Nursing 319 Exam 1 Questions With Complete Solutions

1. catecholamines - ANSWER -same biochemical structure as NE -short duration of action -must be administered parenterally 2. non catecholamines - ANSWER -can be taken orally -longer durations of action because they are not rapidly destroyed by MAO or COMT 3. direct-acting sympathomimetics - ANSWER Bind to and activate adrenergic receptors, i.e. the 3 endogenous catecholamines 4. indirect-acting sympathomimetics - ANSWER -causes the release of NE from vesicles within presynaptic terminal -*OR* by inhibits the reuptake or destruction of NE -used for central effects in the brain rather than autonomic, i.e. cocaine, amphetamine 5. alpha I drugs - ANSWER For treatment of nasal congestion or hypotension 6. alpha II drugs - ANSWER Treatment of hypertension 7. beta I drugs - ANSWER Treats cardiac arrest, heart failure, shock 8. beta II drugs - ANSWER Treatment of asthma and premature labor contractions 9. adrenergic antagonists - ANSWER -act by directly blocking adrenergic receptors -*sympatholytics* -specific to either alpha or beta blockade -most widely prescribed class 10. alpha-adrenergic antagonists (alpha blockers) - ANSWER -relaxes vascular smooth muscle, causing vasodilation and reducing bp -ability to increase urine flow by relaxing smooth muscle in the bladder neck, prostate, and urethra - treatment of BPH 11. orthostatic hypotension - ANSWER -most common adverse effect from alpha blockers occurs with abrupt change from recumbent to upright position 12. beta-adrenergic antagonists - ANSWER -decrease rate and force of contraction of the heart -slow electrical conduction through AV node -*cardio selective drugs* - actively block beta I receptors -decrease cardiac workload --ease migraine and angina pectoris pain --treatment of hypertension 13. They have little effect on noncardiac tissue - ANSWER Why are there fewer side effects with cardio selective drugs opposed to nonselective drugs? 14. Treats certain types of dysrhythmias - ANSWER Beta adrenergic antagonists slowing electrical conduction across the myocardium does what? 15. Some adverse effects of beta-adrenergic antagonists - ANSWER -may exacerbate heart failure in some patients with pre-existing myocardial conditions -increased risk of hypotension and bradycardia may occur -significant bronchial constriction 16. Acute resurgence of symptoms - ANSWER Beta adrenergic antagonists should be discontinued gradually to avoid what? 17. MAOis - ANSWER An inhibitor that keeps MAO from helping with the reuptake of NE 18. cholinergic - ANSWER Nerves releasing acetylcholine (Ach) are what kind of nerves? 19. nicotinic and muscarinic - ANSWER What are the two types of cholinergic receptors? 20. nicotinic receptors - ANSWER -located at ganglionic synapse in both PSNS and SNS -also present in skeletal muscle (somatic NS) -contraction 21. ganglionic blockers - ANSWER Produce controlled hypotension during surgery or for hypertensive emergencies 22. muscarinic receptors - ANSWER Located on target tissues affected by postganglionic neurons in PSNS 23. muscarine - ANSWER a substance obtained from poisonous mushrooms 24. heart muscarinic receptors - ANSWER On SA and AV nodes -decrease contraction and conduction, decreasing heart rate and bp 25. GI muscarinic receptors - ANSWER increased motility and peristalsis 26. gland muscarinic receptors - ANSWER increased secretions, i.e. GI secretions, salivation, sweat glands 27. smooth muscle muscarinic receptors - ANSWER bronchial constriction -enhanced urination -pupil constriction 28. parasympathomimetic (cholinergic) - ANSWER stimulation of PSNS 29. direct-acting parasympathomimetics - ANSWER -bind to cholinergic receptors to produce the rest-and-digest response -relatively resistant to destructive effects of AchE - longer duration of action than natural Ach -*muscarinic agonists* · Moderately selective to muscarinic receptors 30. indirect-acting parasympathomimetics - ANSWER inhibits action of AchE -allows endogenous Ach to avoid rapid destruction and bind with cholinergic receptors for a longer time -*cholinesterase inhibitors* -non-selective and affect all Ach sites · Autonomic ganglia, muscarinic receptors, skeletal muscle, and Ach sites in CNS 31. anticholinergic (cholinergic-blocking) - ANSWER inhibition of PSNS, inducing fight-or-flight response -drug block Ach: *muscarinic antagonists* -compete with Ach for binding with muscarinic receptors -cholinergic responses blocked at effector organs 32. parasympatholytics - ANSWER Anticholinergic or muscarinic antagonists may also be referred to as what? 33. Norepinephrine (NE) - ANSWER The neurotransmitter used by the SNS that is released from the post-ganglionic nerve terminal 34. sweat glands - ANSWER In which glands is Ach the neurotransmitter and there is no ganglion? 35. Terminates NE action - ANSWER The reuptake of NE does what? 36. catecholamine-O-methyltransferase (COMT) - ANSWER Destroys NE at the synaptic cleft 37. It may be returned to vesicles for future use or destroyed by *monoamine oxidase (MAO)* - ANSWER What happens to NE in the nerve terminal? 38. NE, epinephrine (adrenaline), dopamine - ANSWER What are the natural catecholamines? 39. isoproterenol, dobutamine - ANSWER What are the synthetic catecholamines? 40. ephedrine, phenylephrine, terbutaline - ANSWER What are the noncatecholamines? 41. adrenergic receptors - ANSWER -located at target organs -adrenaline-like responses result -some drugs are *selective* and activate only one type --others may affect more than one 42. alpha and beta - ANSWER What are the two basic types of adrenergic receptors? 43. alpha I receptors - ANSWER -located in vascular smooth muscle -works indirectly on vasculature --constriction of peripheral blood vessels > increase in vascular resistance > increase in bp -contracts radial muscle of iris > dilation of pupils -relaxation of bladder muscle, decreasing micturition -prostate contraction 44. area alpha II receptors - ANSWER -located in presynaptic -inhibits NE release, decreasing bp --negative feedback loop to regulate NE -decreases tone and motility of GI tract 45. beta I receptors - ANSWER -predominant receptor in the heart -found in nodule tissue (in lungs), conduction system, myocytes (muscle cells)