The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
What are the major functions of the α1 receptor? - ansIncrease vascular smooth muscle
contraction, increase pupillary dilator muscle contraction (mydriasis), increase intestinal and
bladder sphincter muscle contraction
What are the major functions of the α2 receptor? - ansDecrease sympathetic outflow,
decrease insulin release, decrease lipolysis, increase platelet aggregation, decrease aqueous
humor production
What are the major functions of the β1 receptor? - ansIncrease heart rate, increase
contractility, increase renin release, increase lipolysis
What are the major functions of the β2 receptor? - ansVasodilation, bronchodilation, increase
lipolysis, increase insulin release, decrease uterine tone (tocolysis), ciliary muscle relaxation,
increase aqueous humor production
What are the major functions of the M1 receptor? - ansCNS, enteric nervous system
What are the major functions of the M2 receptor? - ansDecrease heart rate and contractility of
atria
What are the major functions of the M3 receptor? - ansIncrease exocrine gland secretions
(e.g., lacrimal, salivary, gastric acid), increase gut peristalsis, increase bladder contraction,
increase bronchoconstriction, pupillary sphincter muscle contraction (miosis), ciliary muscle
contraction (accommodation)
What are the major functions of the D1 receptor? - ansRelaxes renal vascular smooth muscle
What are the major functions of the D2 receptor? - ansModulates transmitter release,
especially in the brain
What are the major functions of the H1 receptor? - ansIncrease nasal and bronchial mucus
production, increase vascular permeability, contraction of bronchioles, pruritis, pain
What are the major functions of the H2 receptor? - ansIncrease gastric acid secretion
What are the major functions of the V1 receptor? - ansIncrease vascular smooth muscle
contraction
What are the major functions of the V2 receptor? - ansIncrease H2O permeability and
reabsorption in collecting tubules of kidney (V2 is found in the "2" kidneys)
What receptors are associate with Gq? - ansH1, α1, V1, M1, and M3
What receptors are associated with Gs? - ansH2, B1, B2, V2, D1
What receptors are associated with Gi? - ansM2, α2, D2
Bethanechol - ans-Direct cholinergic agonist
-Activates bowel and bladder smooth muscle
-Used in postoperative and neurogenic ileus
-Resistant to AChE
Carbachol - ans-Direct cholinergic agonist
-Carbon copy of acetylcholine
-Constricts pupils and relieves intraocular pressure in glaucoma
Methacholine - ans-Direct cholinergic agonist
-Stimulates muscarinic receptors in airways when inhaled
-Used as a challenge test for diagnosis of asthma
,The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
Pilocarpine - ans-Direct cholinergic agonist
-Contracts ciliary muscle of eye (open angle glaucoma), contracts pupillary sphincter (closed
angle glaucoma)
-Potent stimulator of sweat, tears and saliva
-AChE resistant
Donepezil - ans-Anticholinesterse - increases ACh
-Alzheimer disease
Galantamine - ans-Anticholinesterse - increases ACh
-Alzheimer disease
Rivastigmine - ans-Anticholinesterse - increases ACh
-Alzheimer disease
Edrophonium - ans-Anticholinesterse - increases ACh
-Historically used to diagnose myasthenia gravis (MG is now diagnosed by anti-AChR Ab
test.
Neostigmine - ans-Anticholinesterse - increases ACh
-Used in postoperative and neurogenic ileus and urinary retention, myasthenia gravis, and
postoperative reversal of neuromuscular junction blockade
Physostigmine - ans-Anticholinesterse - increases ACh
-Used in anticholinergic toxicity
-Crosses the blood-brain barrier (CNS)
Pyridostigmine - ans-Anticholinesterse - increases ACh
-Increases muscle strength
-Used in myasthenia gravis (long acting)
-Does not penetrate CNS
Atropine - ans-Muscarinic antagonist
-Used in bradycardia and for ophthalmic applications
-Also used as antidote for cholinesterase inhibitor poisoning
-Actions include increase pupil dilation, cycloplegia, decreased airway secretions, decreased
acid secretions, decreased gut motility, decreased bladder urgency in cystitis
-Toxicity: increased body temp (due to decreased sweating), rapid pulse, dry mouth, dry and
flushed skin, cycloplegia, constipation, disorientation;
-Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in
men with prostatic hyperplasia, and hyperthermia in infants
-See also homatropine and tropicamide
Benztropine - ans-Muscarinic antagonist
-Works in CNS
-Used in Parkinson disease and acute dystonia
Glycopyrrolate - ans-Muscarinic antagonist
-Parental use: preoperative use to reduce airway secretions
-Oral use: drooling, peptic ulcer
Hyoscyamine - ans-Muscarinic antagonist
,The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
-Antispasmodics for IBS
Dicyclomide - ans-Muscarinic antagonist
-Antispasmodics for IBS
Ipratropium - ans-Muscarinic antagonist
-Used in COPD and asthma
Tiotropium - ans-Muscarinic antagonist
-Used in COPD and asthma
Oxybutynin - ans-Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Solifenacin - ans-Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Tolterodine - ans-Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Scopalamine - ans-Muscarinic antagonist
-Motion sickness
Tetrodotoxin - ans-Poisoning can result from ingestion of poorly prepared puffer fish (exotic
sushi)
-Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue,
preventing depolarization - blocks action potential without changing resting potential (same
mechanism as Lidocaine)
-Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes.
