NURS 5334 Exam 2 Study Questions and Answers – Latest Updated 2024/2025 (Graded A+)

NURS 5334 Exam 2 Study Questions and Answers – Latest Updated 2024/2025 (Graded A+) WhatIareItheIbasicImechanismsIbyIwhichIneuropharmocologicIagentsIact? o CanImodifyItheIdiseaseIprocess o ActIatItheIsitesIofIactionsIwhichIisItheIaxonsIversusIsynapsesIandIstepsIinIsynaptic ItransmissionIandIeffectsIofIdrugsIonItheIstepsIofIsynapticItransmission • TransmittterIsynthesisIisItheIfirstIstepIinItransmission.IWhatIareItheIotherI4Isteps? o Transmitterstorage, I ItransmitterIrelease, IreceptorIbinding, IandIterminationIofIthe Itransmission • TrueIorIFalse:INeuropharmacologicIdrugsIhaveIhighIselectivity. o True—theInervousIsystemIusesImanyIdifferentIreceptorItypes • InformationIneeded: o TypeIofIreceptors—throughIwhichItheIdrugIacts ▪ AlphaIandIbeta o Normal IresponsesItoItheIactivationIofIthoseIreceptors ▪ AgonistsIvs.Iantagonists o WhatItheIdrugIinIquestionsIdoesItoItheIreceptorIfunction • WhatIareItheI3IfunctionsIofIANS? o RegulatesItheIheart o RegulatesItheIsecretoryIglands, IsalivaIglands, Igastric, Isweat, IandIbronchial o ItIregulatesIsmoothImuscles:Ibronchi, IbloodIvessels, Iurogenital Isystem, IandItheIGIItract • WhatIareItheIregulatoryIfunctionsIofItheIparasympatheticINS? o SevenIregulatoryIfunctions ▪ SlowingItheIheartIrate ▪ IncreasingItheIgastricIsecretions ▪ EmptyingItheIbladder ▪ EmptyingItheIbowel ▪ FocusingItheIeyeIforInearIvision, ▪ ConstrictingItheIpupil ▪ ContractingItheIbronchial IsmoothImuscle o ItIalsoIregulatesItheIdigestionIofIfood, IexcretionIofIwaste, Icontrol IofIvisionIand IconservationIofIenergy • WhatIareItheIfunctionsIofItheIsympatheticINS? o RegulationIofItheIcardiovascularsystem I ▪ MaintainingIbloodIflowItoItheIbrain ▪ RedistributingIbloodIandIcompensatingIforItheIlossIofIblood o RegulationIofIbodyItemperature ▪ RegulatesIbloodIflowItoItheIskin ▪ PromotesItheIsecretionIofIsweat ▪ InducesIpiloerectionI(erectionIofItheIhair) o ImplementationIofItheIfightIorIflightIreaction ▪ IncreaseIHRIandIBP ▪ BloodIshutsIawayIfromItheIskinIandIvisera NURS 5334 Exam 2 Study Questions and Answers – Latest Updated 2024/2025 (Graded A+) 2 ▪ Bronchi Idilate 3 ▪ PupilsIdilate ▪ UseIenergyIthatIhadIbeenIstored • WhatIisItheIbaroreceptorIreflex? o TheIreceptorsInearItheIheartImonitorIBPIchangesIandIsendItheIinformationItoItheIbrain o TheIbrainIthenIactivatesItheIAutonomicINSItoIrestoreIbloodIpressureItoInormal o WhenIBPIfalls, IthisIreflexIcausesIvasoconstrictionIandIincreasesIcardiacIoutput. o WhenIBPIrises, IitIcausesIvasodilationIandIreducesIcardiacIoutput • WhereIisIacetylcholineIemployed? o MostIjunctionsIatItheIperipheral InervousIsystem • WhereIisIepinephrineIandInorepinephrineIreleased? o Norepinephrine—postganglionicIneurons o Epinephrine—adrenal Imedulla • WhatIareItheIcholinergicIreceptorsImediatedIby?IWhatIareItheIsubtypes? o ReceptorsIthatImediateIresponsesItoIacetylcholine o Subtypes: ▪ Nicotinic ▪ Muscarinic • WhareIareIadrenergicIreceptorsImediatedIby?IWhatIareItheIsubtypes? o MediateIresponsesItoIepinephrineIandInorepinephrine o Subtypes: ▪ Alphas ▪ Betas ▪ Dopamine • WhatIareItheIfunctionsIofIeachIadrenergic Isubtype? o AlphaI1—vasoconstriction, IejaculationIandIcontractionIofItheIbladderIneck, IandIprostate o AlphaI2—(locatedIinIpresynapticIjunction)—minimal Iclinical Isignificance o BetaI1—control ItheIheart ▪ IncreaseIHR, IincreaseIforceIofIcontractionIandIvelocityIofIconductionIinItheIAV Inode;IstimulateIreninIreleasedIinItheIkidney o BetaI2—bronchial Idilation, IrelaxationIofItheIuterineImuscle, Ivasodilation, Iglycogenolysis o Dopamine—dilatesIrenal IbloodIvessels • EpinephrineIcanIactivateIall IalphaIandIbetaIreceptorsIbutInotIdopamineIreceptors • NorepinephrineIcanIactivateIalpha1, Ialpha2, IandIbetaIreceptorsIbutInotIbeta2IorIdopamine Ireceptors • DopamineIcanIactivateIalpha1, Ibeta1IandIdopamineIreceptors • MuscarinicIagonistsImimicItheIeffectsIofIacetylcholineIatImuscarinicIreceptors • MuscarinicIantagonistsIselectivelyIbloodItheIeffectsIofIacetylcholineI(andIotherImuscarinic Iagonists)IatImuscarinicIreceptors • WhatIareItherapeuticIusesIofIBethanechol? o Urinary Iretention o Investigational IGIIuses—offIlabel IGIIreflux • WhatIareIactionsIonIsmoothImuscle, IexocrineIglands, IandIeye? o SmoothImuscle— 4 ▪ lungIbyIcausingIconstrictionIofItheIbronchi ▪ theIGIIsystemIbyIincreasingItoneIandImotility ▪ theIbladderIbyIcontractionIofItheIdetrusorImuscle ▪ relaxationIofItheItrigoneIandIsphincter o ExocrineIglands—increasedIsweatingIsalivation, Ibronchial IsecretionsIandIsecretionIof IgastricIacid o Eye—causesImiosisIandIcontractionIofItheIciliaryImuscle • AdverseIEffects? o Hypotension o Abdominal Icramps o Diarrhea o IncreasedIsalivation o ExacerbateIasthma o CanIcauseIdysrhythmiasIinIpatientsIwithIhyperthyroidism • WhatIareIcevimeline, Ipilocarpine,IandIacetylcholineIusedIfor? o Cevimeline—treatIdrymouth I IandISjogren’sIsyndrome o Pilocarpine—topical ItreatmentIofIglaucomaIasIwell IasIdryImouthIfromISjogren’s Isyndrome o Acetylcholine—rapidImyosisIafterIdeliveryIandIcataractIsurgery • Anticholinergics o Competitively IblockItheIactionsIofIacetylcholineIasImuscarinicIreceptors o MostImuscarinicIreceptorsIareIonIstructuresIinnervatedIbyIparasympatheticInerves o AlsoIknownIasIparasympatholyticIdrugs, IantimuscarinicIdrugs, ImuscarinicIblockers, Iand IanticholinergicIdrugs o AnticholinergicIdrugs:IproduceIselectiveIblockadeIofItheImuscarinicIreceptorsI(notIall IcholinergicIreceptors) o Can’tIpee, Isee, IspitIorIshit • WhatIareItheIpharmacologicIeffectsIofIatropine? o TheIheart—increasesIinIrate o TheIexocrineIglands—decreaseIsecretions