Deck 6: Drugs Affecting the Sympathetic Nervous System

Question 1

Identify the primary effect produced by the beta-2 receptors when they are stimulated by epinephrine.

A) Vasodilation of skeletal muscle blood vessels
B) Vasodilation of coronary arteries
C) Bronchodilation of the bronchiolar smooth muscle
D) All of these are correct.

Answer 1

All of these are correct.

Question 2

Infiltration of the skin by alpha-adrenergic drugs during IV administration can lead to necrosis and gangrene of the skin cells.Select the reason for this effect.

A) Vasodilation leads to increased blood flow.
B) Vasoconstriction leads to decreased blood flow.
C) Vasodilation leads to decreased blood flow.
D) Vasoconstriction leads to increased blood flow.

Answer 2

Vasoconstriction leads to decreased blood flow.

Question 3

Identify the type of muscles that are affected by norepinephrine.

A) Smooth and skeletal muscle
B) Skeletal and cardiac muscle
C) Smooth and cardiac muscle
D) None of these are correct.

Answer 3

Smooth and cardiac muscle

Question 4

Select the correct clinical indication associated with the use of IV dobutamine (Dobutrex),a drug that is similar to dopamine but has greater beta-1 effects.

A) Benign prostatic hyperplasia
B) Acute allergy or asthma
C) Acute heart failure
D) Hypertension

Question 5

Use the low-dose range of 0.5-2 mcg/kg/min to determine the appropriate dose range of dopamine that would result in vasodilation and increased renal blood flow for a patient who weighs 132 pounds.

A) 0.3-6.2 mg/hr
B) 1-4.5 mg/hr
C) 1.8-7.2 mg/hr
D) None of these are correct.

Question 6

Select the primary effects of stimulation by epinephrine on the beta-1 receptors.

A) Increase in heart rate and increase in the force of cardiac contractions
B) Decrease in heart rate and decrease in the force of cardiac contractions
C) Increase in heart rate and increase in blood flow to the heart
D) Decrease in heart rate and decrease in blood flow to the heart

Question 7

The alpha and beta agonists are also known as sympathomimetics.It can be concluded that these agonists:

A) produce effects similar to the sympathetic nervous system.
B) produce effects similar to the parasympathetic nervous system.
C) produce effects similar to the cardiovascular system.
D) None of these are correct.

Question 8

Identify the correct use of an EpiPen Auto-Injector.

A) EpiPen must be carried at all times and should be administered immediately following the onset of an anaphylactic allergic reaction.
B) EpiPen must be carried at all times and should be administered upon suspecting the onset of an anaphylactic allergic reaction.
C) EpiPen must be carried at all times and should be administered after 15 minutes of the onset of an anaphylactic allergic reaction.
D) EpiPen must be carried at all times and should be administered within 60 minutes of the onset of an anaphylactic allergic reaction.

Question 9

One of the differences between alpha-adrenergic blockers and adrenergic neuronal blockers is that unlike alpha-adrenergic blockers,adrenergic neuronal blockers:

A) compete with epinephrine for binding to adrenergic nerve endings.
B) compete with norepinephrine for binding to adrenergic nerve endings.
C) reduce the release of epinephrine from the adrenergic nerve endings.
D) decrease the formation of norepinephrine at the adrenergic nerve endings.

Question 10

What is the disadvantage of using norepinephrine as a drug?

A) It cannot be used to produce beta-adrenergic drugs.
B) It stimulates all alpha and beta receptors.
C) It must be administered by injection.
D) It provides a very long duration of action.

Question 11

Analyze the major adrenergic effects of the alpha-adrenergic drug class,and select the main drug effect that the alpha-adrenergic drugs have on the alpha-2 receptors.

A) Negative feedback effect to decrease the release of epinephrine
B) Negative feedback effect to decrease the release of norepinephrine
C) Contraction of smooth muscle
D) Increased blood pressure

Question 12

The physical effects of anaphylaxis caused by insect stings,drugs,or other allergens in sensitized individuals include:

A) difficulty in breathing.
B) decreased blood pressure.
C) symptoms of shock.
D) All of these are correct.

