Deck 4: Autonomic Drugs

Question 1

Which of the following is true concerning the pharmacologic effects associated with cholinergic agents?

A)Tachycardia and an increase in blood pressure and cardiac output
B)Stasis of intestinal motility
C)Miosis
D)An increase in intraocular pressure

Answer 1

Miosis

Question 2

A combination of pralidoxime and atropine is used to treat an overdose of _____ inhibitors.

A)acetylcholine
B)cholinesterase
C)epinephrine
D)norepinephrine

Answer 2

cholinesterase

Question 3

In the autonomic nervous system (ANS),the target organ is innervated by the _____ neuron.

A)preganglionic afferent
B)preganglionic efferent
C)postganglionic afferent
D)postganglionic efferent

Answer 3

postganglionic efferent

Question 4

Which of the following conditions is not a relative contraindication or caution with the use of cholinergic agents?

A)Bronchial asthma
B)Hypothyroidism
C)Myasthenia gravis treated with neostigmine
D)Peptic ulcer

Question 5

Which drug would be best to treat xerostomia?

A)Atropine
B)Propranolol
C)Pilocarpine
D)Pseudoephedrine

Question 6

Which of the following agents is used in the treatment of an overdose of acetylcholinesterase inhibitors?

A)Malathion
B)Epinephrine
C)Pralidoxime
D)Physostigmine

Question 7

Which of the following statements is true concerning direct- and indirect-acting cholinergic agents?

A)A direct agent causes release of neurotransmitter and an indirect agent acts on the receptor.
B)The indirect-acting agents include the choline derivatives and pilocarpine.
C)The indirect-acting cholinesterase inhibitors act by stimulating release of acetylcholine.
D)Inhibiting the enzyme that normally destroys acetylcholine results in stimulation of the PANS.

Question 8

The anatomy of what system contains long preganglionic nerves and short postganglionic nerves?

A)Parasympathetic autonomic
B)Sympathetic autonomic
C)Somatic
D)Sensory afferent

Question 9

The direct effect of acetylcholine on the heart is _____ chronotropic and _____ inotropic action.

A)negative;negative
B)positive;positive
C)negative;positive
D)positive;negative
E)None of the above are correct.

Question 10

Which of the following choices would occur during a generalized discharge of the sympathetic nervous system?

A)Diarrhea
B)Urination
C)Glycogen breakdown
D)Miosis
E)None of the above

Question 11

The parasympathetic fibers originate in the nuclei of the _____ segments of the spinal cord.

A)sacral and lumbar
B)cranial nerves and sacral
C)cranial nerves and lumbar
D)thoracic and lumbar
E)None of the above are correct.

Question 12

The S in SLUD stands for

A)sympathetic.
B)salivation.
C)severe.
D)secretion.

Question 13

The acronym SLUD denotes adverse reactions associated with administration of _____ agents.

A)cholinergic
B)anticholinergic
C)adrenergic
D)antiadrenergic

Question 14

When the SANS is stimulated,the adrenal _____ releases primarily _____ into the systemic circulation.

A)cortex;epinephrine
B)cortex;acetylcholine
C)medulla;epinephrine
D)medulla;acetylcholine

Question 15

Which of the following statements is true concerning the organization of the sympathetic division of the autonomic nervous system (SANS)?

A)The cell bodies that give origin to the postganglionic fibers of the SANS span from the thoracic (T1)to the lumbar (L2)portion of the spinal cord.
B)The preganglionic fibers exit the spinal column to enter the sympathetic chain located along each side of the vertebral column.
C)Once a part of the sympathetic chain,preganglionic fibers form a single synaptic connection,with postganglionic cell bodies located up and down the sympathetic chain.
D)Stimulation of the SANS produces a more targeted effect than stimulation of the parasympathetic division of the autonomic nervous system (PANS).

Question 16

The autonomic nervous system (ANS)functions as a(n)_____ system for many bodily functions.

A)somatic negative feedback
B)somatic modulating
C)automatic negative feedback
D)automatic modulating

Question 17

Which of the following statements is true concerning the organization of the autonomic nervous system (ANS)?

A)All body tissues are innervated by the ANS.
B)All organs receive both parasympathetic and sympathetic innervation.
C)If a tissue receives both innervations,the response will be equal to the sum of excitatory and inhibitory influences of the two divisions of the ANS.
D)Sensory fibers in one division cannot influence the motor fibers in the other.

