EXAM 2 PHARMACOLOGY UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS VERIFIED 2027 EDITION
1. When the parasympathetic nervous system (PNS) is activated, what actions are facilitated?
Salivation, lacrimation, urination, defecation (SLUD) Originates in cranium/sacral area of spinal cord
2. What drug are used to constrict pupils and why?
Cholinergic agonists because they activate cholinergic receptors of PARASYMPATHETIC nervous system
(ACETYLCHOLINE is neurotransmitter)
3. What drugs are used to dilate pupils and why?
Adrenergic agonists because they activate adrenergic receptors of SYMPATHETIC nervous system
(NOREPINEPHRINE is neurotransmitter)
4. What are the associated conditions/diagnoses for cholinergic agonists?
Glaucoma, urinary retention
5. Side effects/adverse effects of DIRECT-ACTING cholinergic agonists
- Blurred vision, miosis - Hypotension, bradycardia, sweating - Increased salivation and gastric acid,
nausea, vomiting, diarrhea, abdominal cramps - Bronchoconstriction
6. Contraindications for DIRECT-ACTING cholinergic agonists
Bradycardia, hypotension, COPD, peptic ulcer, parkinsonism, hyperthyroidism
7. What are the distinct differences between alpha 1 and 2 agonism/stimulation?
- Alpha-1 agonism stimulates A1 receptors on blood vessels to increase vasoconstriction/BP and relieve
nasal congestion - Alpha-2 agonism inhibits norepinephrine release, which promotes vasodilation and
decreased BP
8. What are the vasoconstrictive medications? What do they treat?
Alpha 1 Agonists, can treat hypotension and polyuria/nocturia
9. What is your patient teaching related to beta blockers?
Selective Beta-1 antagonists (blockers): - Reduce heart rate & BP, often first-line medications for HTN -
Have little influence on beta-2 receptors Non-selective Beta Blockers: - Block beta-2 receptors on bronchial
smooth muscle, leads to impaired breathing (CONTRAINDICATED IN PTS W ASTHMA/COPD) - Inhibit
glycogenolysis (DECREASES BLOOD GLUCOSE), CONTRAINDICATED in pts w diabetes!
10. What are the effects of epinephrine?
It is nonselective Alpha/Beta agonist, so stimulates both receptors: - Alpha1 increases blood pressure -
Beta1 increases heart rate - Beta2 promotes bronchodilation Uses: - Anaphylaxis, anaphylactic shock -
Bronchospasms, status asthmaticus - Cardiogenic shock, cardiac arrest
11. What are the different types of inhaled beta 2 agonists? What are important education points for
pts taking these medications?
- Available as inhalers, nebulized solutions, tablets, and oral liquids - Often used to dilate bronchial smooth
muscle in patients that have difficulty breathing (Asthma, COPD) - Pt's should know that though beta 2
agonists are mostly selective, beta 1 stimulation usually does occur with administration: Leads to
tachycardia, hyperglycemia (liver glycogenolysis is activated, so BG increases)
1
, 12. What are the different classifications of insomnia meds?
All sedative hypnotics, but broken down into: - Barbiturates (not used as much anymore, overdose = fatal) -
Benzodiazepines - Non-benzodiazepines - Melatonin Agonists - OTC (Use antihistamine bcs of
anti-cholinergic properties that cross over to brain producing sedation)
13. How would you assess for and expect to address a vasoconstrictive IV extravasation?
- Extravasation - when IV fluid is VESICANT (irritates tissues!), S/s = redness, edema, pain/tenderness, cool
temperature - Typically happens with norepinephrine/epinephrine, would want to stop infusion
immediately, flush, and give IV PHENTOLAMINE (Regitine)
14. How do you treat a cholinergic agonist overdose?
IV Atropine (is an anticholinergic)
15. What special considerations must we make in treating insomnia in the elderly?
- Respiratory depression is COMMON side effect, so check vital signs before administering benzo! - Make
sure they don't receive opiates at same time BCS of synergism (respiratory depression will be even worse!)
- Make sure they're aware they're at INCREASED RISK OF FALLS!!
