Spring 2020 - Pharm exam 2

Question 1

Two major classes of cholinergic drugs are: (2)

Answer 1

• Cholinergic agonists

- Anticholinesterase drugs

Question 2

Which of the following medications would the SRNA hold during an induction of a patient with a major burn 4 days prior:

Answer 2

Succinylcholine

Question 3

After acetylcholine stimulates the ____ receptor, it is destroyed by ______.

Answer 3

Cholinergic

Acetylcholinesterase

Question 4

which of the following symptoms would the SRNA not expect from a cholinergic agonist drug:

Answer 4

Mydraisis

Direct effects: miosis, decreased HR, bronchoconstriction, increased secretions, etc

Question 5

Cholinergic agonists are used in the following conditions: (2)

Answer 5

• urinary retention due to weak or atonic bladder

- lack of bowel movement

Question 6

An example of an irreversible long-lasting anticholinesterase would be:

Answer 6

Insecticide or Nerve gas

Question 7

Pharmacokinetics of cholinergic drugs include:

Answer 7

Crossing BBB

Question 8

Crossing the BBB is an element of pharmacokinetics in :

Answer 8

cholinergic drugs

Question 9

cholinergic blocking agents have all the following adverse reactions except which two: (choose 2)

Answer 9

• bradycardia

- increased sweating

Question 10

Adverse reactions to cholinergic blocking agents include:

Answer 10

“blind as a bat, red as a beet, mad as a hatter, hot as a hare, dry as a bone”

Dry mouth
decreased sweating
reduced secretions
blurred vision d/t mydriasis
confusion
tachycardia
increased temp

Question 11

Considering the dose-dependent effects of atropine, which is true:

a. slight cardiac slowing at 5mg
b. hallucinations at 8mg
c. Coma > 10mg
d. pupil constriction at 5 mg

Answer 11

C. Coma > 10mg of atropine

Question 12

atropine speeds up the heart rate by:

Answer 12

blocking acetylcholine

Question 13

what would be used to treat organophosphate poisoning, and treat disorders of the GI and lower urinary tract?

Answer 13

Atropine

Question 14

anticholinergic drugs competitively antagonize

Answer 14

acetylcholine at the cholinergic post ganglionic sites

Question 15

muscarinic receptors are located in:

Answer 15

GU tract
GI smooth muscle
Heart

Question 16

Muscarinic receptors are not located in

Answer 16

spinal tract

Question 17

What drug is more potent than its parent compound, has no CNS effects secondary to poor brain penetration?

Answer 17

glycopyrrolate

Question 18

Does Atropine cross the placenta?

Answer 18

yes

Question 19

Does atropine affect the fetal heart rate?

Answer 19

Little fetal heart change

Question 20

This drug crosses the placenta with little fetal heart change:

Answer 20

atropine

Question 21

which drug would be the best choice when sedation and an antisialagogue is needed?

Answer 21

scopolamine

Question 22

What drug, when given in the same dose as atropine produces a similar increase in HR, but with a slower onset?

Answer 22

Glycopyrrolate

Question 23

Is an increase in extrapyramidal side effects a disadvantage of using anticholinergics in patients with Parkinson’s Disease?

Answer 23

No.

Question 24

Name a few disadvantages of using anticholinergics in pts with Parkinson’s Disease:

Answer 24

• aggravation of glaucoma
• Hallucinations
• Visual blurring

Question 25

Treatment of Central Anticholinergic Syndrome :

Answer 25

Physostigmine

Question 26

Glycopyrrolate is not likely to cause Central Anticholinergic Syndrome because:

Answer 26

It does not cross the BBB

Question 27

What are synthesized in the liver and catalyzes the hydrolysis of succinylcholine:

Answer 27

- butyrylcholinesterase - plasma cholinesterase - pseudocholinesterase

Question 28

Which of the following drugs would be considered a benzyl lisoquinolinium? - pancuronium - cisatricurium - rocuronium - vecuronium

Answer 28

-Cisatricurium

Question 29

List (Greatest to least) the inhalation anesthetics that potentiate the NMB effect of NMB drugs:

Answer 29

Des>Sevo>Halothane> Nitrous "DSHN"

Question 30

Will Hyperthermia potentiate the blockade of a NMB drug?

Answer 30

no

Question 31

What will potentiate the blockage of NMB drugs?

Answer 31

- LAs in large doses - Magnesium - some antidysrhythmics

Question 32

What is most likely to DECREASE the potency of NMB agents?

Answer 32

- hypercalecemia | - hyperparathyroidism

Question 33

Regarding NMB Drugs: High potency =

Answer 33

slow onset

Question 34

Regarding NMB Drugs: Low potency =

Answer 34

rapid onset

Question 35

buffered diffusion can be seen in

Answer 35

High potency drugs

Question 36

What NMB drugs are typically not associated with histamine release:

Answer 36

Cisatricurium | Rocuronium

Question 37

Common dose of Succinylcholine:

Answer 37

1-1.5mg/kg

Question 38

Max dose of Neostigmine:

Answer 38

5mg

Question 39

Dose for glycopyrrolate:

Answer 39

7-15mcg/kg

Question 40

Sugammadex reversal from greatest to least:

Answer 40

Roc > Vec >> Pancuronium

Question 41

Sugammadex is based on:

Answer 41

actual body weight

Question 42

Substantia Gelatinosa is located in Lamina:

Answer 42

II and III

Question 43

What opioid receptor is associated with respiratory depression due to decrease sensitivity of respiratory center to CO2?

Answer 43

Mu-2

Question 44

What is a depolarizing skeletal muscle relaxant?

Answer 44

succinylcholine

Question 45

Induction dose of ketamine would be:

Answer 45

1-2 mg/kg

Question 46

Indirect stimulation of alpha and beta adrenergic receptors and direct stimulation of adrenergic receptors and stimulation of release of endogenous norepinephrine by indirect action best describes:

Answer 46

Ephedrine

Question 47

Naloxone dose:

Answer 47

1-4mcg/kg

Question 48

Intubating dose of vecuronium:

Answer 48

0.1 mg/kg