pharmacology exam

Which of these drugs is considered specific alpha adrenergic agents? A) epinephrine B)phenylephrine C)isoproterenol

B

which of these would be useful in pulmonary function lab before and after bronchodialator therapy? A) bitolterol B)isoetharine C)albuterol

B

What neurotransmitter is used for both the sympathetic and parasympathetic nervous system?

acetylcholine (ACH)

ATP is broken down into cyclic-AMP by what enzyme?

adenyl cyclase

What is a type of saligenin bronchodialator?

albuterol

Give examples of beta agonists

albuterol, isoetharine, epinephrine

which of these is given by MDI? a. albuterol b. bitolterol c. terbutaline d.metaproterenol e. all of the above

all of the above

Which response in the sympathetic nervous system is responsible for decreasing airway edema?

alpha stimulation

which response in the sympathetic nervous system is responsible for elevating blood pressure through vasoconstriction?

alpha stimulation

What is the name of the xanthine used in the ER/ ICU through an IV?

aminophylline

What are two examples of xanthines and how are they administered?

aminophylline- IV in ER/ICU theophylline- orally preferred xanthine used as bronchodilator

ipratropium bromide and atropine are what type of drug?

anti-cholinergic

What is the prototype drug in the category anticholinergics?

atropine

bronchial smooth muscle are apart of which branch of the nervous system?

autonomic nervous system because we cannot control them

why do catecholamines cause side effects?

because they stimulate beta- one receptors which cause cardiac stimulation

What drugs increase sympathetic stimulation?

beta adrenergic drugs or beta agonists

What drugs result in a greater supply of cyclic- AMP, therefore causing bronchodilation?

beta adrenergic/ beta agonists -albuterol -metaproterenol -isoetharine

Which category of bronchodilators acts by stimulating adenyl cyclase to increase cyclic-AMP?

beta agonists

which receptors need to be stimulated to cause cardiac acceleration?

beta-one

which response in the sympathetic nervous system is responsible for accelerating both cardiac rate and contractility?

beta-one stimulation

which response in the sympathetic nervous system is responsible for promoting bronchodialation?

beta-two stimulation

what is an example of a Prodrug?

bitolterol

Whenever cyclic-AMP is greater than cyclic-GMP _____ occurs and if cyclic-GMP is greater ______ occurs.

bronchodiation brochospasm

An increase in the intra-cellular mediator cyclic-AMP correlates with?

bronchodilation

What effects do xanthines have?

bronchodilation pulmonary vasodilation cardiac stimulation diuresis cerebral stimulation skeletal muscle stimulation

how is bitolterol administered?

by MDI

what is another name for the sympathetic nervous system?

cholinergic

Where the parasympathetic uses acetylcholine at the synapse is referred to as?

cholinergic system

xanthines include compounds such as?

coffee (caffeine) cola (caffeine) tea (theophylline) cocoa (theobromine)

Cyclic-GMP correlates with ___ of bronchial smooth muscle

constriction

What are the effects of the parasympathetic nervous system?

decreased HR, digestion, increases peristalsis

What is the desired effect in using an alpha adrenergic agent in cases of upper airway edema?

decreased mucosal edema

epinephrine is most commonly used where? and for what?

during emergency treatments; for anaphylactic shock and allergic reactions

which two drugs have alpha, beta- one and beta- two activity?

epinephrine and racemic epinephrine

Where are alpha receptors found and what do they cause?

found in smooth muscles such as blood vessels and cause an increase in contractile activity resulting in vasoconstriction

An allergic reaction releases what into the airways?

histamine

Give an example of how cyclic-GMP can be increased and promote bronchospasm

histamine release because of allergies and vagus nerve stimulation because of suctioning

Substances that promote the increase of Cyclic-GMP are?

histamine release, parasympathetic stimulation such as irritation of vagus nerve which might occur when you suction a pt.

What effect would be expect if we administer a drug such as isoproterenol, with a potent beta-one activity?

increase in HR

which of these drugs is most likely to cause tachycardia as a serious side effect associated with its administration? a. albuterol b. isoproterenol c. isoetherine

isoproterenol

once in the body what is bitolterol converted to by enzymes?

its active form. colterol

wj=hat is norepinephrine mainly used for?

its affect of blood pressure (not used to treat airway edema)

Anti-cholingergic agents have more effect ____ airways and beta adrenergics have more effect on ____ airways

larger smaller

What are the two types of resorcinol bronchodialators?

metaproterenol and terbutaline

How do xanthines cause bronchodilation?

xanthines inhibit phosphodiesterase, therefore it cannot breakdown cyclic-AMP so there is more of it present causing bronchodilation

how long can saligenin last and it is good for what type of use?