Question 13

Use the low-dose range of 0.5-2 mcg/kg/minute to determine the appropriate dose range of dopamine that would result in vasodilation and increased renal blood flow for a patient who weighs 220 pounds.

A) 3-12 mg/hr
B) 10-15 mg/hr
C) 20-25 mg/hr
D) None of these are correct.

Question 14

Analyze the major adrenergic effects of the adrenergic neuronal blockers,and select the main drug effect that the adrenergic neuronal blockers have on the adrenergic nerve endings.

A) Increase in the production and release of epinephrine
B) Increase in blood pressure
C) Decrease in the basal metabolic rate
D) Decrease in all sympathetic activity

Question 15

Jason is brought to the ER after feeling dizzy and fainting on his way to work.The doctor diagnoses hypotension as the cause for the dizziness and subsequent fainting and prescribes Levophed to be administered intravenously.As a medical assistant,you have been asked to peruse Jason's medical history and the doctor's prescription for contraindications.Which of the following in Jason's medical history would serve as a contraindication?

A) Jason fainted a month ago and broke his arm during the fall.
B) Jason has never been known to suffer from hypotension.
C) Jason has been under medication for hypotension for about a month.
D) Jason is currently receiving treatment for angina pectoris.

Question 16

Identify the most common side effect of decongestant use.

A) Irritation of the nasal sinuses or eyes due to excessive dryness
B) Excessive secretion of mucus, causing itchy, watery eyes or runny nose
C) Headache caused due to increased vasoconstriction
D) None of these are correct.

Question 17

Use the moderate-dose range of 2-10 mcg/kg/min to determine the appropriate dose range of dopamine that would result in increased cardiac output for a patient who weighs 176 pounds.

A) 2.4-12 mg/hr
B) 9.6-48 mg/hr
C) 19.2-96 mg/hr
D) None of these are correct.

Question 18

Analyze the drugs (primarily used as nasal decongestants)in each group below,and select the group of drugs that are available in the form of both nasal solution and ophthalmic drops.

A) Naphazoline and tetrahydrozoline
B) Naphazoline and xylometazoline
C) Xylometazoline and tetrahydrozoline
D) None of these are correct.

Question 19

Analyze the drugs in each group below,and select the group of drugs that is administered by parenteral injection and used to elevate blood pressure.

A) Midodrine, norepinephrine, and phenylephrine
B) Xylometazoline, midodrine, and phenylephrine
C) Metaraminol, norepinephrine, and phenylephrine
D) Pseudoephedrine, midodrine, and phenylephrine

Question 20

Identify the sympathetic signs for overdose of adrenergic drugs.

A) Sweating and trembling
B) Chest pain and respiratory difficulty
C) Significant increase in blood pressure
D) All of these are correct.

Question 21

Identify a symptom associated with benign prostatic hyperplasia in males.

A) Enlargement of the prostate gland
B) Decreased urine flow
C) Increased constriction of the smooth muscle of the urethra
D) All of these are correct.

Question 22

Identify the major pharmacokinetic differences that exist between the drug effects of nonselective beta-blockers and selective beta-1 blockers that can alter their therapeutic responses.

A) Duration of action and extent of drug metabolism
B) Onset of action and extent of drug metabolism
C) Duration of action and extent of drug excretion
D) Onset of action and extent of drug absorption

Question 23

Select the beta-adrenergic drugs that can be inhaled via a nebulizer in order to open the respiratory airway.

A) Isoetharine and salmeterol
B) Salmeterol and terbutaline
C) Isoetharine and levalbuterol
D) Levalbuterol and terbutaline

Question 24

Analyze the common dosage ranges of the alpha-adrenergic blocking drugs,and select the correct common daily dosage range of tamsulosin (Flomax)for treatment of benign prostatic hyperplasia in males.

