NURS 3517 - Pharmacology - Test 1
ACCURATE CURRENTLY TESTING
REAL EXAM QUESTIONS WITH
CORRECT SOLUTIONS (100%
CORRECT ANSWERS) ||GRADED
A+|NEWEST VERSION
snake venom mechanism of action - ANSWER ✓ irreverisbly bind to nicotinic
receptors (paralysis), have novel form of cholinesterase (breaks down other Ach's),
and acts presynaptically to prevent Ach release
direct and indirect acting cholinomimetic and cholinolytic transmitters -
ANSWER ✓ direc works on the post synaptic receptors (stimulating or blocking)
and indirect acts on the transmitter in the terminal or presynaptically (like
presynaptic inhibition of Ach release by snake venom)
what does cholinergic stimulation result in? - ANSWER ✓ SLUD (salivation,
lacrimation, urination, and defecation)
cimeveline (evoxac) - ANSWER ✓ sialagogue, DDI with drugs that inhibit 2D6
and 3A4 due to the metabolism of this drug is through these two enzymes,
contraindicated in those deficient in 2D6 also
exaggerated muscarinic effects - ANSWER ✓ extreme salivation/lacrimation,
involuntary defecation/urination, difficulty breathing due to bronchial constriction
and secretion
aricept - ANSWER ✓ a cholinesterase inhibitor drug used to prolong the half life
of acetylecholine giving the transmitter a better ability to stimulate
exaggerated nicotinic effects - ANSWER ✓ overstimulation leading to paralysis
of respiratory muscles, delayed neurotoxiciy
, malathion - ANSWER ✓ organophosphate (pesticide) that is an irreversible
cholinesterase inhibitor
two examples of irreversible cholinesterase inhibitors - ANSWER ✓ *sarin*-
nerve gas that is an irreversible cholinesterase inhibitor
*malathion*-organophosphate (pesticide) that is an irreversible cholinesterase
inhibitor
anticholinergic drugs - ANSWER ✓ antimuscarinic, neuromuscular jxn blockers,
and ganglionic blocking drugs
antimuscarinic drugs - ANSWER ✓ atropine and scopolamine, act as competitive
receptor blockers a postganglionic postsynaptic muscarinic receptor sites
which muscarinic receptors are most important to us (dentists)? - ANSWER ✓ M3
receptors are most important to us (involved in salivary flow)
neuromuscular jxn blockers - ANSWER ✓ curare, succinycholine, these act at
nicotinic receptors at the neuromuscular jxn of skeletal muscle causing paralysis
ganglionic blocking drugs - ANSWER ✓ hexamethonium, bind to nicotinic
receptors at autonomic ganglionic level (not great because there is lack of
specificity)
antimuscarinic drug effects - ANSWER ✓ decreased salivation, lacrimation,
urination, defecation, GI mobility, and bronchial constrictions, increased HR due
to block of vagal reflex, pupillary dilation (mydriasis), drowsiness, hallucinations
(dry as a bone, hot as hell, red as a beet, blind as a bat, mad as a hatter)
contraindications to antimuscarinic drugs - ANSWER ✓ glaucoma, prostate
hypertrophy (dont want to retain even more urine), intestinal obstruction, pts with
cardiovascular and pulmonary disease bc atropine increases pulse rate without
increasing cardiac output
list of antimuscarinic drugs - ANSWER ✓ scopolamine, benzotropine, aropine,
homatropine, pirenzipine, propantheline, oxybutynin, opratropium bromide
(atrovent), tolterodine tartrate (detrol)
, antimuscarinic DDIs - ANSWER ✓ antihistamines, MAO inhibitors, and Tricyclic
antidepressants (all work by anticholinergic activity), these will potentiate the
action
nondepolarizing neruomuscular (nicotinic) jxn blockers - ANSWER ✓
competitive receptor blockers, *D-tubocurarine (curare)*, can be reversed because
we can increase the agonist to overwhelm the drug
depolarizing neuromuscular (nicotinic) jxn blockers - ANSWER ✓ agonists that
cause a block because they provide prolonged stimulation leading to
depolarization, *succinylcholine*, can not be reversed
botox - ANSWER ✓ indirect acting drug, preventing release of Ach, reduces
wrinkles and gives some thereapy by inducing paralysis, can be used dentally for
something like bruxism or esthetically for a gummy smile
what is the neruotransmitter for the cholinergic system?