16. How do we reverse benzodiazepine effects?
Effects can be reversed with antidote = Flumazenil (Romazicon) - Useful in toxicity/overdose situations -
Useful in "waking up" patients after procedures - Use with caution: could precipitate withdrawal seizures
17. How do depressant medications work? (What's their mechanism of action?)
- Increasing amount of neurotransmitter GABA released, promotes drowsy/calming effects bcs brain is
being inhibited - GABA = inhibitory neurotransmitter, glutamate = excitatory, so when GABA > Glutamate,
CNS is depressed
18. What are some concerns related to abrupt stoppage of benzodiazepines?
- Abrupt stoppage of benzodiazepines will lead to withdrawal symptoms, which will always be the opposite
of the effect of the drug - Ex: Fever, tachycardia, hypertension, seizures (anxiety, insomnia, etc) - Need to
TAPER OFF!
19. Albuterol (Ventolin)
Selective short-acting beta-2 agonist (Acts on beta2-adrenergic receptors) - Available as inhaler, nebulized
solution, tablet, and oral liquid Uses: Treats bronchospasm, asthma, bronchitis, COPD, promotes
bronchodilation Contraindications: Severe cardiac disease, Hypertension, hyperthyroidism, Diabetes
mellitus, pregnancy, Renal dysfunction Side effects/adverse reactions: Tremors, nervousness, restlessness,
dizziness, Tachycardia, palpitations, cardiac dysrhythmias Drug interaction: - May increase effect with
other adrenergic agonists, MAO inhibitors, and tricyclic antidepressants - Antagonizing effect with
beta-blockers
20. Amphetamine/Dextroamphetamine (Adderall/Dexedrine)
- Amphetamine (HIGHLY ADDICTIVE) - Action: Stimulate release of norepinephrine and dopamine
(indirect-acting!) - Uses: ADHD (more effective here), Narcolepsy
21. Atenolol (Tenormin)
- Selective Beta 1 Blocker - Action: Block beta 1 receptors on cardiac tissue (reduce heart rate & BP), have
little influence on beta-2 receptors - Adverse/Side effects: Bradycardia, Edema, Fatigue, Dizziness
22. Atomoxetine (Strattera)
- Non-Amphetamine for ADHD treatment - Action: Norepinephrine reuptake inhibitor (has same kind of
mechanism, more focused on N, less likely to be addictive bcs of that) - Useful in patients (6 years or older)
with strong family history of dependence - Side/Adverse effects: Tachycardia, HTN, - Contraindications: Use
with MAOIs (for depression), BCS it allows norepinephrine to build up
2
ANSWERS VERIFIED 2027 EDITION
1. When the parasympathetic nervous system (PNS) is activated, what actions are facilitated?
Salivation, lacrimation, urination, defecation (SLUD) Originates in cranium/sacral area of spinal cord
2. What drug are used to constrict pupils and why?
Cholinergic agonists because they activate cholinergic receptors of PARASYMPATHETIC nervous system
(ACETYLCHOLINE is neurotransmitter)
3. What drugs are used to dilate pupils and why?
Adrenergic agonists because they activate adrenergic receptors of SYMPATHETIC nervous system
(NOREPINEPHRINE is neurotransmitter)
4. What are the associated conditions/diagnoses for cholinergic agonists?
Glaucoma, urinary retention
5. Side effects/adverse effects of DIRECT-ACTING cholinergic agonists
- Blurred vision, miosis - Hypotension, bradycardia, sweating - Increased salivation and gastric acid,
nausea, vomiting, diarrhea, abdominal cramps - Bronchoconstriction
6. Contraindications for DIRECT-ACTING cholinergic agonists
Bradycardia, hypotension, COPD, peptic ulcer, parkinsonism, hyperthyroidism
7. What are the distinct differences between alpha 1 and 2 agonism/stimulation?
- Alpha-1 agonism stimulates A1 receptors on blood vessels to increase vasoconstriction/BP and relieve
nasal congestion - Alpha-2 agonism inhibits norepinephrine release, which promotes vasodilation and
decreased BP
8. What are the vasoconstrictive medications? What do they treat?
Alpha 1 Agonists, can treat hypotension and polyuria/nocturia
9. What is your patient teaching related to beta blockers?
Selective Beta-1 antagonists (blockers): - Reduce heart rate & BP, often first-line medications for HTN -
Have little influence on beta-2 receptors Non-selective Beta Blockers: - Block beta-2 receptors on bronchial
smooth muscle, leads to impaired breathing (CONTRAINDICATED IN PTS W ASTHMA/COPD) - Inhibit
glycogenolysis (DECREASES BLOOD GLUCOSE), CONTRAINDICATED in pts w diabetes!