A) 0.4-0.8 mg PO
B) 1-5 mg PO
C) 10 mg PO
D) 1-8 mg PO

Question 25

Lewis is prescribed Uroxatral for the treatment of benign prostatic hyperplasia.Each Uroxatral tablet contains 10 mg of alfuzosin,and the common daily dosage is one tablet.However,considering that Lewis's condition is not as severe,the doctor prescribes a daily dosage of 5 mg.How many tablets should Lewis take in a day?

A) Half
B) One
C) Two
D) Four

Question 26

Use your critical-thinking skills to determine the effects of beta-adrenergic blocking drugs on the heart.

A) Increase in heart rate, increase in the force of contractions, and increase in impulse conduction through the heart
B) Decrease in heart rate, decrease in the force of contractions, and decrease in impulse conduction through the heart
C) Decrease in heart rate, decrease in the force of contractions, and increase in impulse conduction through the heart
D) Increase in heart rate, increase in the force of contractions, and decrease in impulse conduction through the heart

Question 27

Use your critical-thinking skills to determine the primary reason that methyldopa is classified as a false transmitter.

A) Methyldopa is converted to a neurotransmitter-like substance while also reducing neuronal activity.
B) Methyldopa is converted to alpha-methylnorepinephrine by the adrenergic nerve ending.
C) Methyldopa interferes with the production of norepinephrine in the nerve endings.
D) All of these are correct.

Question 28

Compare beta-blocking drugs and alpha-blocking drugs and identify the similarity between these drugs.

A) Both classes of drugs bind to adrenergic receptors and release false neurotransmitters.
B) Both classes of drugs reduce blood pressure and are subsequently used to treat hypertension.
C) Both classes of drugs increase cardiac function, which increases blood flow to the heart.
D) Both classes of drugs stimulate the activity of the sympathetic nervous system.

Question 29

Analyze the common dosage ranges of beta-adrenergic blocking drugs,and select the correct dosage range of atenolol (Tenormin)for the treatment of hypertension and angina pectoris.

A) 50-100 mg by mouth
B) 1-3 mg by intravenous injection
C) 6.25-100 mg by mouth
D) 12.5-50 mg by mouth

Question 30

Select the primary clinical use of the alpha-adrenergic blocking drugs alfuzosin,tamsulosin,terazosin,and doxazosin.

A) Treatment of benign prostatic hyperplasia
B) Treatment of hypotension
C) Treatment of excessive production of epinephrine
D) Treatment of pheochromocytoma

Question 31

Using critical thinking,select the underlying effect of taking propranolol,a beta-blocking drug that directly decreases rate,force of contraction,and conduction velocity of the heart.

A) Increase in oxygen consumption by the body
B) Decrease in oxygen consumption by the body
C) Decrease in drug metabolism by the liver
D) None of these are correct.

Question 32

What is the primary reason for the use of alpha-blockers in treating Raynaud's disease?

A) They cause vasoconstriction, which increases blood flow to the skin and extremities.
B) They cause vasodilation, which lowers blood pressure.
C) They cause vasodilation, which increases blood flow to the skin and extremities.
D) None of these are correct.

Question 33

Esmolol is a short-acting drug,administered intravenously,that is used for emergencies and has a half-life of 10 minutes.Use the definition of half-life to select the correct statement about esmolol.

A) In 10 minutes, the concentration of esmolol will be reduced to 50 percent of the initial dose.
B) In 10 minutes, the dose of esmolol will be completely eliminated from the body.
C) In 10 minutes, 50 percent of the esmolol dose will be activated to exert its effect.
D) All of these are correct.

Question 34

Using the common dosage ranges of the beta-adrenergic blocking drugs,select the correct dosage range of propranolol (Inderal)for the treatment of angina pectoris.

A) 40-120 mg by mouth
B) 20-40 mg by mouth
C) 80-320 mg by mouth
D) None of these are correct.

Question 35

Using the Physicians' Desk Reference,you determine that reserpine,prescribed for severe hypertension,is rarely used today because of its numerous side effects.The side effects of reserpine include:

A) increased salivation.
B) diarrhea.
C) bradycardia.
D) All of these are correct.