-Treatment is primarily supportive.
Ciguatoxin - ans-Consumption of reef fish (e.g. barracuda, snapper, eel...)
-Causes ciguatera fish poisoning.
-Opens Na+ channels causing depolarization. Symptoms easily confused with cholinergic
poisoning.
-Temperature-related dysesthesia (e.g., "cold feels hot; hot feels cold") is regarded as a
specific finding of ciguatera.
-Treatment is primarily supportive.
Scombroid poisoning - ans-Caused by consumption of dark-meat fish (e.g., bonito, mackerel,
mahi-mahi, tuna) improperly stored at warm temperature.
-Bacterial histidine decarboxylase converts histidine to histamine. Histamine is not degraded
by cooking.
-Acute-onset burning sensation of the mouth, flushing of face, erythema, urticaria, pruritus,
headache. May cause anaphylaxis-like presentation (i.e., bronchospasm, angioedema,
hypotension).
-Frequently misdiagnosed as allergy to fish.
-Treat supportively with antihistamines; if needed, antianaphylactics (e.g., bronchodilators,
epinephrine).
Albuterol - ans-β2 > β1 direct agonist
-Acute asthma
, The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
Salmterol - ans-β2 > β1 direct agonist
-Long term asthma or COPD control
Dobutamine - ans-β1 > β2, α direct agonist
-Uses: heart failure (HF) (inotropic > chronotropic), cardiac stress testing.
Dopamine - ans-D1 = D2 > β > α direct agonist
-Uses: unstable bradycardia, HF, shock; inotropic and chronotropic α effects predominate at
high doses.
Epinephrine - ans-β > α direct agonist
-Uses: anaphylaxis, asthma, open-angle glaucoma;
α effects predominate at high doses. Significantly stronger effect at β2-receptor than
norepinephrine.
Isoprterenol - ans-β1 = β2 direct agonist
-Uses: electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia
Norepinephrine - ans-α1 > α2 > β1 direct agonist
-Hypotension (butrenal perfusion). Significantly weaker effect at β2-receptor than
epinephrine.
Phenylephrine - ans-α1 > α2 direct agonist
-Uses: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
Amphetamine - ans-Indirect general sympathetic agonist
-reuptake inhibitor; also releases stored catecholamines
-Narcolepsy, obesity, ADHD.
Cocaine - ans-Indirect general sympathetic agonist
-Reuptake inhibitor
-Causes vasoconstriction and local anesthesia.
-Never give β-blockers if cocaine intoxication is
suspected (can lead to unopposed α1 activation and extreme hypertension).
Ephedrine - ans-Indirect general sympathetic agonist
-Releases stored catecholamines
-Nasal decongestion, urinary incontinence, hypotension.
Norepinephrine vs. isoproterenol - ans-Norepinephrine increases systolic and diastolic
pressures as a result of α1-mediated vasoconstriction causing increased in mean arterial
pressure and reflex bradycardia. -However, isoproterenol (no longer commonly used) has
little α effect but causes β2-mediated vasodilation, resulting in decreased mean arterial
pressure and increased heart rate through β1 and reflex activity.