o SmoothImuscle—relaxesItheIbronchi, IdecreasesItheItoneIofItheIurinaryIbladderIdetrusor IandIdecreasesItheItoneImotilityIofItheIGIItract o MydriasisIandIcycloplegiaIinItheIeyes o MildIexcitationItoIhallucinationsIandIdeliriumIinItheICentral INervousIsystem • TherapeuticIUsesIofIAtropine? o Pre-anestheticImedicationItoIhelpIdryIupIsecretions o DisordersIofItheIeye o InIcodesIforIbradycardia, Iintestinal IhypertonicityIandIhypermotility o MuscarinicIagonistIpoisoning o Peptic IulcerIdisease o Asthma o BiliaryIcolic • SideIeffectsIofIAtropine 5 o DryImouth o BlurredIvision o Photophobia o ElevationIofIinterocularIpressure o Urinary Iretention o ConstipationIanhidrosis o Tachycardia o Asthma • OveractiveIbladder o Oxybutyin—actsIonIM3ImuscarinicIreceptors ▪ HighlyIlipidIsoluble ▪ MetabolizedICYP3A4 ▪ VeryIshortI½IlifeIandImustIbeIdosedIfrequently o Darifenacine— ▪ CanIreduceIOABIsymptomsIwhileIhavingInoIeffectIorIM1IreceptorsIinItheIbrain IorIM2IreceptorsIinItheIheart ▪ GreatestIdegreeIofIM3Iselectivity o Solifenacin—atIhighIdoseIcanIprolongIQTIinterval o Tolterodine—nonselectiveImuscarinicIantagonist o Fesoterodine—nonselectiveImuscarinicIantagonist o Trospium-nonselectiveImuscarinicIantagonist • Scopalamine o Uses? ▪ MotionIsickness ▪ ProductionIofIaIcytoplegiaIandImydriasisIforIophthalmicIprocedures ▪ ProductionIofIpre-anestheticIsedationIandIobstetricIamnesia o SideIeffects? ▪ XerostomiaI(dryImouth) ▪ BlurredIvision ▪ Photophobia ▪ Urinary Iretention ▪ Constipation ▪ Hyperthermia ▪ Tachycardia • IpratropiumIBromide o Uses? ▪ TreatIasthma, ICOPDIandIrhinitisIcausedIbyIallergiesIorIcommonIcold o SideIeffects? ▪ NotIassociatedIwithItypical Ianti-muscarinicIsideIeffects • WhatIareImydriatic Icycloplegics? o Atropine, Ihomatropine, Iscopolamine, IcyclopentolateIandItropicamide o UsedItoIproduceImydriasisIandIcyclopediaIinIophthalmicIprocedures • MuscarinicIPoisoning 6 o Cause? ▪ Direct-actingImuscarinicIagonistIandIcholinesteraseIinhibitors ▪ SymptomsIresultIfromIexcessiveIactivationIofItheImuscarinicIreceptors o Treatment? ▪ MuscarinicIblockingIagent—atropine • Cholinesteraseinhibitors I o Reversible ▪ Neostigmine • Uses? o ManagementIofImyastheniaIgravis o Irreversible ▪ HighlyItoxic ▪ Used—asIinsecticides ▪ OnlyIclinical IapplicationIisIglaucoma • Catecholamines o CannotIbeIusedIorally IdueItoIshortIhalfIlifeIandItheyIbecomeIinactivatedIinItheIliver IbeforeItheyIreachIcirculation o HaveIbriefIdurationsIofIaction o CannotIcrossIblood-brainIbarrier • Noncatecholamines o MetabolizedIslower ▪ NotImetabolizedIbyICOMT o CanIbeIgivenIorally o LessIpolarIandIcanIcrossIblood-brainIbarrier • Receptors o AlphaI1—vasoconstrictionI(1st)IthenImydriasis ▪ TherapeuticIapplication • Hemostasis—epinephrine • Nasal Idecongestion—phenylephrineI(topical)IandIpseudophedrine • AdjuctItoIlocal IanesthesiaItoIdelayIabsorption • Mydriasis—dilationIofIpupil ▪ Activation-vasoconstriction ▪ AdverseIeffectsIdueItoIvasoconstriction? • Hypertension • NecrosisIofItissues • Bradycardia o AlphaI2 ▪ Activation—reductionIofIsympatheticIoutflowItoItheIheart ▪ PainIrelief o BetaI1 ▪ Activation-heart o BetaI2- ▪ Activation-lungIandIuterus o Dopamine 7 ▪ Renal Ivasodilation • AdrenergicIAgonistsI2 o Epinephrine ▪ Receptor—alphaI1, IalphaI2, IbetaI1, IandIbetaI2 ▪ Uses—delaysIabsorptionIofIlocal Ianesthetics, IcanIcontrol Isuperficial Ibleeding, IcanIelevateIBP, IcanIovercomeIAVIheartIblock,restore I Icardiac Ifunctions, Icause bronchodilation, ItreatingIanaphylacticIshock o Norepinephrine ▪ Receptors—alphaI1, IalphaI2, IandIbetaI1 ▪ Uses—hypotensiveIstatesIinIcardiacIarrest o Isoproterenol ▪ Receptors—betaI1IandIbetaI2 ▪ Uses—AVIblockIandIcardiacIarrests o Dopamine ▪ Receptors—doseIdependentIspecificity—dopamine, IbetaI1IandIalphaI1I(onlyIat IhighIdoses) ▪ Uses—shockI(canIdecreaseIrenal IperfusionIandIdoImoreIdamageItoIkidneys) o Dobutamine ▪ Receptors—betaI1 ▪ Uses—heartIfailure o Phenylephrine ▪ Receptors—alphaI1 ▪ Uses—nasal IcongestionIandIsometimesIepistaxis, IelevateIBP, IdilateIpupils o Albuterol ▪ Receptors—betaI2 ▪ Uses-asthmaI(bronchodilation) o Ephedrine ▪ Receptors—alphaI1, IalphaI2, IbetaI1IandIbetaI2—poorIselectivity ▪ Uses—decongestants,Istimulant, IdietIproducts,IasthmaI(bronchodilation) • AdrenergicIAntagonists o Alpha-adrenergicIblockingIagents ▪ Uses? • Essential Ihypertension • Reversal IofItoxicityIfromIalpha-1Iagonists • OverdoseIofIalpha-adrenergicIagonistI(epinephrine) • HypertensionIdueItoIexcessiveIactivationIofIalphaI1IreceptorsIonIblood Ivessels • UsedIasIreversal IforIanIalphaIblockingIagent • UsedIforIextravasatedInecrosis • BlocksIvasoconstrictionIandIpreventsIinjurty • BenignIprostaticIhyperplasia o Symptoms—dysuria, IincreasedIfrequencyIofIdaytimeIurination, Inoctura,IurinaryIhesitancy, IurinaryIagency, IaIsensationIof 8 incompleteIvoidingIandIreducationIinIsizeIandIforceIofIurinary Istream • Pheichromocytoma—causesIuncontrolledIhypertension • Raynaud’sIdisease—preventsIvasoconstriction ▪ SideIeffects? • Orthostatichypotension I • Reflextachycardia I • Nasal Icongestion • ImpotenceI(reversibleIandIresolvesIonceIdrugIisId/c) • SodiumIretentionIandIincreaseIbloodIvolume o DueItoIretentionIofIsodiumIandIwater ▪ CombinedIwithIdiuretic IwhenIusedIforIhypertension o Beta-adrenergicIblockingIagents ▪ Uses? • Antianginal Itherapy • Hypertension • ReduceIperipheral IvascularIresistanceI(long-termIuse) • CardiacIdysrhythmias—excessIofIelectrical IactivityIinItheIsinusInodeIand Iatria • MI • HeartIfailure o OnlyIthreeIareIeffective—carvedilol, Ibisoprolol, Imetoprolol • Hyperthyroidism • MigraineIprophylaxis • StageIfright • Pheochromocytoma