adrenergic agonists MCQ
A group of volunteers are involved in a phase 1 clinical trial of a new autonomic drug. When administered by intravenous bolus, the blood pressure increases. When given orally for 1 week, the blood pressure decreases. Which of the following standard agents does the new drug most resemble? (A) Atropine (B) Clonidine (C) Phentolamine (an α blocker) (D) Phenylephrine (E) Propranolol (a β blocker)
(B) Clonidine
If this child has signs of anaphylaxis, what is the treatment of choice? (A) Diphenhydramine (an antihistamine) (B) Ephedrine (C) Epinephrine (D) Isoproterenol (E) Methylprednisolone (a corticosteroid)
(C) Epinephrine
Your 30-year-old patient has moderately severe new onset asthma, and the physician prescribes a highly selective β2 agonist inhaler to be used when needed. In considering the possible drug effects in this patient, you would note that β2 stimulants can cause (A) Direct stimulation of renin release (B) Hypoglycemia (C) Itching due to increased cGMP (cyclic guanine monophosphate) in mast cells (D) Skeletal muscle tremor (E) Vasodilation in the skin
(D) Skeletal muscle tremor - albuterol side effect
Which of the following are probable signs of the anaphylactic reaction to bee stings? (A) Bronchodilation, tachycardia, hypertension, vomiting, diarrhea (B) Bronchospasm, tachycardia, hypotension, laryngeal edema (C) Diarrhea, bradycardia, vomiting (D) Laryngeal edema, bradycardia, hypotension, diarrhea (E) Miosis, tachycardia, vomiting, diarrhea
B) Bronchospasm, tachycardia, hypotension, laryngeal edema -reflex tachycardia due to hypotension, otherwise all parasympathetic effects
Which of the following statements is not correct? a) Epinephrine acts on both alpha- and beta-receptors b) Norepinephrine has a predominantly beta action c) Phenylephrine has a predominantly alpha action d) Isoproterenol has a predominantly beta action
B)Norepinephrine has a predominantly beta action -mixed alpha and beta agonist
Characteristics of dobutamine include all of the following EXCEPT: a) It is a relatively beta1-selective synthetic catecholamine b) It is used to treat bronchospasm - it treats heart failure c) It increases atrioventricular conduction d) It causes vasodilation in renal blood vessels by acting on D1 receptors.
Two answers: b) It is used to treat bronchospasm - it treats heart failure d) It causes vasodilation in renal blood vessels by acting on D1 receptors.
Which of the following statement is not correct? a) Alpha agonists cause miosis b) Alpha agonists cause mydriasis c) Beta antagonists decrease the production of aqueous humor d) Alpha agonists increase the outflow of aqueous humor from the eye
a) Alpha agonists cause miosis
In which of the following tissues both alpha and beta1 adrenergic stimulation produces the same effect? a) Blood vessels b) Intestine c) Uterus d) Bronchial muscles
a) Blood vessels - This is a hard one. Beta1 receptors on kidney promote renin release, which increases blood pressure. Alpha1 receptor activation increases vascular resistance too.
Epinephrine produces all of the following effects EXCEPT: a) Decrease in oxygen consumption b) Bronchodilation c) Hyperglycemia d) Mydriasis
a) Decrease in oxygen consumption -increase in HR cycles blood faster and more oxygen uptake
The adverse effects of sympathomimetics include all of the following EXCEPT: a) Drug-induced parkinsonism b) Cerebral hemorrhage or pulmonary edema c) Myocardial infarction d) Ventricular arrhythmias
a) Drug-induced parkinsonism
Catecholamine includes the following EXCEPT: a) Ephedrine b) Epinephrine c) Isoproterenol d) Norepinephrine
a) Ephedrine - no catechol
Indicate the sympathomimetic agent, which is combined with a local anesthetic to prolong the duration of infiltration nerve block: a) Epinephrine b) Xylometazoline c) Isoproterenol d) Dobutamine
a) Epinephrine
Which of the following sympathomimetics is used in the therapy of bronchial asthma? a) Formoterol b) Norepinephrine c) Methoxamine d) Dobutamine
a) Formoterol -beta 2 selective, long acting
Distribution of alpha adrenoreceptor subtypes is associated with all of the following tissues except those of: a) Heart b) Blood vessels c) Prostate d) Pupillary dilator muscle
a) Heart - only upregulation in heart disease
Compared with epinephrine, ephedrine produces all of the following features EXCEPT: a) It is just a direct-acting sympathomimetic b) It has oral activity c) It is resistant to MAO and has much longer duration of action d) Its effects are similar to epinephrine, but it is less potent
a) It is just a direct-acting sympathomimetic
Which of the following effects is associated with beta3-receptor stimulation? a) Lipolysis b) Decrease in platelet aggregation c) Bronchodilation d) Tachycardia
a) Lipolysis
Indicate the drug, which is a direct-acting both alpha- and beta-receptor agonist: a) Norepinephrine b) Methoxamine c) Isoproterenol d) Ephedrine
