Maryville Pharm Exam 2 Questions With 100% Correct Answers

Maryville Pharm Exam 2 Questions With 100% Correct Answers How does doxazosin work? - answerSelective alpha 1 antagonist reversibly blocks the effects of catecholamine's at the postsynaptic alpha 1 receptors in the vascular smooth muscle of the bladder neck and prostate, causes vasodilatation. Treats HTN and BPH. Increases urine outflow and decreases BP. What effect does prazosin (Minipress) produce? - answerTreats HTN and BPH. Decreases BP and increases urinary outflow. Chronic use of A1-antagonists may lead to compensatory increase in blood volume. May cause supine and standing hypotension. May result in orthostatic BP. Alpha adrenergic receptor blockers. Relaxes the smooth muscle in the bladder neck, thus facilitating urinary flow through the prostatic urethra. ADR: blocking of adrenergic receptors could include dizziness, postural hypotension, urinary frequency, impotence, dry mouth, blurred vision. What is the action and effect of beta blockers? - answerBB also known as beta adrenergic blockers are a class of drug that works by blocking the neurotransmitters norepi and epi from binding receptors. 3 types: B1- adrenergic is located commonly on the heart and kidneys. B2- adrenergic are located mainly in the lungs, GI, liver, uterus, vascular smooth muscle, and skeletal muscle. B3- Adrenergic receptors in the fat cells. When the neurotransmitters are prevents from binding to the receptors, it in turn causes the effects of adrenaline to be blocked. This action allows the heart to relax and beat more slowly thereby reducing the amount of blood that the heart must pump. Over time this action improves the pumping mechanism of the heart. The blockade of B adrenergic receptors produces significant on: CV: decreases HR, contractility, conduction velocity, and conduction. Renal: block JG cells, decreases rennin, effect on RAAS (decreases angiotensin 2 (vasoconstriction), decrease aldosterone (volume expansion) and decrease BP). Resp: increases bronchoconstriction and increases airway resistance. Ocular: decreases intraocular pressure and increases aqueous humor outflow. Metabolic & Endocrine: decreases inhibition of gluconeogenesis in liver, decreases insulin release, hypoglycemia, and impaired recovery of hypoglycemia in DM. BB decrease vascular resistance, increase vasodilation, increase triglycerides, increase cholesterol, and decrease HDL. What are the adverse effects of beta blockers? - answerBrady, HF, PE, brochospasm, dyspnea, hypotension, fatigue, dizziness, weakness, drowsiness, depression, anxiety, confusion, insomnia, nightmares, altered carb metabolism, hypo/hyperglycemia, dry mouth, impotence, decreased libido, pruritis, rash, joint pain, facial swelling, hyperlipidemia, alopecia, wheezing, hyperkalemia and weight gain. What effect will result with rapid withdrawal of a beta blocker? - answerLife threatening arrhythmia, HTN, MI, angina, death. Taper dose by ½ every 4 days. What patient teaching should be provided when prescribing clonidine or any centrally acting adrenergic blocker? - answerTake medication as prescribed, missed doses are taken as soon as remembered, don't double doses, withdrawal slowly over 2-3 days to prevent rebound HTN, missed doses increase risk of rebound HTN, have enough medication available, interacts with licorice, apply transdermal to hairless area every 7 days, keep patch in place for bathing and swimming, exercise, quit smoking, manage stress, don't stop abruptly (can cause MI, angina, ventricular arrhythmias). What are the adverse effects of a beta 1 selective blocker? - answerBeta blockade, especially of the beta-1 receptor at the macula densa, inhibits renin release, thus decreasing the release of aldosterone. This causes hyponatremia and hyperkalemia. Why are beta blockers cautiously prescribed to diabetic clients? - answerMay mask s/s of hypoglycemia Which medication used in the treatment of Alzheimer's disease is not an anticholinergic agent? - answerMemantine (Namenda) blocks stimulation of N-methyl-D-asparate (NMDA) receptors What is the anticholinesterase agents used to treat? - answerMG (used to increase neuromuscular transmission), Alzheimer's, glaucoma, POTS, antidote for anticholinergic poisoning, reverse effect of non-depolarizing muscle relaxants, apathy, increase changes of lucid dreaming, treat cognitive impairments in patients with schiz, and treat autism and increase the percent of rapid eye movement sleep in autism children. What effect does nicotine have on the nicotinic receptors? - answerNicotine binds steroselectively to ACH receptors in the autonomic ganglia in the adrenal medulla, at neuromuscular junctions, and the brain. Stimulates the locus serulius, enhances dopamine release-stimulus then depresses, and increases gastric acid. What effect is produced with cholinergic blockers? - answerProduce selective muscarinic blockade against the actions of ACH. Muscarinic receptors are found in the eye, heart, blood vessels, lungs, GI tract, bladder and sweat glands. Causes effects on CV, resp, GU, GI, CNS, exocrine and eye. Causes tachy, bronchial relaxation, decreased secretions, relaxation of GI/GU. Blocks action of PNS.