Autonamic Pharmocology - copy SW

Organophosphate Poisoning causes the inhibition of acetylcholinesterase (AChE), an accumulation of acetylcholine (ACh), and profound parasympathetic effects. What class of drugs would be used to reverse these effects?

Anticholinergics

In parasympathetic nervous action, the binding of acetylcholine at nicotinic receptors produces: a. A blocking of the effector organ b. A relaxation of the effector organ c. An inhibition of the effector organ d. An excitatory response in the effector organ

I know its not b. A relaxation of the effector organ

Atropine works by occupying muscarinic receptor sites thus reducing the muscarinic response to acetylcholine. This has the effect of:

Increased heart rate and dilated pupils

What two types of receptor sites are found at cholinergic synapses?

Muscarinic and nicotinic

Your patient is 6 months pregnant. She is having an allergic reaction to a bee sting. Her husband hesitated to administer her epinephrine auto injector because he was told that it can cause premature labor. You should a. contact medical control and ask for instructions. b. administer an antihistamine and transport emergently. c. administer epinephrine. d. administer oxygen and transport emergently.

NOT: b. administer an antihistamine and transport emergently.

Parasympathetic ganglia lie close to or within the walls of the effector organ they target. The anatomical gap between neurons is known as the: a. Cleft b. Crevice c. Synapse d. Myelin sheath

Synapse

The space that exists between nerve cells is known as the

Synapse

You are dispatched to a pediatric drowning. While treating this apneic patient, you administer drugs with alpha stimulating properties. Because of alpha stimulating drugs, what effect would you anticipate regarding the patient's pupil response?

The pupils would be dilated

Stimulation of ___________ receptors results in peripheral vasoconstriction, mild bronchoconstriction, and stimulation of metabolism. a. Alpha1 b. Alpha2 c. Beta1 d. Beta2

a. Alpha1

Physostigmine (Antilirium) is a useful antidote for which drug overdose? a. Atropine b. Dopamine c. Norepinephrine d. Epinephrine

a. Atropine

You are caring for a 45-year-old male patient who was tending to his fruit orchard when he suddenly developed headache, dizziness, blurred vision, and tremors. You note that he was incontinent of urine, has pupillary constriction, and is salivating excessively. Which of the following medications would be most appropriate to manage this patient? a. Atropine sulfate b. Physostigmine c. Diazepam d. Ipratropium bromide

a. Atropine sulfate

__________ are used to mimic the actions of the sympathetic nervous system. a. Catecholamines b. Inotropic agents c. Parasympathomimetics d. Sympatholytics

a. Catecholamines

Which of the following is a property of a reversible cholinesterase inhibitor? a. Enables parasympathetic stimulation for a finite period b. Blocks sympathetic stimulation for a finite period c. Blocks parasympathetic stimulation for a finite period d. Enables sympathetic stimulation for a finite period

a. Enables parasympathetic stimulation for a finite period

Beta receptors are subdivided into two categories: beta-1 and beta-2 receptors. Beta-1 receptors are located primarily: a. In the heart b. In the brain c. In the lungs d. In the peripheral vascular system

a. In the heart

If a drug were to block the nicotinic receptors at the neuromuscular junction, what symptomatic effect might this have on the patient? a. Inability to move voluntary and involuntary muscles b. Decrease in heart rate c. Increase in gastric motility d. Pupillary constriction

a. Inability to move voluntary and involuntary muscles

The chief physiologic effect of nerve gas, such as VX, is to: a. Irreversibly block the enzyme acetylcholinesterase b. Competitively block the nicotinic receptor sites at the neuromuscular junction c. Competitively block the muscarinic receptor sites at the target organs d. Produce an adrenergic blockade throughout the body

a. Irreversibly block the enzyme acetylcholinesterase

Atropine is classified as a parasympathetic blocker. How does this drug affect the parasympathetic nervous system? a. It blocks muscarinic receptor sites in the heart thus increasing the heart rate. b. It stimulates both muscarinic and nicotinic receptor sites in the heart thus slowing the heart rate. c. It stimulates muscarinic receptor sites while blocking the nicotinic receptor sites thus slowing the heart rate. d. It blocks both muscarinic and nicotinic receptor sites for the heart and smooth muscles of the gastrointestinal tract.

a. It blocks muscarinic receptor sites in the heart thus increasing the heart rate.