a) Norepinephrine
Which of the following topical decongestant agents is an alpha1-selective agonist? a) Phenylephrine b) Clonidine c) Ephedrine d) Epinephrine
a) Phenylephrine
Beta2 receptor stimulation includes all of the following effects EXCEPT: a) Stimulation of renin secretion b) Fall of potassium concentration in plasma c) Relaxation of bladder, uterus d) Tachycardia
a) Stimulation of renin secretion
Which of the following sympathomimetics is a beta2-selective agonist? a) Terbutaline b) Xylometazoline c) Isoproterenol d) Dobutamine
a) Terbutaline
Beta1 receptor stimulation includes all of the following effects EXCEPT: a) Increase in heart contractility b) Bronchodilation c) Tachycardia d) Increase in conduction velocity in the atrioventricular node
b) Bronchodilation
Ephedrine causes: a) Miosis b) Bronchodilation c) Hypotension d) Bradycardia
b) Bronchodilation
Which of the following agents is an alpha2-selective agonist? a) Norepinephrine b) Clonidine c) Ritodrine d) Ephedrine
b) Clonidine
Indicate the beta1-selective agonist: a) Isoproterenol b) Dobutamine c) Metaproterenol d) Epinephrine
b) Dobutamine
Which of the following sympathomimetics is preferable for the emergency therapy of cardiogenic shock? a) Ephedrine b) Dobutamine -beta1 agonist so specific to the heart c) Isoproterenol d) Methoxamine
b) Dobutamine -beta1 agonist so specific to the heart
A nonselective beta receptor agonist causes all of the following effects EXCEPT: a) Increase cardiac output b) Increase peripheral arterial resistance c) Decrease peripheral arterial resistance d) Decrease the mean pressure
b) Increase peripheral arterial resistance - Isoproterenol example
Characteristics of oxymetazoline include all of the following EXCEPT: a) It is a direct-acting alpha1-receptor agonist b) It increases heart rate, contractility and cardiac output c) It causes reflex bradycardia d) It increases total peripheral resistance
b) It increases heart rate, contractility and cardiac output
Characteristics of epinephrine include all of the following EXCEPT: a) It is synthesized into the adrenal medulla b) It is mainly synthesized into the nerve ending c) It is transported in the blood to target tissues d) It directly interacts with and activates adrenoreceptors
b) It is mainly synthesized into the nerve ending (I think she meant "in")
Which of the following sympathomimetics is an effective mydriatic? a) Salmeterol b) Phenylephrine c) Dobutamine d) Norepinephrine
b) Phenylephrine -alpha1 pupillary dilator muscle
Which of the following drugs causes bronchodilation without significant cardiac stimulation? a) Isoproterenol b) Terbutaline c) Xylometazoline d) Clonidine
b) Terbutaline -Beta2 selective
Epinephrine decreases intracellular cAMP levels by acting on: a) α1 receptor b) α2 receptor c) beta1 receptor d) beta2 receptor
b) α2 receptor
Direct effects on the heart are determined largely by: a) Alpha1 receptor b) Alpha2 receptor c) Beta1 receptor d) Beta2 receptor
c) Beta1 receptor
Isoproterenol produces all of the following effects EXCEPT: a) Increase in cardiac output b) Fall in diastolic and mean arterial pressure c) Bronchoconstriction d) Tachycardia
c) Bronchoconstriction
Indicate the indirect-acting sympathomimetic agent: a) Epinephrine b) Phenylephrine c) Ephedrine d) Isoproterenol
c) Ephedrine
Which of the following sympathomimetics acts indirectly? a) Epinephrine b) Norepinephrine c) Ephedrine d) Methoxamine
c) Ephedrine - releases catecholamines, inhibits MAO, as well as direct activation of alpha and beta adrenoreceptors
Indicate the sympathomimetic, which may be useful in the emergency management of cardiac arrest: a) Methoxamine b) Phenylephrine c) Epinephrine d) Xylometazoline
c) Epinephrine
Which of the following agents is an alpha1, alpha2, beta1, and beta2 receptor agonist? a) Methoxamine b) Albuterol c) Epinephrine d) Norepinephrine
c) Epinephrine
A relatively pure alpha agonist causes all of the following effects EXCEPT: a) Increase peripheral arterial resistance b) Increase venous return c) Has no effect on blood vessels d) Reflex bradycardia
c) Has no effect on blood vessel
Indirect action includes all of the following properties EXCEPT: a) Displacement of stored catecholamines from the adrenergic nerve ending b) Inhibition of reuptake of catecholamines already released c) Interaction with adrenoreceptors d) Inhibition of the metabolism of endogenous catecholamines from peripheral adrenergic neurons
c) Interaction with adrenoreceptors
Which of the following agents is a nonselective beta receptor agonist? a) Norepinephrine b) Terbutaline c) Isoproterenol d) Dobutamine
c) Isoproterenol
Characteristics of salmeterol include all of the following EXCEPT: a) It is a potent selective beta2 agonist b) It causes uterine relaxation c) It stimulates heart rate, contractility and cardiac output d) It is used in the therapy of asthma
c) It stimulates heart rate, contractility and cardiac output