-6 hrs. -maintenance on a long term basis and is potent enough to be used in acute cases as well

When your sympathetic nervous system is in action what increases?

-HR, blood pressure, increase in ventilation

What are the three categories of drugs that decrease bronchospasms? (bronchodilators)

-beta adrenergics -anti-cholinergics -xanthines

Where the sympathetic nervous system uses norepinepherine at the synapse is referred to as?

Adrenergic system

Where are beta receptors found and what do they cause?

-beta-one are found in the heart cause an increase in HR, contraction of heart muscle, conduction of impulses through heart -beta-two are found in bronchial smooth muscle, blood vessels, and skeletal muscles and cause relaxation of smooth muscle causing bronchodialation and vasodialation

What is an example of selective beta-one drug and what is it used for?

-dobutamine -used so we can get specific cardiac activity without extra effects on the body (cardiac arrest)

what effects are associated with atropine?

-increased HR -relaxation of smooth muscle -drying of airway secretions

How are resorcinols taken and how long do they last?

-orally -last up to 6 hrs. so they are useful for maintenance therapy on a long term basis

What are the 2 branches of the autonomic nervous system?

-sympathetic -parasympathetic

What do sympatholytics and parasympatholytics(anti-cholinergic agents) do?

-sympatholytics block norepinephrine -parasympatholytics block acetylcholine

What type of drugs mimic the affects of the sympathetic and parasympathetic nervous systems?

-sympathomimetics -parasympathomimetic

What is a normal adult dose of atropine?

1-2 mgm four times a day via hand held nebulizer

what are 3 types of catecholamine sympathomimetic bronchodilators?

1. isoproterenol 2. epinephrine 3. isoetharine

What is the therapeutic level of theophylline the serum?

10-20 mcg/mL

how long does bitolterol stay active?

8 hours

If we wished to increase nasal stuffiness we should administer a drug with which activity? A)alpha B)beta-one C)beta-two

A

Which of these is the longest lasting bronchodilator? A)bitolterol B)albuterol C)epinephrine

A

catecholamines are rapidly inactivated by what?

COMT ( catechol-o- methyltransferse)

What is the difference between the autonomic nervous system and the somatic nervous system?

We do not have control over the autonomic nervous system and we do have control over our somatic nervous system

What is a neurotransmitter?

a chemical mediator that transmits impulses from one nerve to another nerve or tissue

what is an example of an alpha stimulation form and how does it work?

nasal sprays; it constricts the blood vessels decreasing the amount of blood flow to the area and allows the excess edema to be absorbed by the body which eliminates the swelling

phenylephrine is a component of what? and is used for what?

nasal sprays; used for relieving nasal edema associated with allergies and common colds

Above 20 mcg/mL of theophylline an individual can develop toxic effects such as?

nausea, headaches, tachycardia followed by cardiac arrhythmias and seizures

can catecholamines be taken orally?

no. because of rapid degredation of the gut and they are inactivated by the light.

what are examples of alpha andrenergic agents?

norepinephrine and phynelephrine

how long do catecholamines work for?

one and a half to three hours at best

Give another name for the category of bronchodilators known as anti-cholinergics

parasympatholytics

What group of medications are used to prevent the breakdown of cyclic-GMP?

parasympatholytics/anti-cholinergics

What enzyme is inhibited by xanthines, causing an increase in cyclic-AMP?

phosphodiesterase

What could cause a bronchospasm?

pollen, dust, penicillin, cigarette smoke

which category of sympathomimetic bronchodilators is bitolterol? a. prodrug b. catecholamine c. resorcinol

prodrug

what is a milder form of epinephrine called and what kind of activity does it have?

racemic epinephrine; alpha activity

when are catecholamines used?

short term cases examples: emergency room management of bromchospasms or for pulmonary testing where rapid response is needed for follow up testing

bronchospasm of airways occurs due to constriction of?

smooth musvle

Norepinephrine (NE) is the neurotransmitter for which nervous system?

sympathetic

To decrease a bronchospasm you want to increase_____ stimulation?

sympathetic

Which nervous system is fight or flight?

sympathetic

If a patient has dilated pupils, hyperventilation, and tachycardia what type of drug did they take?

sympathomimetic such as epinephrine

How does the body increase ventilation during a stressful episode?

the bronchial smooth muscles relax

Smokers need greater amounts of theophylline to get the same effects as non-smokers? T/F

true

ipratropium bromide has fewer side effects than atropine? T/F

true

what is racemic epinephrine used for?

upper airway edemas examples: croup, edema from removing the ETT