the adrenergic system? - ANSWER ✓ acetylcholine
norepinephrine
difference between cholinergic and adrenergic recycling of neurotransmitters -
ANSWER ✓ cholinergic-broken down in the synapse and taken up by the
presynaptic nerve
adrenergic-receptor (alpha1) on presynaptic reuptakes NE to be stored or to
inhibitorially feedback on the nerve to slow down the transmission
adrenergic stimulation - ANSWER ✓ increased HR/contractility, peripheral
resistance/BP, bronchodilation, pupillary dilation/mydriasis, urinary retention, and
sweating
Alpha1 receptors - ANSWER ✓ found in all blood vessels, vasoconstriction
Beta2 receptors - ANSWER ✓ found in the lungs, if stimulated there will be
bronchodilation
clonidine - ANSWER ✓ works as a direct agonist for the alpha2 receptor (which
works on the presynaptic nerve) decreasing the amount of neurotransmitter in the
synapse, so its an antagonist by working as a direct agonist
, alpha1 stimulation - ANSWER ✓ peripheral vascular SMOOTH muscle,
vasoconstriction, phenylephrine (nasal decongestant) and methoxamine for
hypotension are specific for A1
alpha1 antagonism - ANSWER ✓ vasodilation, examples of drugs all end in *-
osin*
alpha2 stimulation - ANSWER ✓ reduces outflow of NE, clonidine, methyldopa,
guanfacine, used for hypertension, ADHD, and drug withdrawal
phentolamine - ANSWER ✓ non-selective adrenergic alpha receptor antagonist,
competitive and reversible, used as oraverse, frostbite, ED, and
pheochromocytoma induced hptnsn dx
phenoxybenzamine - ANSWER ✓ non-selective adrenergic alpha receptor
antagonist, non-competitive and irreversible, used for pheochromocytoma hptnsn
tx
alpha 1 antagonists and epinephrine - ANSWER ✓ epi nomally binds a1 and b2,
but an a1 antagonst (-zosin) will block epi-receptor binding there and not at b2,
causing ONLY vasodilation (b2) with no vasocontriction (a1) thus decreasing the
pulse
where are beta1 receptors found? what is their action? - ANSWER ✓ post synaptic
nerves in cardiac muscle, they act to increase cardiac output and contractile force
(*dobutamine* works on shock/hypotension)
antagonist-*atenolol* (end in olol)
where are beta2 receptors found? what is their action? - ANSWER ✓ found in
bronchioles and skeletal muscles, they act to bronchodilate and vasodilate
(*albuterol*)
propranolol - ANSWER ✓ nonselective beta receptor antagonist, decrease BP and
increase bronchoconstriction, want to give it to a hypertensive patient but NOT a
hypertensive asthmatic, would rather go with a selective beta1 blocker (cardiac
tissue)
ACCURATE CURRENTLY TESTING
REAL EXAM QUESTIONS WITH
CORRECT SOLUTIONS (100%
CORRECT ANSWERS) ||GRADED
A+|NEWEST VERSION
snake venom mechanism of action - ANSWER ✓ irreverisbly bind to nicotinic
receptors (paralysis), have novel form of cholinesterase (breaks down other Ach's),
and acts presynaptically to prevent Ach release
direct and indirect acting cholinomimetic and cholinolytic transmitters -
ANSWER ✓ direc works on the post synaptic receptors (stimulating or blocking)
and indirect acts on the transmitter in the terminal or presynaptically (like
presynaptic inhibition of Ach release by snake venom)
what does cholinergic stimulation result in? - ANSWER ✓ SLUD (salivation,
lacrimation, urination, and defecation)
cimeveline (evoxac) - ANSWER ✓ sialagogue, DDI with drugs that inhibit 2D6
and 3A4 due to the metabolism of this drug is through these two enzymes,
contraindicated in those deficient in 2D6 also
exaggerated muscarinic effects - ANSWER ✓ extreme salivation/lacrimation,
involuntary defecation/urination, difficulty breathing due to bronchial constriction
and secretion
aricept - ANSWER ✓ a cholinesterase inhibitor drug used to prolong the half life
of acetylecholine giving the transmitter a better ability to stimulate
exaggerated nicotinic effects - ANSWER ✓ overstimulation leading to paralysis
of respiratory muscles, delayed neurotoxiciy
, malathion - ANSWER ✓ organophosphate (pesticide) that is an irreversible
cholinesterase inhibitor
two examples of irreversible cholinesterase inhibitors - ANSWER ✓ *sarin*-
nerve gas that is an irreversible cholinesterase inhibitor
*malathion*-organophosphate (pesticide) that is an irreversible cholinesterase
inhibitor
anticholinergic drugs - ANSWER ✓ antimuscarinic, neuromuscular jxn blockers,
and ganglionic blocking drugs
antimuscarinic drugs - ANSWER ✓ atropine and scopolamine, act as competitive
receptor blockers a postganglionic postsynaptic muscarinic receptor sites
which muscarinic receptors are most important to us (dentists)? - ANSWER ✓ M3