Question 18

The primary objective of cholinergic drug therapy in the treatment of glaucoma is

A)increasing the convexity of the lens.
B)dilating the vessels of the eye.
C)dilating the pupil.
D)reducing intraocular pressure.
E)inhibiting cholinesterase.

Question 19

Which of the following substances will block the action of acetylcholine at the postganglionic endings in the parasympathetic autonomic nervous system (PANS)?

A)Atropine
B)Curare
C)Hexamethonium
D)Acetic acid

Question 20

The neurotransmitter released from a preganglionic neuron in the sympathetic division of the autonomic nervous system (ANS)is

A)epinephrine.
B)norepinephrine.
C)dopamine.
D)acetylcholine.

Question 21

Which of the following agents is known to deplete endogenous norepinephrine?

A)Propranolol
B)Reserpine
C)Phentolamine
D)Yohimbine
E)None of the above

Question 22

The action of norepinephrine is terminated by which of the following choices?

A)Uptake into the presynaptic nerve terminal by an amine-specific pump
B)Action of catechol-O-methyltransferase (COMT)
C)Action of monoamine oxidase (MAO)
D)All of the above
E)None of the above

Question 23

Indications for the use of anticholinergic agents include

A)stimulation of salivary secretion for xerostomic patients.
B)treatment of gastrointestinal disorders associated with decreased motility.
C)treatment in combination with levodopa for patients with Parkinson disease.
D)use as an antipsychotic.

Question 24

Anticholinergics

A)accelerate gastric emptying.
B)decrease esophageal and gastric motility.
C)cause miosis.
D)do not have an effect on heart rate.

Question 25

Sympathomimetic agents should be used with caution in patients with (1)angina, (2)hypertension, (3)hypothyroidism.

A)1,2,3
B)1,2
C)1,3
D)2,3

Question 26

Neostigmine is an indirect-acting cholinergic agent that is classified as (1)indirect acting and (2)irreversible.

A)Both claims are true.
B)Claim 1 is true;claim 2 is false.
C)Claim 1 is false;claim 2 is true.
D)Neither claim 1 nor claim 2 is true.

Question 27

Sarin was used on a subway in Japan to poison riders.Sarin is a(n)

A)sympathomimetic.
B)anticholinergic.
C)anticholinesterase.
D)sympatholytic.

Question 28

Which of the following agents is an indirect-acting sympathetic agonist?

A)Albuterol
B)Pseudoephedrine
C)Amphetamine
D)Physostigmine
E)Epinephrine

Question 29

Anticholinergic agents prevent the action of acetylcholine at the _____ endings.

A)preganglionic sympathetic
B)postganglionic parasympathetic
C)Preganglionic sympathetic
D)Postganglionic parasympathetic

Question 30

Sympathomimetic agents will stimulate salivary flow from which of the following salivary glands: (1)parotid, (2)submandibular, (3)sublingual?

A)1,2,3
B)1,2
C)1,3
D)2,3

Question 31

Which of the following choices represents potential cardiac effects of anticholinergic agents?

A)Bradycardia exclusively
B)Tachycardia exclusively
C)Variable;bradycardia predominates with small doses and tachycardia with large doses
D)No cardiac effect from the use of these agents

Question 32

Which of the following categories of autonomic nervous system (ANS)agents can cause an acute rise in intraocular blood pressure in patients with narrow-angle glaucoma?

A)Cholinergic
B)Anticholinergic
C)Adrenergic
D)Antiadrenergic

Question 33

Agents such as albuterol (Proventil,Ventolin)cause bronchodilation by binding to _____ receptors.

A)alpha
B)betA₁
C)betA₂
D)nicotinic

Question 34

Stimulation ofβ₂-receptors results in

A)vasoconstriction of skin and skeletal muscle.
B)increase in heart rate and force of contraction.
C)smooth-muscle relaxation.
D)bronchoconstriction.

Question 35

Tertiary anticholinergic agents are _____ soluble and _____ penetrate the brain.

A)lipid soluble;easily
B)lipid soluble;do not
C)not lipid soluble;easily
D)not lipid soluble;do not

Question 36

A drug with anticholinergic side effects might exhibit all of the following except

A)mydriasis.
B)salivation.
C)tachycardia.
D)constipation.

Question 37

a-Adrenergic agonists cause

A)vasoconstriction.
B)vasodilation.
C)tachycardia.
D)miosis.

Question 38

Which of the following is a catecholamine?

