mucosa during surgical procedures
5
Q
Vasoconstriction effects of a-agonists include:
A
decongestant
lowering IOP
“red eye” reduction
6
Q
Indirect-acting sympathomimetics act by
A
facilitating catecholamine (e.g., DA and NE) release blocking NE reuptake
7
Q
As an alternate approach to treating ADHD, the actions of guanafacine [Intuniv] include _____________.
A
central inhibitory actions that decrease NE release
8
Q
Relaxation of bronchial and uterine smooth muscle is achieved through _________.
A
β2 agonists
9
Q
Methamphetamine actions for treatment of ADD include _____________________.
A
actions on α2a,2b,2c receptors
blocking reuptake of DA and NE
blocking reuptake of 5-HT
10
Q
Modafinil currently has FDA use approval for _______________________.
A
narcolepsy
11
Q
Modafinil has low abuse potential
A
True
12
Q
Modafinil has no side effects
A
False
13
Q
Allergic reactions to bee stings can be treated with ______________.
A
epinephrine
14
Q
Atropine competes with _____________ for a binding site on the muscarinic receptor.
A
Acetylcholine
15
Q
Atropine Sensitivity Curve, ___________ are most sensitive to the effects of muscarinic antagonism, while the _____________ is least sensitive.
A
salivary glands; gastrointestinal tract
16
Q
Scopolamine is a _________ and a(n) ___________that is used for _____________.
A
belladonna alkaloid - muscarinic antagonist - motion sickness
17
Q
Muscarinic antagonists treat peptic ulcer by ____________________.
A
reducing gastric motility and gastric acid secretion
18
Q
Atropine, __________ and ____________ are components of an antidote for nerve gas poisoning
A
pralidoxime – diazepam
19
Q
Muscarinic antagonists constrict pupils (miosis) and increase lung secretions
A
False
20
Q
Tolterodine tartrate [Detrol LA] is a ___________ used as treatment for ____________.
A
muscarinic antagonist; overactive bladder
21
Q
Ipratropium Bromide [Atrovent] and Tiotropium Bromide [Spiriva ] are most effective for ______________.
A
preventing bronchospasm
22
Q
Which of the following is NOT a likely side effect of a muscarinic antagonist: mydriasis, diarrhea, constipation, xerostomia
A
diarrhea
23
Q
Which of the following effects would require the lowest dosage of atropine? dry mouth, pupil dilation, increased heart rate, decreased gastric secretions and motility
A
dry mouth
24
Q
Atropine is an antidote for all types of mushroom poisoning.
A
False
25
Which of the following is NOT a clinical use of a muscarinic antagonist? motion sickness & vertigo, dilate pupils for ocular exam, dilate airways in COPD patients, glaucoma
glaucoma
26
Carbidopa actions include ________________.
inhibiting synthesis of dopamine
27
The actions of a 1 - antagonists that decrease hypertension include _____________.
relaxing smooth muscle in bladder neck, prostate and urethra OR reducing peripheral resistance in vasculature OR slowing down heart rate OR intracavernous vasodilation
reducing peripheral resistance in vasculature
28
The actions of a 1 - antagonists that treat BPH include _____________.
relaxing smooth muscle in bladder neck, prostate and urethra
29
b-antagonists treat glaucoma by ____________________________.
inhibiting aqueous formation via β2-receptor antagonism on nonpigmented ciliary epithelium
30
The a s -antagonist, yohimbine, increases blood pressure and heart rate by an action on:
pre-synaptic autoreceptors
31
Non-selective b-antagonists have utility in treating _______________
cardiac arrhythmias
acute dissecting aortic aneurysm
hyperthyroidism
32
b 1 -antagonists are most selective for receptors located ________________.
on cardiac muscle
33
In general, the older the man, the larger his _________________.
prostate gland
34
The actions of a b1-receptor antagonist in treating panic symptoms are due to __________________.