The space that exists between nerve cells is known as the: a. Synapse b. Postganglionic region c. Preganglionic region d. Neuroeffector junction

a. Synapse

The nervous system is divided into two anatomical systems. These are

a. The brain and the spinal cord b. Cranial nerves and peripheral nerves c. The central and peripheral nervous systems d. The sympathetic and parasympathetic nervous systems Incorrect

An important physiologic distinction between the sympathetic and parasympathetic divisions of the autonomic nervous system is: a. The sympathetic ganglia are close to the spinal cord b. Only the sympathetic division innervates the target organs or tissue directly c. The parasympathetic nervous system contains no ganglionic fibers d. The sympathetic division does not use acetylcholine as a neurotransmitter Incorrect

a. The sympathetic ganglia are close to the spinal cord b. Only the sympathetic division innervates the target organs or tissue directly c. The parasympathetic nervous system contains no ganglionic fibers d. The sympathetic division does not use acetylcholine as a neurotransmitter Incorrect

Which of the following is NOT associated with the sympathetic nervous system? a. Vagus nerve b. Adrenergic c. Thoracolumbar d. Fight or flight

a. Vagus nerve

After acetylcholine (ACh) is synthesized and used by the body: a. acetylcholinesterase breaks the ACh down into choline and acetate. b. it arrives at the nerve ending, where it stimulates voltage-sensitive channels. c. the physiologic effects of tachycardia and hypertension are observed.

a. acetylcholinesterase breaks the ACh down into choline and acetate.

The two major types of peripheral nerves are the: a. afferent and efferent nerves b. sensory and afferent nerves. c. motor and efferent nerves. d. spinal and cranial nerves.

a. afferent and efferent nerves

Emergency medications that affect the heart and blood vessels do so via the: a. autonomic nervous system. b. somatic nervous system. c. involuntary nervous system. d. parasympathetic nervous system

a. autonomic nervous system.

In order to cause a negative inotropic effect on the heart, you would have to administer a/an: a. beta-1 adrenergic antagonist. b. alpha-2 adrenergic agonist. c. beta-2 adrenergic agonist. d. alpha-1 adrenergic antagonist.

a. beta-1 adrenergic antagonist.

A medication that possesses a negative chronotropic effect will: a. cause a decrease in the heart rate. b. cause an increase in blood pressure. c. decrease myocardial contractile force. d. increase cardiac electrical conduction velocity.

a. cause a decrease in the heart rate.

Your patient is 6 months pregnant. She is having an allergic reaction to a bee sting. Her husband hesitated to administer her epinephrine autoinjector because he was told that it can cause premature labor. You should a. contact medical control and ask for instructions. b. administer an antihistamine and transport emergently. c. administer epinephrine. d. administer oxygen and transport emergently

a. contact medical control and ask for instructions.

muscarinic cholinergic antagonists: a. include medications such as atropine and cause an increase in heart rate. b. cause excessive salivation and lacrimation and decrease the heart rate. c. are found in pesticides and effectively deactivate acetylcholinesterase. d. include medications such as epinephrine and cause an increase in blood pressure.

a. include medications such as atropine and cause an increase in heart rate.

Which of the following is NOT associated with the parasympathetic division of the autonomic nervous system? a. Thoracolumbar b. Craniosacral c. Vagal tone d. Cholinergic

a. thoracolumbar

Shortly after you have treated a patient who was experiencing a cardiac dysrhythmia, the patient complains of dry mouth, blurred vision, palpitations, and sensitivity to light. Which of the following drugs is most likely to cause these effects?

atropine

The neurotransmitter responsible for transmitting impulses through somatic nerves is: a. Norepinephrine b. Acetylcholine c. Dopamine d. Acetylcholinesterase

b. Acetylcholine

The neurotransmitter responsible for transmitting impulses through somatic nerves is: a. Norepinephrine b. Acetylcholine c. Dopamine d. Acetylcholinesterase

b. Acetylcholine

Receptors located on organs located throughout the body that are stimulated by the release of norepinephrine and epinephrine are known as: a. Hormonal receptors b. Adrenergic receptors c. Cholinergic receptors d. Preganglionic receptors

b. Adrenergic receptors

Sympathetic nervous system stimulation that results in vasoconstriction is most likely affecting: a. Beta 2 receptor sites b. Alpha 1 receptor sites c. Beta 1 receptor sites d. Alpha 2 receptor sites

b. Alpha 1 receptor sites

Stimulation of _______________ result in an increase in heart rate, cardiac contractile force, increased automaticity, and increased conduction. a. Alpha1 b. Beta1 c. Beta2 d. Dopaminergic

b. Beta1

sympathetic nerves arising from the collateral ganglia located in the abdominal cavity, when stimulated, cause all of the following EXCEPT: a. Reduction of blood flow to abdominal organs b. Bronchodilation c. Relaxing of smooth muscle in the wall of the urinary bladder d. Release of glucose stores from the liver