Which of the following sympathomimetics is preferable for the treatment of chronic orthostatic hypotension? a) Epinephrine b) Norepinephrine c) Midodrine d) Salmeterol
c) Midodrine - alpha1 agonist
Which of the following sympathomimetics is related to short-acting topical decongestant agents? a) Albuterol b) Terbutaline c) Phenylephrine d) Norepinephrine
c) Phenylephrine - alpha1
Which of the following direct-acting drugs is a relatively pure alpha agonist, an effective mydriatic and decongestant and can be used to raise blood pressure? a) Epinephrine b) Norepinephrine c) Phenylephrine d) Ephedrine
c) Phenylephrine - alpha1 agonist
Beta adrenoreceptor subtypes are contained in all of the following tissues EXCEPT: a) Bronchial muscles b) Heart c) Pupillary dilator muscle d) Fat cells
c) Pupillary dilator muscle - a beta antagonist will decrease aqueous humor outflow however
Which of the following effects is related to direct beta1-adrenoreceptor stimulation? a) Bronchodilation b) Vasodilatation c) Tachycardia d) Bradycardia
c) Tachycardia
Epinephrine produces all of the following effects EXCEPT: a) Positive inotropic and chronotropic actions on the heart (beta1 receptor) b) Increase peripheral resistance (alpha receptor) c) Uterine contraction d) Skeletal muscle blood vessel dilatation (beta2 receptor)
c) Uterine contraction - beta2 receptors cause relaxation
All of the following agents are beta receptor agonists EXCEPT: a) Epinephrine b) Isoproterenol c) oxymetazoline d) Dobutamine
c) oxymetazoline - alpha agonist, a nasal decongestant
Sympathetic stimulation is mediated by: a) Release of norepinephrine from nerve terminals b) Activation of adrenoreceptors on postsynaptic sites c) Release of epinephrine from the adrenal medulla d) All of the above
d) All of the above
The effects of sympathomimetics on blood pressure are associated with their effects on: a) The heart rate b) The peripheral resistance c) The cardiac output d) All of the above
d) All of the above
Hyperglycemia induced by epinephrine can be due to: a) Gluconeogenesis (beta2) b) Inhibition of insulin secretion (alpha2) c) Stimulation of glycogenolysis (beta2) d) All of the above
d) All of the above - all of these mechanisms serve to increase plasma glucose
A bronchial smooth muscle contains: a) Alpha1 receptor b) Alpha2 receptor c) Beta 1 receptor d) Beta 2 receptor
d) Beta 2 receptor
Indicate the agent of choice in the emergency therapy of anaphylactic shock: a) Methoxamine b) Terbutaline c) Phenylephrine d) Epinephrine
d) Epinephrine
Indicate the sympathomimetic, which may cause hypotension, presumably because of a clonidine-like effect: a) Epinephrine b) Phenylephrine c) Xylometazoline d) Isoproterenol
d) Isoproterenol - beta1,2 agonist increases HR, which decreases blood pressure reflexively "Isoproterenol is a nonselective β agonist; it activates both β1 and β2 receptors. The net effect is to maintain or slightly increase systolic pressure and to lower diastolic pressure, so that mean blood pressure is decreased (Figure 9-6)." -Katzung
Characteristics of ephedrine include all of the following EXCEPT: a) It acts primarily through the release of stored cathecholamines b) It is a mild CNS stimulant c) It causes tachyphylaxis (lessening of drug effect with repeated doses) with repeated administration d) It decreases arterial pressure
d) It decreases arterial pressure
Which of the following statements is not correct? a) Alpha receptors increase arterial resistance, whereas beta2 receptor promote smooth muscle relaxation b) The skin and splanchnic vessels have predominantly alpha receptors c) Vessels in a skeletal muscle may constrict or dilate depending on whether alpha or beta2 receptors are activated d) Nasal mucosa blood vessels have predominantly beta receptors and constrict in the presence of epinephrine and norepinephrine
d) Nasal mucosa blood vessels have predominantly beta receptors and constrict in the presence of epinephrine and norepinephrine - (alpha receptors predominantly)
Isoproterenol is: a) Both an alpha- and beta-receptor agonist b) beta1-selective agonist c) beta2-selective agonist d) Nonselective beta receptor agonist
d) Nonselective beta receptor agonist
Indicate the direct-acting sympathomimetic, which is an alpha1, alpha2, and beta1 receptor agonist: a) Isoproterenol b) Ephedrine c) Dobutamine d) Norepinephrine
d) Norepinephrine
Epinephrine is used in the treatment of all of the following disorders EXCEPT: a) Bronchospasm b) Anaphylactic shock c) Cardiac arrhythmias d) Open-angle glaucoma
d) Open-angle glaucoma
Indicate the sympathomimetic drug, which is used in a neurogenic hypotensive emergency: a) Xylometazoline b) Ephedrine c) Terbutaline d) Phenylephrine
d) Phenylephrine
Indicate the long-acting topical decongestant agents: a) Epinephrine b) Norepinephrine c) Isoproterenol d) Xylometazoline
d) Xylometazoline - alpha1