blocking certain fight-or- flight reactions
35
The sympathetic nervous system is part of the
peripheral nervous system
36
Acetylcholine is the neurotransmitter at:
- the preganglionic synapse of the parasympathetic nervous system
- the postganglionic synapse of the parasympathetic nervous system
- the preganglionic synapse of the sympathetic nervous system
37
Preganglionic parasympathetic nerves exit the spinal cord at the:
cranial & sacral level
38
Pre-ganglionic neurons of the sympathetic nervous system:
- synapse on a ganglionic chain
- are short and myelinated
- release ACh
39
After release into the synapse, acetylcholine:
interacts with muscarinic and nicotinic receptors
40
Adrenergic receptors consist of:
α and β subtypes
41
After release into the synapse, norepinephrine:
- is broken down in the synapse to inactive metabolites that can be detected in blood and urine
- is recycled back into the terminal vesicles for subsequent release
- is taken back up into the terminal and broken down by MAO
42
Which of the following statements is true about the “Fight or Flight” response:
- it is facilitated by diverging preganglionic sympathetic neurons synapsing on multiple postganglionic sympathetic neurons
- it functions to maintain steady organ functions
- it is also referred to as the “Feed or Breed” response
it is facilitated by diverging preganglionic sympathetic neurons synapsing on multiple postganglionic sympathetic neurons
43
Nicotinic cholinergic receptors are:
ligand gated ion channels
44
Postganglionic release of acetylcholine from parasympathetic nerves activates ______________ on
exocrine glands, smooth muscle and cardiac muscle.
muscarinic receptors
45
Preganglionic __________ neurons can diverge and synapse with many postganglionic ________
neurons, while preganglionic __________ neurons generally form only single synaptic connections with
postganglionic _____________ neurons.
sympathetic, sympathetic, parasympathetic, parasympathetic
46
What is the rate-limiting factor of the production of all catecholamines?
tyrosine hydroxylase
47
cAMP, DAG and IP3 are examples of:
secondary messengers
48
Adenylate cyclase and phospholipase C are:
second messenger system effectors
49
Which enzyme converts dopamine (DA) to norepinephrine (NE)?
dopamine-β hydroxylase
50
Stimulation of any of the b-adrenergic receptors leads to:
increased production of cAMP and cAMP-dependent protein kinase
51
Elements for neurotransmitter synthesis, storage release and inactivation are located:
in the nerve terminal
52
The signal transduction processes used by the odd-numbered muscarinic cholinergic receptors:
are similar to those utilized by the α1-adrenergic receptors
53
Clearing NE from the synaptic cleft involves which of the following processes:
neuronal re-uptake, MAO degradation, extraneuronal diffusion, COMT degradation
54
Inhibition of adenylate cyclase and decreased cAMP-dependent protein kinase results from
α2-receptor activation
55
The following statement(s) regarding autoreceptors is (are) true:
A. they regulate output of neurotransmitter based on the amount of transmitter detected in the synapse
B. they act to regulate post-synaptic receptor sensitivity
C. blockade of the α2 autoreceptor by an antagonist leads to a reduction in NE outflow
D. A&C
A. they regulate output of neurotransmitter based on the amount of transmitter detected in the synapse
56
Which of the following statements is true:
A. Clonidine binding to a presynaptic autoreceptor results in decreased NE release
B. Yohimbine binding to a presynaptic autoreceptor results in decreased NE release
C. Isoproterenol binding to a presynaptic autoreceptor results in decreased NE release
D. Clonidine binding to a presynaptic autoreceptor results in enhanced NE release
A. Clonidine binding to a presynaptic autoreceptor results in decreased NE release
57
Nicotinic and/or muscarinic receptors are located in ____.
postganglionic parasympathetic nervous system
sweat glands
brain
neuromuscular junction
58
Cholinomimetics relieve symptoms of Sjogrens syndrome by ______.
increasing secretions of salivary and tear glands
59
Direct-acting cholinomimetics include _____________.
bethanecol and cevimeline
60
The acetylcholinesterase enzyme _____.
causes rapid hydrolysis of ACh
61
Edrophonium is a(n) ______.
indirect acting cholinomimetic
62
A reversible cholinesterase inhibitor acts by _____.
reversibly binding to AChE
63
An irreversible cholinesterase inhibitor _____.
phosphorylates/inactivates the substrate-binding domain AChE
64
Standard medications used for Alzheimer's patients include:
Donepezil [Aricept]
65
The purpose of treating Alzheimer's Disease symptoms with cholinomimetics is to ____.
enhance Ach-associated memory processes
66
Varenicline is a _______.