b. Bronchodilation

The nervous system is divided into two major components known as the: a. The endocrine and the autonomic b. Central nervous system and peripheral nervous system c. Sympathetic and parasympathetic d. Somatic and autonomic

b. Central nervous system and peripheral nervous system

Catecholamines act directly on alpha and beta receptors. Alpha-1 stimulation is associated with: a. Dilation of smooth muscle b. Contraction of smooth muscle c. Norepinephrine releases inhibition d. Dilation of bronchial smooth muscle

b. Contraction of smooth muscle

Beta-2 receptors are located predominantly in the: a. Heart b. Lungs c. Peripheral vascular system d. Renal and mesenteric vascular systems

b. Lungs

Propranolol (Inderal) causes a ________ effect. a. Positive chronotropic b. Negative chronotropic c. Positive dromotropic d. Positive inotropic

b. Negative chronotropic

Nervous tissue that exits the autonomic ganglia and terminates in various target tissues are referred to as a. Preganglionic nerves b. Postganglionic nerves c. Autonomic nerves d. Central nervous tissue

b. Postganglionic nerves

Monoamine oxidase inhibitors (MAOIs) achieve their therapeutic effects by: a. Enhancing degradation of monoamine neurotransmitters at the synapses b. Preventing the breakdown of neurotransmitters, such as norepinephrine, in the CNS c. Enhancing the effects of monoamine oxidase at the synapse d. Blocking the norepinephrine receptor sites in the CNS

b. Preventing the breakdown of neurotransmitters, such as norepinephrine, in the CNS

A large concern during the administration of an alpha agonist is infiltration because it may cause: a. Enhanced systemic effects b. Tissue necrosis c. Excessive bleeding at the site of infiltration d. Cardiac dysrhythmias

b. Tissue necrosis

A medication that stimulates a response in a receptor site is said to be: a. synergistic. b. an agonist. c. an antagonist. d. a competitive binder.

b. an agonist.

Epinephrine stimulates beta-1 receptors, resulting in: a. an increase in gastrointestinal function. b. an increase in ventricular contractile force. c. an overall decrease in systemic blood pressure. d. decreased cardiac electrical conduction velocity.

b. an increase in ventricular contractile force.

which hormone, released from the adrenal medulla, stimulates beta-2 receptors in the lungs to promote bronchodilation? a. Albuterol b. Epinephrine c. Acetylcholine d. Methylprednisolone

b. epinephrine

The process of chemical signaling between cells is called: a. antagonism. b. neurotransmission. c. chemotransmission. d. nerve innervation.

b. neurotransmission.

When administered, epinephrine produces a/an _____________ effect. a. anticholinergic b. sympathomimetic c. sympatholytic d. parasympatholytic

b. sympathomimetic

Epinephrine stimulation of beta-2 receptors will cause: a.. bronchoconstriction. b. the airway diameter to dilate. c. vasoconstriction and hypertension. d. a decreased release of norepinephrine.

b. the airway diameter to dilate.

All preganglionic and postganglionic parasympathetic nerve fibers are stimulated by the neurotransmitter ___________ a. Epinephrine b. Norepinephrine c. Acetylcholine d. Dopamin

c. Acetycholine

The preganglionic neurotransmitter for sympathetic and parasympathetic nerve fibers is: a. Adrenalin b. Muscarine c. Acetylcholine d. Norepinephrine

c. Acetylcholine

Which adrenergic receptor controls the release of norepinephrine? a. Beta-1 b. Alpha-1 c. Alpha-2 d. Beta-2

c. Alpha-2

Which of the following medications is a cardioselective beta-blocker? a.. Propranolol b. Atenolol c. Metaproterenol d. Albuterol

c. Atenolol

Autonomic nerves exit the central nervous system into specialized areas known as the a. Peripheral nervous system b. Endocrine system c. Autonomic ganglia d. Somatic nervous system

c. Autonomic ganglia

which type of receptor binding results in increased heart rate, force of contraction and contraction velocity? a. Muscarinic b. Beta2 c. Beta1 d. Alpha

c. Beta-1

Which type of receptor binding results in increased heart rate, force of contraction and conduction velocity? a. Muscarinic b. Beta2 c. Beta1 d. Alpha

c. Beta1

administration of a nonselective beta-antagonist will most likely result in: a. Tachycardia and diaphoresis b. Increased cardiac output c. Bronchoconstriction and inhibited glycogenolysis d. Bradycardia and some bronchodilation

c. Bronchoconstriction and inhibited glycogenolysis

Fibers that release acetylcholine are known as: a. Adrenergic b. Muscarinic c. Cholinergic d. Anticholinergic