Clonidine - ans-α2-agonist
-Uses: hypertensive urgency (limited situations); does not decrease renal blood flow; ADHD,
Tourette syndrome
-Toxicity: CNS depression, bradycardia, hypotension, respiratory depression, miosis
α-methyldopa - ans-α2-agonist
-Used for hypertension in pregnancy
-Toxicity: Direct Coombs ⊕ hemolysis, SLE-like syndrome
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
What are the major functions of the α1 receptor? - ansIncrease vascular smooth muscle
contraction, increase pupillary dilator muscle contraction (mydriasis), increase intestinal and
bladder sphincter muscle contraction
What are the major functions of the α2 receptor? - ansDecrease sympathetic outflow,
decrease insulin release, decrease lipolysis, increase platelet aggregation, decrease aqueous
humor production
What are the major functions of the β1 receptor? - ansIncrease heart rate, increase
contractility, increase renin release, increase lipolysis
What are the major functions of the β2 receptor? - ansVasodilation, bronchodilation, increase
lipolysis, increase insulin release, decrease uterine tone (tocolysis), ciliary muscle relaxation,
increase aqueous humor production
What are the major functions of the M1 receptor? - ansCNS, enteric nervous system
What are the major functions of the M2 receptor? - ansDecrease heart rate and contractility of
atria
What are the major functions of the M3 receptor? - ansIncrease exocrine gland secretions
(e.g., lacrimal, salivary, gastric acid), increase gut peristalsis, increase bladder contraction,
increase bronchoconstriction, pupillary sphincter muscle contraction (miosis), ciliary muscle
contraction (accommodation)
What are the major functions of the D1 receptor? - ansRelaxes renal vascular smooth muscle
What are the major functions of the D2 receptor? - ansModulates transmitter release,
especially in the brain
What are the major functions of the H1 receptor? - ansIncrease nasal and bronchial mucus
production, increase vascular permeability, contraction of bronchioles, pruritis, pain
What are the major functions of the H2 receptor? - ansIncrease gastric acid secretion
What are the major functions of the V1 receptor? - ansIncrease vascular smooth muscle
contraction
What are the major functions of the V2 receptor? - ansIncrease H2O permeability and
reabsorption in collecting tubules of kidney (V2 is found in the "2" kidneys)
What receptors are associate with Gq? - ansH1, α1, V1, M1, and M3
What receptors are associated with Gs? - ansH2, B1, B2, V2, D1
What receptors are associated with Gi? - ansM2, α2, D2
Bethanechol - ans-Direct cholinergic agonist
-Activates bowel and bladder smooth muscle
-Used in postoperative and neurogenic ileus
-Resistant to AChE
Carbachol - ans-Direct cholinergic agonist
-Carbon copy of acetylcholine
-Constricts pupils and relieves intraocular pressure in glaucoma
Methacholine - ans-Direct cholinergic agonist
-Stimulates muscarinic receptors in airways when inhaled
-Used as a challenge test for diagnosis of asthma
,The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
Pilocarpine - ans-Direct cholinergic agonist
-Contracts ciliary muscle of eye (open angle glaucoma), contracts pupillary sphincter (closed
angle glaucoma)
-Potent stimulator of sweat, tears and saliva
-AChE resistant
Donepezil - ans-Anticholinesterse - increases ACh
-Alzheimer disease
Galantamine - ans-Anticholinesterse - increases ACh
-Alzheimer disease
Rivastigmine - ans-Anticholinesterse - increases ACh
-Alzheimer disease
Edrophonium - ans-Anticholinesterse - increases ACh
-Historically used to diagnose myasthenia gravis (MG is now diagnosed by anti-AChR Ab
test.
Neostigmine - ans-Anticholinesterse - increases ACh
-Used in postoperative and neurogenic ileus and urinary retention, myasthenia gravis, and
postoperative reversal of neuromuscular junction blockade
Physostigmine - ans-Anticholinesterse - increases ACh
-Used in anticholinergic toxicity
-Crosses the blood-brain barrier (CNS)
Pyridostigmine - ans-Anticholinesterse - increases ACh
-Increases muscle strength
-Used in myasthenia gravis (long acting)
-Does not penetrate CNS
Atropine - ans-Muscarinic antagonist
-Used in bradycardia and for ophthalmic applications
-Also used as antidote for cholinesterase inhibitor poisoning
-Actions include increase pupil dilation, cycloplegia, decreased airway secretions, decreased
acid secretions, decreased gut motility, decreased bladder urgency in cystitis
-Toxicity: increased body temp (due to decreased sweating), rapid pulse, dry mouth, dry and
flushed skin, cycloplegia, constipation, disorientation;
-Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in
men with prostatic hyperplasia, and hyperthermia in infants
-See also homatropine and tropicamide
Benztropine - ans-Muscarinic antagonist
-Works in CNS
-Used in Parkinson disease and acute dystonia
Glycopyrrolate - ans-Muscarinic antagonist
-Parental use: preoperative use to reduce airway secretions
-Oral use: drooling, peptic ulcer
Hyoscyamine - ans-Muscarinic antagonist
,The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
-Antispasmodics for IBS
Dicyclomide - ans-Muscarinic antagonist
-Antispasmodics for IBS
Ipratropium - ans-Muscarinic antagonist
-Used in COPD and asthma
Tiotropium - ans-Muscarinic antagonist
-Used in COPD and asthma
Oxybutynin - ans-Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Solifenacin - ans-Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Tolterodine - ans-Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Scopalamine - ans-Muscarinic antagonist
-Motion sickness
Tetrodotoxin - ans-Poisoning can result from ingestion of poorly prepared puffer fish (exotic
sushi)
-Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue,
preventing depolarization - blocks action potential without changing resting potential (same
mechanism as Lidocaine)
-Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes.
