Question 1

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

Accepted Answer

The answer of Several classes of drugs have interactions with...

Question 2

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:

Accepted Answer

Fasciculations of voluntary muscles indicate overstimulation of the neuromuscular junction and can quickly progress to respiratory failure. Immediate action is necessary to prevent further toxicity. Dizziness, headache, and nausea are common but less urgent adverse reactions. Decreased salivation is actually a therapeutic effect of AChE inhibitors for conditions such as dry mouth.

Question 3

You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH). He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient is:

Accepted Answer

Tamsulosin is an alpha-1 blocker used to relieve urinary symptoms caused by BPH, but it can also lower blood pressure and cause dizziness. If a patient experiences dizziness with tamsulosin, it may be necessary to switch to a different medication, such as doxazosin, which also treats BPH but may not cause dizziness. Therefore, discontinuing tamsulosin and switching to doxazosin is the best option for this patient.

Question 4

Which of the following drugs should be used only when clearly needed in pregnant and breastfeeding women?

Accepted Answer

The answer of Which of the following drugs should be...

Question 5

You are treating a patient with a diagnosis of Alzheimer's disease. The patient's wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Accepted Answer

Donepezil is a medication used for Alzheimer's disease that can be taken once daily, making it easier for patients who have difficulty with transportation to the clinic. Tacrine, on the other hand, is rarely used due to its potential liver toxicity, which requires frequent monitoring, and it needs to be taken four times a day. Doxazosin and verapamil are medications used for hypertension and arrhythmias, respectively, and are not indicated for Alzheimer's disease.

Question 6

Taking which drug with food maximizes it bioavailability?

Accepted Answer

The answer of Taking which drug with food maximizes it...

Question 7

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?

Accepted Answer

Memantine is not an anticholinergic. Donepezil, rivastigmine, and galantamine are all cholinesterase inhibitors and are also anticholinergics. Memoantine works differently by regulating the activity of glutamate, a different neurotransmitter involved in learning and memory.

Question 8

Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine?

Accepted Answer

Nicotine actually causes vasoconstriction and increased heart rate by activating the sympathetic nervous system.

Question 9

Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily?

Accepted Answer

Only Donepezil can be given once daily. Tacrine is given 4 times daily, Memantine is given twice daily and Pyridostigmine is given multiple times daily.

Question 10

Success rates for smoking cessation using NRT:

Accepted Answer

Research has shown that the success rates for smoking cessation using NRT vary from 40% to 50% at 12 months, depending on the method chosen.

Question 11

Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:

Accepted Answer

Scopolamine tablets should be swallowed at least 1 hour before traveling to prevent motion sickness. This allows enough time for the medication to be absorbed and start working. Option A refers to the transdermal disk, which should be applied at least 4 hours before travel, but this is not the preferred method for preventing motion sickness. Option C is not recommended as the tablet should not be placed under the tongue. Option D is also incorrect as the transdermal patch should be changed every 3 days, not daily.

Question 12

Nicotine gum products are:

Accepted Answer

Nicotine gum is designed to release nicotine when chewed, as it is bound to exchange resins that release nicotine during the chewing process.

Question 13

Your patient calls for an appointment before going on vacation. Which medication should you ensure he has an adequate supply of before leaving to avoid life-threatening complications?

Accepted Answer

Carvedilol is a medication used to treat high blood pressure and heart failure. Suddenly stopping this medication can lead to a rebound effect and potentially life-threatening complications, such as worsening heart failure or heart attack. Therefore, it is important for patients taking carvedilol to have an adequate supply before leaving on vacation. Donepezil, bethanechol, and tacrine are all medications used to treat Alzheimer's disease and are not typically associated with life-threatening complications if discontinued abruptly.

Question 14

A patient presents with a complaint of dark stools and epigastric pain described as gnawing and burning. Which of the medications is the most likely cause?

Accepted Answer

Bethanechol can increase gastric acid secretion, potentially leading to peptic ulcers, which can cause dark stools and epigastric pain.

Question 15

Nicotine replacement therapy (NRT):

Accepted Answer

Nicotine, regardless of the form in which it is consumed (including nicotine replacement therapy), can delay the healing of esophagitis and peptic ulcers because it increases gastric acid secretion and can impair the mechanisms of mucosal defense and repair.

Question 16

Cholinergic blockers are used to:

Accepted Answer

Cholinergic blockers have multiple uses, including counteracting extrapyramidal symptoms (EPS) effects of phenothiazines, controlling tremors and relaxing smooth muscle in Parkinson's disease, and inhibiting the muscarinic action of ACh on bladder muscle. Therefore, all of the above answers are correct.

Question 17

Activation of central alpha₂ receptors results in inhibition of cardioacceleration and ______________ centers in the brain.

Accepted Answer

Activation of central alpha2 receptors leads to inhibition of cardioacceleration and vasoconstriction centers in the brain, which can result in decreased blood pressure and heart rate.

Quiz 14: Drugs Affecting the Autonomic Nervous System

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:

You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH) . He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient is:

Which of the following drugs should be used only when clearly needed in pregnant and breastfeeding women?

You are treating a patient with a diagnosis of Alzheimer's disease. The patient's wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Taking which drug with food maximizes it bioavailability?

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?

Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine?

Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily?

Success rates for smoking cessation using NRT:

Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:

Nicotine gum products are:

Your patient calls for an appointment before going on vacation. Which medication should you ensure he has an adequate supply of before leaving to avoid life-threatening complications?

A patient presents with a complaint of dark stools and epigastric pain described as gnawing and burning. Which of the medications is the most likely cause?

Nicotine replacement therapy (NRT) :

Cholinergic blockers are used to:

Activation of central alpha₂ receptors results in inhibition of cardioacceleration and ______________ centers in the brain.

Quiz 14: Drugs Affecting the Autonomic Nervous System

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:

You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH) . He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient is:

Which of the following drugs should be used only when clearly needed in pregnant and breastfeeding women?

You are treating a patient with a diagnosis of Alzheimer's disease. The patient's wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Taking which drug with food maximizes it bioavailability?

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?

Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine?

Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily?

Success rates for smoking cessation using NRT:

Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:

Nicotine gum products are:

Your patient calls for an appointment before going on vacation. Which medication should you ensure he has an adequate supply of before leaving to avoid life-threatening complications?

A patient presents with a complaint of dark stools and epigastric pain described as gnawing and burning. Which of the medications is the most likely cause?

Nicotine replacement therapy (NRT) :

Cholinergic blockers are used to:

Activation of central alpha2 receptors results in inhibition of cardioacceleration and ______________ centers in the brain.

Activation of central alpha₂ receptors results in inhibition of cardioacceleration and ______________ centers in the brain.