10. What are the effects of epinephrine?
It is nonselective Alpha/Beta agonist, so stimulates both receptors: - Alpha1 increases blood pressure -
Beta1 increases heart rate - Beta2 promotes bronchodilation Uses: - Anaphylaxis, anaphylactic shock -
Bronchospasms, status asthmaticus - Cardiogenic shock, cardiac arrest
11. What are the different types of inhaled beta 2 agonists? What are important education points for
pts taking these medications?
- Available as inhalers, nebulized solutions, tablets, and oral liquids - Often used to dilate bronchial smooth
muscle in patients that have difficulty breathing (Asthma, COPD) - Pt's should know that though beta 2
agonists are mostly selective, beta 1 stimulation usually does occur with administration: Leads to
tachycardia, hyperglycemia (liver glycogenolysis is activated, so BG increases)
1
, 12. What are the different classifications of insomnia meds?
All sedative hypnotics, but broken down into: - Barbiturates (not used as much anymore, overdose = fatal) -
Benzodiazepines - Non-benzodiazepines - Melatonin Agonists - OTC (Use antihistamine bcs of
anti-cholinergic properties that cross over to brain producing sedation)
13. How would you assess for and expect to address a vasoconstrictive IV extravasation?
- Extravasation - when IV fluid is VESICANT (irritates tissues!), S/s = redness, edema, pain/tenderness, cool
temperature - Typically happens with norepinephrine/epinephrine, would want to stop infusion
immediately, flush, and give IV PHENTOLAMINE (Regitine)
14. How do you treat a cholinergic agonist overdose?
IV Atropine (is an anticholinergic)
15. What special considerations must we make in treating insomnia in the elderly?
- Respiratory depression is COMMON side effect, so check vital signs before administering benzo! - Make
sure they don't receive opiates at same time BCS of synergism (respiratory depression will be even worse!)
- Make sure they're aware they're at INCREASED RISK OF FALLS!!
16. How do we reverse benzodiazepine effects?
Effects can be reversed with antidote = Flumazenil (Romazicon) - Useful in toxicity/overdose situations -
Useful in "waking up" patients after procedures - Use with caution: could precipitate withdrawal seizures
17. How do depressant medications work? (What's their mechanism of action?)
- Increasing amount of neurotransmitter GABA released, promotes drowsy/calming effects bcs brain is
being inhibited - GABA = inhibitory neurotransmitter, glutamate = excitatory, so when GABA > Glutamate,
CNS is depressed
18. What are some concerns related to abrupt stoppage of benzodiazepines?
- Abrupt stoppage of benzodiazepines will lead to withdrawal symptoms, which will always be the opposite
of the effect of the drug - Ex: Fever, tachycardia, hypertension, seizures (anxiety, insomnia, etc) - Need to
TAPER OFF!
19. Albuterol (Ventolin)
Selective short-acting beta-2 agonist (Acts on beta2-adrenergic receptors) - Available as inhaler, nebulized
solution, tablet, and oral liquid Uses: Treats bronchospasm, asthma, bronchitis, COPD, promotes
bronchodilation Contraindications: Severe cardiac disease, Hypertension, hyperthyroidism, Diabetes
mellitus, pregnancy, Renal dysfunction Side effects/adverse reactions: Tremors, nervousness, restlessness,
dizziness, Tachycardia, palpitations, cardiac dysrhythmias Drug interaction: - May increase effect with
other adrenergic agonists, MAO inhibitors, and tricyclic antidepressants - Antagonizing effect with
beta-blockers
20. Amphetamine/Dextroamphetamine (Adderall/Dexedrine)
- Amphetamine (HIGHLY ADDICTIVE) - Action: Stimulate release of norepinephrine and dopamine
(indirect-acting!) - Uses: ADHD (more effective here), Narcolepsy
21. Atenolol (Tenormin)
- Selective Beta 1 Blocker - Action: Block beta 1 receptors on cardiac tissue (reduce heart rate & BP), have
little influence on beta-2 receptors - Adverse/Side effects: Bradycardia, Edema, Fatigue, Dizziness
22. Atomoxetine (Strattera)
- Non-Amphetamine for ADHD treatment - Action: Norepinephrine reuptake inhibitor (has same kind of
mechanism, more focused on N, less likely to be addictive bcs of that) - Useful in patients (6 years or older)
with strong family history of dependence - Side/Adverse effects: Tachycardia, HTN, - Contraindications: Use
with MAOIs (for depression), BCS it allows norepinephrine to build up
2
