Test Bank For Lehnes Pharmacology for Nursing Care 11th
Edition Chapter 1-112 | 9780323825221 | All Chapters with
Answers and Rationals
in blood vessels, the ____ NS produces the predominant tone - ANSWER: sympathetic
the peripheral NS employs three transmitters: - ANSWER: ACh, NE, and EPI
activation of nicotinic N receptors promotes transmission at all autonomic ganglia and promotes
release of ____ from the adrenal medulla - ANSWER: epi
Activation of muscarinic receptors ____ glandular secretion (from pulmonary, gastric, intestinal, and
sweat glands); _____ smooth muscle in the bronchi and GI tract; ____ heart rate; _____ the iris
sphincter muscle; ____ the ciliary muscle (thereby focusing the lens for near vision); ____ blood
vessels; and _____ bladder voiding (by contracting the detrusor muscle and relaxing the trigone and
sphincter) - ANSWER: increases, contracts, slows, contracts, contracts, dilates, promotes
activation of alpha 1 receptors affects the....
eye
veins and arterioles
sex glands
prostatic capsule
bladder - ANSWER: mydriasis (contracts the radial muscle of the eye)
constricts veins and arterioles
promotes ejaculation
contracts smooth muscle in the prostatic capsule
contracts the bladder (trigone and sphincter)
activation of beta 1 receptors ____ HR, force of myocardial contraction, and conduction velocity
through the AV node, and promotes release of renin by the kidney - ANSWER: increases
activation of beta 2 receptors ____ the bronchi, ____ uterine smooth muscle, _____ glycogenolysis,
____ contraction of skeletal muscle, and _____ arterioles (in the heart, lungs, and skeletal muscle) -
ANSWER: dilates, relaxes, increases, enhances, dilates
neurotransmission at cholinergic junctions is terminated by degradation of ACh by ________ -
ANSWER: acetylcholinesterase
neurotransmission at adrenergic junctions is terminated by reuptake of intact _____ into nerve
terminals - ANSWER: NE
following reuptake, NE may be stored in ____ for reuse or destroyed by _____ - ANSWER: vesicles,
monoamine oxidase
muscarinic poisoning is characterized by... - ANSWER: profuse salivation, tearing, visual disturbances,
bronchospasm, diarrhea, bradycardia, and hypotension
muscarinic agonist poisoning is treated with... - ANSWER: atropine
applications of anticholinergic drugs include preanesthetic medications, opthalmic exams, reversal of
bradycardia, treatment of OAB, and _______ - ANSWER: management of muscarinic poisoning
M3 selective drugs will not do what? - ANSWER: will not slow HR AND will be largely devoid of
cognitive effects
, classic adverse effects of anticholinergic drugs are... - ANSWER: dry mouth, blurred vision,
photophobia, tachycardia, urinary retention, constipation, and anhidrosis
what drugs should be used cautiously, if at all, in patients receiving atropine or other muscarinic
antagonists? - ANSWER: drugs that have prominent antimuscarinic effects:
antihistamines
tricyclic antidepressants
phenothiazine antipsychotics
muscarinic antagonist poisoning is characterized by... - ANSWER: dry mouth, blurred vision,
photophobia, hyperthermia, hallucinations, and delirium, and skin that is hot, and flushed
The best antidote for muscarinic antagonist poisoning is - ANSWER: physostigmine, a cholinesterase
inhibitor
cholinesterase inhibitors prevent breakdown of ACh by acetylcholinesterase, causing ACh to
accumulate in synapses, which in turn causes activation of ______ receptors, _________ receptors in
ganglia and NMJ, and cholinergic receptors in the _____ - ANSWER: muscarinic, cholinergic, and CNS
the major use of cholinesterase inhibitors is.... - ANSWER: treatment of myasthenia gravis
secondary use of reversible cholinesterase inhibitors are _______ (5 words) and treatment of
glaucoma, Alzhiemer's, Parkinsons, and __________(3 words) - ANSWER: reversal of competitive
(nondepolarizing) neuromusclar blockade AND poisoning by muscarinic antagonists
Most of the organophosphate cholinesterase inhibitors are _____ - ANSWER: highly lipid soluble
organophosphate cholinesterase inhibitors can easily be absorbed where? - ANSWER: directly through
the skin and distributed easily to all tissues and organs
overdose of cholinergic inhibitors produces cholinergic crisis which is characterized by.... - ANSWER:
depolarizing neuromuscular blockade plus signs of excessive muscarinic stimulation, and death results
by respiratory distress
what are the signs of excessive muscarinic stimulation that is part of a cholinergic crisis? - ANSWER:
hypersalivation, tearing, sweating, bradycardia, involuntary urination and defecation, miosis, and
spasm of accomodation
Poisoning by reversible cholinesterase inhibitors is treated with - ANSWER: atropine and mechanical
ventilation
poisoning by organophosphate cholinesterase inhibitors is treated with... - ANSWER: atropine,
mechanical ventilation, PRALIDOXIME (to reverse inhibition of cholinesterase, primarily at the NMJ),
and diazepam (to suppress seizures)
neuromuscular blockers interfere with ______ receptor activation, and thereby cause muscle
relaxation - ANSWER: Nicotinic M
How does succinylcholine work? - ANSWER: binds to nicotinic M receptors, causing the end plate to
depolarize, the drug remains bound, which keeps the end plate from repolarizing
what 4 main things are neuromuscular blockers used for? - ANSWER: muscle relaxation during
surgery, endotracheal intubation, mechanical ventilation, and electroshock therapy
T/F: neuromuscular blockers reduce consciousness and pain - ANSWER: FALSE!!! they do not reduce
consciousness
Edition Chapter 1-112 | 9780323825221 | All Chapters with
Answers and Rationals
in blood vessels, the ____ NS produces the predominant tone - ANSWER: sympathetic
the peripheral NS employs three transmitters: - ANSWER: ACh, NE, and EPI
activation of nicotinic N receptors promotes transmission at all autonomic ganglia and promotes
release of ____ from the adrenal medulla - ANSWER: epi
Activation of muscarinic receptors ____ glandular secretion (from pulmonary, gastric, intestinal, and
sweat glands); _____ smooth muscle in the bronchi and GI tract; ____ heart rate; _____ the iris
sphincter muscle; ____ the ciliary muscle (thereby focusing the lens for near vision); ____ blood
vessels; and _____ bladder voiding (by contracting the detrusor muscle and relaxing the trigone and
sphincter) - ANSWER: increases, contracts, slows, contracts, contracts, dilates, promotes
activation of alpha 1 receptors affects the....