Nicotine receptor partial agonist
67
Physostigmine is an _____.
indirect-acting reversible AChE substrate inhibitor
68
What is a likely effect of muscarinic agonist drugs?
miosis
69
Nicotine patches may be more useful for _____ than for smoking cessation.
enhancing attention and memory
70
Acetylcholinesterase is larger than acetylcholine. (true/false)
true
71
Cholinomimetics:
physostigmine
neostigmine
Indirect acting cholinomimetics with reversible substrate inhibition
72
Cholinomimetics:
endrophonium
ambenonium
Indirect acting cholinomimetics with reversible competitive enzyme inhibition
73
Cholinomimetics:
pilocarpine
carbachol
direct acting cholinomimetics that are muscarinic agonists
74
Cholinomimetics:
ecothiophate
isoflurophate
indirect acting cholinomimetics that are irreversible AChE inhibitiors
75
Cholinomimetics:
parathion
malathion
indirect acting cholinomimetics that are irreversible AChE inhibitors
76
Cholinomimetics:
sarin
soman
tabun
indirect acting cholinomimetics that are irreversible AChE inhibitors
77
Cholinomimetics:
bethanecol [Urecholine]
cevimeline [Evoxac]
direct acting cholinomimetics that are muscarinic agonists
78
```
Cholinomimetics:
Tacrine [Cognex]
Donepezil [Aricept]
Rivastigmine [Exelon]
Galantamine [Razadyne]
```
indirect acting cholinomimetics that are reversible AChE inhibitors
79
Cholinomimetics used to treat glaucoma
pilocarpine
carbachol
physostigmine
80
Drugs used to treat Sjogren's Syndrome symptoms
Cholinomimetics:
salagen tablets (pilocarpine HCl)
Urecholine (bethanechol)
Evoxac (cevimeline)
81
Standard medications for Alzheimer's patients
```
Cholinomimetics:
Donepezil (Aricept)
Galantamine (Razadyne)
Rivastigmine (Exelon)
Tacrine (Cognex)
```
82
A smoking cessation tool that has potential uses in parkinson's, adhd, schizo, and cognitive enhancement is ______.
nicotine
83
Side effects and toxicity of muscarinic agonists include:
Salivation Lacrimation Urination Defecation
Eyes: miosis, blurred vision
Lungs: bronchial secretions & constriction
Skin: sweating
Heart: bradycardia
GI tract: cramping, motility and gastric acid secretion
Brain-mediated: tremor, hypothermia, convulsions
Blood vessels: vasodilation, decreased blood pressure
Cardiac ventricles: decreased force of contraction, cardiac failure
84
Side effects and toxicity of cholinesterase inhibitors include:
Similar to muscarinic agonists + other effects associated with cholinergic activity + toxic effects at neuromuscular junction sites
Increased Exposure Levels: *Decreased Blood pressure *Skeletal muscle weakness *Depolarization blockade at NMJ =
diaphragm paralysis/respiratory failure
85
Side effects and toxicity of nicotine poisoning include:
Nausea, vomiting, salivation, diarrhea, visual problems
Brain: mental confusion, tremors, convulsions, depression, coma
NMJ: stimulation -> blockade, muscle weakness, diaphragm paralysis, respiratory failure
Cardio: BP changes, weak pulse, variable heart rate
86
Atropine
Muscarinic antagonist
Belladonna alkaloid
Antidote for nerve gas, poisonous mushroom
87
Scopolamine [transderm scop]
Muscarinic antagonist
Belladonna alkaloid
Used for motion sickness
88
Tropicamide [mydriacyl]
muscarinic antagonist
| used in eye examinations
89
Homatropine [Isopto Homatropine]
muscarinic antagonist
| used in eye examinations
90
Ipratropium bromide [Atrovent]
muscarinic antagonist
| COPD (chronic obstructive pulmonary disease)
91
Oxybutynin [Ditropan]
| Dicyclomine hydrochloride [Bentyl]