c. Cholinergic

Three naturally occurring catecholamines present in the body are: a. Sodium, potassium, and calcium b. Levophed, Adrenalin, and Intropin c. Epinephrine, norepinephrine, and dopamine d. Sodium bicarbonate, calcium chloride, and dopamine

c. Epinephrine, norepinephrine, and dopamine

Examples of synthetic catecholamines include: a. Sodium, potassium, and calcium b. Insulin, glucagon, and dextrose c. Levophed, Adrenalin, and Intropin d. Epinephrine, norepinephrine, and dopamine

c. Levophed, Adrenalin, and Intropin

The binding of acetylcholine at muscarinic receptors: a. Will always produce an excitatory response in the effector organ b. Will always produce an inhibition of the effector organ c. May produce either an excitatory response or an inhibition depending on the tissues involved d. Will either block the subsequent reuptake of muscarine or cause a massive release of muscarine into the synapse depending on the effector organ involved

c. May produce either an excitatory response or an inhibition depending on the tissues involved

When stimulated, alpha-2 receptors are responsible for: a. Dilation of smooth muscle b. Contraction of smooth muscle c. Norepinephrine release inhibition d. Dilation of bronchial smooth muscle

c. Norepinephrine release inhibition

_______ nervous system activity is associated with reduced heart rate, reduced mean arterial blood pressure and bronchoconstriction. a. Sympathetic b. Central c. Parasympathetic d. Peripheral

c. Parasympathetic

Overstimulation of the vagus nerve will mimic the effects of which class of medications? a. Antihypertensives b. Sympathomimetics c. Parasympathomimetics d. Anticholinergics

c. Parasympathomimetics

If a patient were exhibiting pupillary constriction, hypersalivation, bronchial wheezing, and bradycardia, you should suspect ________ of the ________ nervous system. a. Blockade, voluntary b. Stimulation, sympathetic c. Stimulation, parasympathetic d. Blockade, cholinergic

c. Stimulation, parasympathetic

A medication that mimics the actions of the sympathetic nervous system such as epinephrine, is known as a/an: a. Parasympathomimetic b. Parasympatholytic c. Sympathomimetic d. Sympatholytic

c. Sympathomimetic

The nervous system is divided into two anatomical systems. These are: a. The brain and the spinal cord b. Cranial nerves and peripheral nerves c. The central and peripheral nervous systems d. The sympathetic and parasympathetic nervous systems

c. The central and peripheral nervous systems

Your 63 year old patient has a history of cardiac arrhythmia and hypertension. She is dizzy and is seeing "yellow halos." She takes digoxin (an antiarrhythmic) and metoprolol (a Beta-Blocker) and was recently diagnosed with renal failure. Her vital signs are: HR 48 with second degree, type 2 AV block; BP 108/64; and R 18. What is the likely cause of her symptoms? a. The patient has overdosed on her medications. b. The patient is experiencing antagonism between the two medications. c. The patient's renal failure makes her susceptible to "dig toxicity" due to decreased renal filtration. d. The patient may have undiagnosed heart failure that has decreased her cardiac output resulting in less circulating medication.

c. The patient's renal failure makes her susceptible to "dig toxicity" due to decreased renal filtration

The neurotransmitter at the junction of the parasympathetic postganglionic fiber and the effector cell is: a. Norepinephrine b. Muscarine c. Acetylcholine d. Acetylcholinesterase

c. acetylcholine

Functionally, the nervous system is divided into the: a. brain and spinal cord. b. somatic and autonomic nervous system. c. central and peripheral nervous system. d. sympathetic and parasympathetic nervous system.

c. central and peripheral nervous system

Sympatholytic medications: a. selectively block alpha receptors. b. produce tachycardia and hypertension. c. inhibit the sympathetic nervous system. d. stimulate the sympathetic nervous system.

c. inhibit the sympathetic nervous system.

which of the following foods should a pt on MAOIs avoid?