eye
veins and arterioles
sex glands
prostatic capsule
bladder - ANSWER: mydriasis (contracts the radial muscle of the eye)
constricts veins and arterioles
promotes ejaculation
contracts smooth muscle in the prostatic capsule
contracts the bladder (trigone and sphincter)
activation of beta 1 receptors ____ HR, force of myocardial contraction, and conduction velocity
through the AV node, and promotes release of renin by the kidney - ANSWER: increases
activation of beta 2 receptors ____ the bronchi, ____ uterine smooth muscle, _____ glycogenolysis,
____ contraction of skeletal muscle, and _____ arterioles (in the heart, lungs, and skeletal muscle) -
ANSWER: dilates, relaxes, increases, enhances, dilates
neurotransmission at cholinergic junctions is terminated by degradation of ACh by ________ -
ANSWER: acetylcholinesterase
neurotransmission at adrenergic junctions is terminated by reuptake of intact _____ into nerve
terminals - ANSWER: NE
following reuptake, NE may be stored in ____ for reuse or destroyed by _____ - ANSWER: vesicles,
monoamine oxidase
muscarinic poisoning is characterized by... - ANSWER: profuse salivation, tearing, visual disturbances,
bronchospasm, diarrhea, bradycardia, and hypotension
muscarinic agonist poisoning is treated with... - ANSWER: atropine
applications of anticholinergic drugs include preanesthetic medications, opthalmic exams, reversal of
bradycardia, treatment of OAB, and _______ - ANSWER: management of muscarinic poisoning
M3 selective drugs will not do what? - ANSWER: will not slow HR AND will be largely devoid of
cognitive effects
, classic adverse effects of anticholinergic drugs are... - ANSWER: dry mouth, blurred vision,
photophobia, tachycardia, urinary retention, constipation, and anhidrosis
what drugs should be used cautiously, if at all, in patients receiving atropine or other muscarinic
antagonists? - ANSWER: drugs that have prominent antimuscarinic effects:
antihistamines
tricyclic antidepressants
phenothiazine antipsychotics
muscarinic antagonist poisoning is characterized by... - ANSWER: dry mouth, blurred vision,
photophobia, hyperthermia, hallucinations, and delirium, and skin that is hot, and flushed
The best antidote for muscarinic antagonist poisoning is - ANSWER: physostigmine, a cholinesterase
inhibitor
cholinesterase inhibitors prevent breakdown of ACh by acetylcholinesterase, causing ACh to
accumulate in synapses, which in turn causes activation of ______ receptors, _________ receptors in
ganglia and NMJ, and cholinergic receptors in the _____ - ANSWER: muscarinic, cholinergic, and CNS
the major use of cholinesterase inhibitors is.... - ANSWER: treatment of myasthenia gravis
secondary use of reversible cholinesterase inhibitors are _______ (5 words) and treatment of
glaucoma, Alzhiemer's, Parkinsons, and __________(3 words) - ANSWER: reversal of competitive
(nondepolarizing) neuromusclar blockade AND poisoning by muscarinic antagonists
Most of the organophosphate cholinesterase inhibitors are _____ - ANSWER: highly lipid soluble
organophosphate cholinesterase inhibitors can easily be absorbed where? - ANSWER: directly through
the skin and distributed easily to all tissues and organs
overdose of cholinergic inhibitors produces cholinergic crisis which is characterized by.... - ANSWER:
depolarizing neuromuscular blockade plus signs of excessive muscarinic stimulation, and death results
by respiratory distress
what are the signs of excessive muscarinic stimulation that is part of a cholinergic crisis? - ANSWER:
hypersalivation, tearing, sweating, bradycardia, involuntary urination and defecation, miosis, and
spasm of accomodation
Poisoning by reversible cholinesterase inhibitors is treated with - ANSWER: atropine and mechanical
ventilation
poisoning by organophosphate cholinesterase inhibitors is treated with... - ANSWER: atropine,
mechanical ventilation, PRALIDOXIME (to reverse inhibition of cholinesterase, primarily at the NMJ),
and diazepam (to suppress seizures)
neuromuscular blockers interfere with ______ receptor activation, and thereby cause muscle
relaxation - ANSWER: Nicotinic M
How does succinylcholine work? - ANSWER: binds to nicotinic M receptors, causing the end plate to
depolarize, the drug remains bound, which keeps the end plate from repolarizing
what 4 main things are neuromuscular blockers used for? - ANSWER: muscle relaxation during
surgery, endotracheal intubation, mechanical ventilation, and electroshock therapy
T/F: neuromuscular blockers reduce consciousness and pain - ANSWER: FALSE!!! they do not reduce
consciousness