A)Isoproterenol
B)Norepinephrine
C)Epinephrine
D)Both B and C
E)All of the above

Question 39

On administration of an agent,heart rate increases because of a direct effect on the heart.However,total peripheral resistance decreases dramatically.As a consequence,systolic blood pressure increases only slightly,and mean arterial pressure typically falls.This agent is

A)epinephrine.
B)norepinephrine.
C)phenylephrine.
D)isoproterenol.

Question 40

Ipratropium is a(n)_____ found in an inhaler used to treat asthma.

A)cholinergic
B)anticholinergic
C)adrenergic
D)antiadrenergic

Question 41

Which type of agent such as donepezil (Aricept)has been FDA approved for the treatment of dementia?

A)Cholinergic agents
B)Anticholinergic agents
C)Adrenergic agents
D)Adrenergic blocking agents

Question 42

Which is true of glycopyrrolate (Robinul)?

A)It is a tertiary anticholinergic agent.
B)It is a quaternary anticholinergic agent.
C)It is lipid soluble and easily penetrates the brain.
D)It is a cholinergic agent.

Question 43

Pathways innervating smooth muscles and glands are considered afferent pathways.

Question 44

Which type of agents will block the muscarinic receptors,but not the nicotinic receptors?

A)Cholinergic agents
B)Anticholinergic agents
C)Adrenergic agents
D)Adrenergic blocking agents

Question 45

The fight-or-flight response refers to activation of the parasympathetic nervous system in response to stress.

Question 46

Glycopyrrolate is an a-adrenergic agonist used to produce a dry field before some dental procedures.

Question 47

The following statements are true of d-tubocurarine except which one?

A)It is a competitive nondepolarizing blocker.
B)It binds to nicotinic receptors.
C)It precipitates malignant hyperthermia in susceptible patients when combined with halothane.
D)It has been used in the Amazon for hunting animals.
E)Its action can be overcome by administering neostigmine.

Question 48

Stimulation of which adrenergic receptor allows the bladder to fill?

A)Alpha
B)Beta-1
C)Beta-2
D)Beta-3

Question 49

Which type of autonomic drug is useful to prepare a patient for an ophthalmologic examination?

A)Cholinergic agent
B)Anticholinergic agent
C)Adrenergic agent
D)Adrenergic blocking agent

Question 50

Which type of autonomic drugs are first-line therapy for overactive bladder (OAB)?

A)Adrenergic agents
B)Adrenergic blocking agents
C)Cholinergic agents
D)Anticholinergic agents

Question 51

Which of the following agents is being used to produce methamphetamine?

A)Phenylephrine
B)Pseudoephedrine
C)Dopamine
D)Dipivefrin

Question 52

Which of the following sympathomimetic agents is commonly used in dentistry?

A)Ephedrine
B)Terbutaline
C)Dipivefrin
D)Levonordefrin

Question 53

Salivation,lacrimation,urination,and defecation refer to toxic effects seen with adrenergic agents.

Question 54

An _______ nerve fiber is a sensory fiber,and an _________ nerve fiber is a motor fiber in the autonomic nervous system.

A)afferent;efferent
B)efferent;afferent
C)afferent;neuromuscular junction
D)efferent;neuromuscular junction

Question 55

Muscarinic receptors are found in which of the following? (Select all that apply. )

A)Central nervous system
B)Sympathetic nervous system
C)Parasympathetic nervous system
D)Neuromuscular junction
E)Adrenal medulla

Question 56

Norepinephrine is the neurotransmitter of the

A)pre-ganglionic nerve of the sympathetic division of the autonomic nervous system.
B)post-ganglionic nerve of the sympathetic division of the autonomic nervous system.
C)pre-ganglionic nerve of the parasympathetic division of the autonomic nervous system.
D)post-ganglionic nerve of the parasympathetic division of the autonomic nervous system.

Question 57

The post-synaptic tissue of the para-sympathetic division of the autonomic nervous system can be differentiated from the pre-synaptic tissue by response to which chemical?

A)Atropine
B)Hexamethonium
C)Muscarine
D)Nicotine

Question 58

Which category of autonomic drug is used to treat attention-deficit disorder (ADD)?

A)Adrenergic agent
B)Adrenergic blocking agent
C)Cholinergic agent
D)Anticholinergic agent

Question 59

Patients pretreated with _____ agents are prone to epinephrine reversal.

A)cholinergic
B)anticholinergic
C)a-adrenergic
D)a-adrenergic blocking

Question 60

Tertiary (ammonium)agents cross the blood-brain barrier better than quaternary (ammonium)agents.