cheese

fibers that release Ach are known as:

cholinergic

What are the two structural categories found at adrenergic receptor sites within the membrane of the effector organ? a. Muscarinic and nicotinic b. Adrenergic and cholinergic c. Cholinergic and anticholinergic d. Alpha and beta adrenergic receptors

d. Alpha and beta adrenergic receptors

Shortly after you have treated a patient who was experiencing a cardiac dysrhythmia, the patient complains of dry mouth, blurred vision, palpitations, and sensitivity to light. Which of the following drugs is most likely to cause these effects? a. Adenosine b. Lidocaine c. Amiodarone d. Atropine

d. Atropine

Which classification of drugs affecting the autonomic nervous system would be best suited to treat a patient with spinal shock? a. Alpha antagonist b. Alpha agonist c. Beta antagonist d. Beta agonist

d. Beta agonist

The heart, many glands, and smooth muscles are innervated by: a. Sympathetic nerve fibers only b. Parasympathetic nerve fibers only c. Both cholinergic and anticholinergic nerve fibers d. Both parasympathetic and sympathetic nerve fibers

d. Both parasympathetic and sympathetic nerve fibers

The neurotransmitter at the junction of the sympathetic postganglionic fiber and the effector cell is: a. Adrenalin b. Muscarine c. Acetylcholine d. Norepinephrine

d. Norepinephrine

The branch of the autonomic nervous system that controls vegetative functions such as digestion of food, is the: a. Sympathetic b. Somatic c. Central d. Parasympathetic

d. Parasympathetic

Stimulation of ________________ results in pupillary constriction, digestive gland secretion, bronchoconstriction, and reduction in heart rate and contractile force. a. Sympathetic ganglia b. Adrenal gland c. Somatic nervous system d. Parasympathetic nervous system

d. Parasympathetic nervous system

Where are alpha-1 receptors located? a. In the brain only b. Presynaptic nerve endings c. In the brain and heart only d. Postsynaptic, on the effector organ

d. Postsynaptic, on the effector organ

Where are alpha-2 receptors located? a. In the heart only b. Presynaptic nerve endings c. Postsynaptic, on the effector organ d. Presynaptic and postsynaptic nerve endings

d. Presynaptic and postsynaptic nerve endings

Beta-adrenergic antagonists reduce hypertension through all of the following effects, EXCEPT: a. Diminishing reflex tachycardia as a compensatory response b. Suppressing renin release from the kidneys c. A negative inotropic effect d. Reduction of peripheral vascular resistance through vasodilation

d. Reduction of peripheral vascular resistance through vasodilation

The use of tobacco, because of its nicotine content, may cause subtle symptoms due to stimulation of the: a. Parasympathetic division of the autonomic nervous system b. Nicotinic receptor sites at the neuromuscular junction in the sympathetic nervous system c. Sympathetic division of the autonomic nervous system d. Sympathetic and parasympathetic divisions of the autonomic nervous system

d. Sympathetic and parasympathetic divisions of the autonomic nervous system

Which two divisions of the nervous system function continuously, stimulate many of the same organs, and oppose each other in an attempt to maintain balance? a. The effector and reactor nervous systems b. The central and peripheral nervous systems c. The somatic and autonomic nervous systems d. The parasympathetic and sympathetic nervous systems

d. The parasympathetic and sympathetic nervous systems

Nicotinic receptors are stimulated by ______________, resulting in: a. acetylcholinesterase; bradycardia, hypotension, and weakness. b. epinephrine; hypertension, tachycardia, and pupillary dilation. c. norepinephrine; vasoconstriction, bradycardia, and fasciculations. d. acetylcholine; tachycardia, hypertension, and pupillary dilation.

d. acetylcholine; tachycardia, hypertension, and pupillary dilation.

Stimulation of the sympathetic nervous system produces all of the following effects, EXCEPT: a. increases in the heart rate and blood pressure. b. a release of energy stores throughout the body. c. dilation of the bronchioles and pupils. d. diversion of blood flow to the periphery of the body.

d. diversion of blood flow to the periphery of the body.

________ results in direct stimulation of the adrenal medulla resulting in the release of epinephrine (adrenalin) and norepinephrine (noradrenalin) a. Collateral stimulation b. Parasympathetic stimulation c. Endocrine stimulation d. Sympathetic stimulation

d. sympathetic stimulation

The purpose of a neurotransmitter is a. chemical transport. b. message propagation. c. to block transmission of an impulse across the synapse. d. to allow transmission of an impulse across the synapse.

d. to allow transmission of an impulse across the synapse.

stimulation of the sympathetic nervous system produces all of the following effects, EXCEPT:

diversion of blood flow to the periphery of the body.

When a medication alters the velocity of the conduction of electricity through the heart, it is said to have a/an _______ effect:

dromotropic

stimulation of _______ results in pupillary constriction, digestive gland secretion, bronchoconstriction, and reduction in heart rate and contractile force.

parasympathetic nervous system

Autonamic nerves exit the central nervous system into specialized areas known as the:

peripheral nervous system

norepinephrine is the primary neurotransmitter for which of the following?

sympathetic nervous system, post-ganglionic neurons

The parasympathetic nervous system is

the dominant system during rest and relaxation

A large concern during the administration of an alpha agonist in infiltration because it may cause:

tissue necrosis