-Treatment is primarily supportive.
Ciguatoxin - ans-Consumption of reef fish (e.g. barracuda, snapper, eel...)
-Causes ciguatera fish poisoning.
-Opens Na+ channels causing depolarization. Symptoms easily confused with cholinergic
poisoning.
-Temperature-related dysesthesia (e.g., "cold feels hot; hot feels cold") is regarded as a
specific finding of ciguatera.
-Treatment is primarily supportive.
Scombroid poisoning - ans-Caused by consumption of dark-meat fish (e.g., bonito, mackerel,
mahi-mahi, tuna) improperly stored at warm temperature.
-Bacterial histidine decarboxylase converts histidine to histamine. Histamine is not degraded
by cooking.
-Acute-onset burning sensation of the mouth, flushing of face, erythema, urticaria, pruritus,
headache. May cause anaphylaxis-like presentation (i.e., bronchospasm, angioedema,
hypotension).
-Frequently misdiagnosed as allergy to fish.
-Treat supportively with antihistamines; if needed, antianaphylactics (e.g., bronchodilators,
epinephrine).
Albuterol - ans-β2 > β1 direct agonist
-Acute asthma
, The Pharmacology Nursing Playbook: A
Comprehensive Guide to Mastering Medications
and Patient Care.
Top Rated Exam Study Guide to Excel in
Pharmacology Exam with Grade A+.
Latest Updated 2025/2026 Exam Study Guide
2025/2026
Salmterol - ans-β2 > β1 direct agonist
-Long term asthma or COPD control
Dobutamine - ans-β1 > β2, α direct agonist
-Uses: heart failure (HF) (inotropic > chronotropic), cardiac stress testing.
Dopamine - ans-D1 = D2 > β > α direct agonist
-Uses: unstable bradycardia, HF, shock; inotropic and chronotropic α effects predominate at
high doses.
Epinephrine - ans-β > α direct agonist
-Uses: anaphylaxis, asthma, open-angle glaucoma;
α effects predominate at high doses. Significantly stronger effect at β2-receptor than
norepinephrine.
Isoprterenol - ans-β1 = β2 direct agonist
-Uses: electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia
Norepinephrine - ans-α1 > α2 > β1 direct agonist
-Hypotension (butrenal perfusion). Significantly weaker effect at β2-receptor than
epinephrine.
Phenylephrine - ans-α1 > α2 direct agonist
-Uses: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
Amphetamine - ans-Indirect general sympathetic agonist
-reuptake inhibitor; also releases stored catecholamines
-Narcolepsy, obesity, ADHD.
Cocaine - ans-Indirect general sympathetic agonist
-Reuptake inhibitor
-Causes vasoconstriction and local anesthesia.
-Never give β-blockers if cocaine intoxication is
suspected (can lead to unopposed α1 activation and extreme hypertension).
Ephedrine - ans-Indirect general sympathetic agonist
-Releases stored catecholamines
-Nasal decongestion, urinary incontinence, hypotension.
Norepinephrine vs. isoproterenol - ans-Norepinephrine increases systolic and diastolic
pressures as a result of α1-mediated vasoconstriction causing increased in mean arterial
pressure and reflex bradycardia. -However, isoproterenol (no longer commonly used) has
little α effect but causes β2-mediated vasodilation, resulting in decreased mean arterial
pressure and increased heart rate through β1 and reflex activity.
Clonidine - ans-α2-agonist
-Uses: hypertensive urgency (limited situations); does not decrease renal blood flow; ADHD,
Tourette syndrome
-Toxicity: CNS depression, bradycardia, hypotension, respiratory depression, miosis
α-methyldopa - ans-α2-agonist
-Used for hypertension in pregnancy
-Toxicity: Direct Coombs ⊕ hemolysis, SLE-like syndrome