receptors are most important to us (involved in salivary flow)
neuromuscular jxn blockers - ANSWER ✓ curare, succinycholine, these act at
nicotinic receptors at the neuromuscular jxn of skeletal muscle causing paralysis
ganglionic blocking drugs - ANSWER ✓ hexamethonium, bind to nicotinic
receptors at autonomic ganglionic level (not great because there is lack of
specificity)
antimuscarinic drug effects - ANSWER ✓ decreased salivation, lacrimation,
urination, defecation, GI mobility, and bronchial constrictions, increased HR due
to block of vagal reflex, pupillary dilation (mydriasis), drowsiness, hallucinations
(dry as a bone, hot as hell, red as a beet, blind as a bat, mad as a hatter)
contraindications to antimuscarinic drugs - ANSWER ✓ glaucoma, prostate
hypertrophy (dont want to retain even more urine), intestinal obstruction, pts with
cardiovascular and pulmonary disease bc atropine increases pulse rate without
increasing cardiac output
list of antimuscarinic drugs - ANSWER ✓ scopolamine, benzotropine, aropine,
homatropine, pirenzipine, propantheline, oxybutynin, opratropium bromide
(atrovent), tolterodine tartrate (detrol)
, antimuscarinic DDIs - ANSWER ✓ antihistamines, MAO inhibitors, and Tricyclic
antidepressants (all work by anticholinergic activity), these will potentiate the
action
nondepolarizing neruomuscular (nicotinic) jxn blockers - ANSWER ✓
competitive receptor blockers, *D-tubocurarine (curare)*, can be reversed because
we can increase the agonist to overwhelm the drug
depolarizing neuromuscular (nicotinic) jxn blockers - ANSWER ✓ agonists that
cause a block because they provide prolonged stimulation leading to
depolarization, *succinylcholine*, can not be reversed
botox - ANSWER ✓ indirect acting drug, preventing release of Ach, reduces
wrinkles and gives some thereapy by inducing paralysis, can be used dentally for
something like bruxism or esthetically for a gummy smile
what is the neruotransmitter for the cholinergic system?
the adrenergic system? - ANSWER ✓ acetylcholine
norepinephrine
difference between cholinergic and adrenergic recycling of neurotransmitters -
ANSWER ✓ cholinergic-broken down in the synapse and taken up by the
presynaptic nerve
adrenergic-receptor (alpha1) on presynaptic reuptakes NE to be stored or to
inhibitorially feedback on the nerve to slow down the transmission
adrenergic stimulation - ANSWER ✓ increased HR/contractility, peripheral
resistance/BP, bronchodilation, pupillary dilation/mydriasis, urinary retention, and
sweating
Alpha1 receptors - ANSWER ✓ found in all blood vessels, vasoconstriction
Beta2 receptors - ANSWER ✓ found in the lungs, if stimulated there will be
bronchodilation
clonidine - ANSWER ✓ works as a direct agonist for the alpha2 receptor (which
works on the presynaptic nerve) decreasing the amount of neurotransmitter in the
synapse, so its an antagonist by working as a direct agonist
, alpha1 stimulation - ANSWER ✓ peripheral vascular SMOOTH muscle,
vasoconstriction, phenylephrine (nasal decongestant) and methoxamine for
hypotension are specific for A1
alpha1 antagonism - ANSWER ✓ vasodilation, examples of drugs all end in *-
osin*
alpha2 stimulation - ANSWER ✓ reduces outflow of NE, clonidine, methyldopa,
guanfacine, used for hypertension, ADHD, and drug withdrawal
phentolamine - ANSWER ✓ non-selective adrenergic alpha receptor antagonist,
competitive and reversible, used as oraverse, frostbite, ED, and
pheochromocytoma induced hptnsn dx
phenoxybenzamine - ANSWER ✓ non-selective adrenergic alpha receptor
antagonist, non-competitive and irreversible, used for pheochromocytoma hptnsn
tx
alpha 1 antagonists and epinephrine - ANSWER ✓ epi nomally binds a1 and b2,
but an a1 antagonst (-zosin) will block epi-receptor binding there and not at b2,
causing ONLY vasodilation (b2) with no vasocontriction (a1) thus decreasing the
pulse
where are beta1 receptors found? what is their action? - ANSWER ✓ post synaptic
nerves in cardiac muscle, they act to increase cardiac output and contractile force
(*dobutamine* works on shock/hypotension)
antagonist-*atenolol* (end in olol)
where are beta2 receptors found? what is their action? - ANSWER ✓ found in
bronchioles and skeletal muscles, they act to bronchodilate and vasodilate
(*albuterol*)
propranolol - ANSWER ✓ nonselective beta receptor antagonist, decrease BP and
increase bronchoconstriction, want to give it to a hypertensive patient but NOT a
hypertensive asthmatic, would rather go with a selective beta1 blocker (cardiac
tissue)