Muscarinic Antagonists
| Antispasmodic for Irritable bowel syndrome (IBS)
92
Tolterodine tartrate [Detrol LA]
Muscarinic Antagonist
Anti-spasmodic for overactive bladder
Bladder-specific actions
93
Pirenzepine
M1/M4 Selective Antagonist Used for peptic ulcer
94
Telenzepine
M1 Selective Antagonist Used for peptic ulcer
95
Biperiden [Akineton]
Muscarinic/Nicotinic Antagonist
| Blocks motor symptoms in Parkinson’s and side effects of antipsychotic drugs
96
Mecamylamine [Inversine]
Nicotinic receptor subtype antagonist
| Anti-smoking agent (augmentation with antidepressants)
97
Buproprion
NE and DA reuptake inhibitor and nicotinic receptor subtype antagonist
Depression, bipolar disorder, ADHD, weight loss, smoking cessation
98
Reserpine [Serpalan]
indirect acting sympatholytic
NE/DA/5-HT Storage/Release
Antihypertensive and antipsychoticinhibitor
99
Carbidopa [Lodosyn]
Indirect-acting Sympatholytics
NE/DA synthesis inhibitor
Parkinson’s disease treatment
100
Prazosin [Minipress]
Terazosin [Hytrin]
Phentolamine [Regitine]
Direct-acting Sympatholytics
alpha1-selective Antagonists
Hypertension BPH
101
Tamsulosin Hcl [Flomax] Doxazosin [Cardura]
Direct-acting Sympatholytics
alpha1-selective Antagonists
BPH
102
Yohimbine [Aphrodyne, Yocon]
Direct-acting Sympatholytic
alpha2-selective Antagonist
Male Sexual Dysfunction
103
Mirtazapine [Remeron]
alpha2a-selective antagonist
Increases NE and 5-HT through central presynaptic antagonism on NE and 5-HT neurons
Antidepressant for moderate to severe depression
104
Propranolol [Inderal] Nadolol [Corgard] Timolol [Blocadren] Pindolol [Visken]
Direct-acting Sympatholytics
Non-selective beta-Antagonists
Hypertension Panic Symptoms
105
Timolol [Timoptic] Levobunolol [Betagan] Carteolol [Ocupress] Metipranolol [Optipranolol]
Direct-acting Sympatholytics
Non-selective beta-Antagonists
Glaucoma
106
Acebutolol [Sectral] Atenolol [Tenormin] Metoprolol [Lopressor] Esmolol [Brevibloc]
Direct-acting Sympatholytics
beta1-Selective Antagonists
Hypertension, Angina Sinus Tachycardia, Atrial Fib/Flutter
107
Methylphenidate [Ritalin, Concerta]
Indirect-acting sympathomimetic
| ADHD/ADD
108
Dextroamphetamine [Adderall,
Dexedrine]
Methamphetamine [Desoxyn]
Direct & indirect-acting sympathomimetics
| ADHD/ADD
109
Epinephrine
Direct-acting sympathomimetic Non-selective adrenergic agonist
Allergic reactions Vasoconstriction
110
Isoproterenol [Isuprel]
Direct-acting sympathomimetic non-selective beta-agonist
| Shock
111
Dobutamine [Dobutrex]
Direct-acting sympathomimetic beta-agonist
| Shock
112
phenylephrine [Neosynephrine]
Direct-acting sympathomimetic
| alpha1-selective agonist Nasal decongestant
113
apraclonidine [Iopidine]
Direct-acting sympathomimetic
mostly alpha2 selective agonist (weak alpha1)
Lowering IOP
114
Mephentermine [Wyamine Sulfate]
| Metaraminol [Aramine] Methoxamine [Vasoxyl]
Direct-acting sympathomimetic alpha1-selective agonists
| Hypotension treatment
115
Clonidine [Catapres] Guanafacine tablets [Tenex]
Direct-acting sympathomimetic alpha2-selective agonist Pre-synaptic actions
Hypertension treatment
Also: diarrhea, drug w/drawal, migraine, Tourette’s Syndrome
116
Metaproterenol [Alupent]
Terbutaline [Brethine]
Albuterol [Ventolin, Proventil]
Direct-acting sympathomimetics beta2-selective agonists
| Tx bronchospasm
117
Modafinil [Provigil]
DA and NE re-uptake blocker, partial α1B agonist
FDA approved for narcolepsy
Non-approved but potential uses: ADHD, memory enhancement, addiction, weight control
