Pharm I Retake

Question 1

Short preganglionic neuron, long postganglionic –>Broad effects

Answer 1

Sympathetic

Question 2

Sympathetic Cholinergic neutotransmitter

Answer 2

ACH

Question 3

Sympathetic Adrenergic neurotransmitter

Answer 3

Norepinephrine

Question 4

parasympathetic cholinergic neurotransmitter

Answer 4

ACH
Nicotinic

Question 5

Parasympathetic muscarinic neurotransmitter

Answer 5

ACH
Muscarinic

Question 6

↑HR,↑CO –>↑BP, Bronchodilation, Pupil dilation,↓secretions,↓peristalsis, glycogenlosis –>↑BG,↓urine production, urethreal constriction

Answer 6

SNS

Question 7

↓HR,↓CO –>↓BP, Bronchoconstriction, Pupilconstriction,↑secretions,↑peristalsis, glycogenesis–>↓BG,urethreal dilation

Answer 7

PNS

Question 8

Long preganglionic neuron, short postganglionic –> targeted effects

Answer 8

Parasympathetic

Question 9

constriction of smooth muscle
Vessels, eye, sphincters of GI/Urinary system,

Answer 9

Alpha 1 Activation

Question 10

prevent depolarization of neurons by preventing norepi release –> sedation,↓HR and BP
Pre-synaptic neurons of sympathetic nervous system

Answer 10

Alpha 2 inhibition

Question 11

increased action potentials
SA node, AV node, HIS, myocardium, Kidneys (renin)

Answer 11

B1 Stimulation

Question 12

dilation of smooth muscle/Glucose production in liver
Vessels, bronchioles, eye, GI, bladder, liver, uterus
***Mast cells

Answer 12

B2 Stimulation

Question 13

–> glycogenolysis
Adipose tissue

Answer 13

B3 Stimulation

Question 14

B2 receptors on mast cells inhibit

Answer 14

HIstamine Release

Question 15

CNS, gastric glands –> secretion of gastric secretions for digestion

Answer 15

M1+

Question 16

Heart (SA, AV) –> inhibit action potentials –> decrease HR

Answer 16

M2-

Question 17

Glands (lacrimal, salivary, sweat), pancreas, smooth muscle (bronchi,GI tract,bladder,sphincters, eye) –> increase secretions, increase Insulin, bronchoconstriction, GI peristalsis, vasoconstriction, pupil constriction

Answer 17

M3+

Question 18

CNS –> memory, arousal, analgesia

Answer 18

M4-

Question 19

CNS –> memory, arousal, analgesia

Answer 19

M5+

Question 20

IV Scopolamine likely targets what muscarinic receptors

Answer 20

M4, M5

Question 21

Synthetic non-selective muscarinic agonist
Sometimes used to diagnose asthma

Answer 21

Methacholine

Question 22

Old school treatment for urinary retention

Answer 22

Bethanechol

Question 23

Alkaloid isolated from Aminata muscaria

Answer 23

Muscarine

Question 24

Low–> ↓secretions
Medium –> smooth muscle dilation, increase HR
High –> inhibit urination/defecation, decrease GI motility

Answer 24

Dose dependence of Anticholinergics

Question 25

Increase HR (M2) Bronchodilation (M3) Decrease all secretions ( lacrimal, sweat, saliva, GI), but salivary decrease is particularly pronounced

Answer 25

Atropine

Question 26

NO parasympathetic tone

Answer 26

Atropine overdose

Question 27

CNS – hallucinations, delirium Secretions: decreased sweat, no saliva Tachycardia Uncompensated pupil dilation "blind as a bat" 

Answer 27

Atropine overdose symptoms

Question 28

True/False Atropine overdose can be seen with any muscarinic antagonist

Answer 28

True

Question 29

Organophosphate poisoining antidote

Answer 29

Pradoxime 2-Pram is the ultimate cure/antidote if given within 48 hours

Question 30

Cleaves organophosphate-acetylcholinesterase bond, allowing resumption of normal function

Answer 30

Pralidoxime (2-pram)

Question 31

Certain Pesticides, Sarin gas Profound inhibition of acetylcholinesterase --> acetylcholine overload

Answer 31

Organophosphate poisoining

Question 32

Quaternary amine structure contributes to its slower pharmacokinetics and its inability to cross the Blood-Brain Barrier

Answer 32

Glyocpyrrolate

Question 33

Most commonly used to:  prevent the unwanted side effects of acetylcholine after reversal of neuromuscular blockade with acetylcholinesterase inhibitors increase HR during anesthesia reduce secretions prior to airway manipulation

Answer 33

Glycopyrrolate

Question 34

Glycopyrrolate onset of action

Answer 34

1-3 mins for HR

Question 35

Glycopyrrolate duration of action

Answer 35

2-4 hours

Question 36

Very similar to atropine in terms of pharmacodynamics/kinetics Even greater CNS penetration Drowsiness, amnesia, fatigue, dizziness Helpful in preventing PONV and motion sickness after anesthesia

Answer 36

Scopolamine

Question 37

Profound amnesia with minimal effect on cardiac function when given IV

Answer 37

Scopolamine

Question 38

When might IV Scopolamine be useful?

Answer 38

When used in trauma cases

Question 39

treatment for bladder spasm in PACU post bladder surgery

Answer 39

B&O (Belladonna and opium) suppository

Question 40

Oxybutynin, tolterodine, solifenacin

Answer 40

M3 Antagonism All used in the treatment of overactive bladder

Question 41

How is epinephrine synthesized and where?

Answer 41

Phenylalanine Tyrosine Dopa Dopamine Norepi Epi

Question 42

Metabolized by monoamineoxidase(MAO) and catechol-O-methyltransferase (COMT) in circulation

Answer 42

Norepinephrine

Question 43

Primary neurotransmitter for sympathetic system

Answer 43

Norepi

Question 44

selegiline, phenelzine, tranylcypromine

Answer 44

MAO-Is

Question 45

Ephedrine is contraindicated when a patient is on what class of medication?

Answer 45

MAOIs

Question 46

Inhibits tyrosine hydroxylase, and therefore, norepi production Almost never used in management of pheochromocytomas

Answer 46

A-methyltyrosine

Question 47

Sometimes found in aged cheeses, wines, and meats Enters the nerve synapse and binds to the pre-synaptic norepi receptor causing norepi vesicles to be released into the synapse Also metabolized by MAO, so can cause issues for people on MAO-I's 

Answer 47

Tyramine

Question 48

Blocks dopamine from being converted to norepi in the vesicles and therefore decreases BP by decreasing norepi signaling Treatment for HTN

Answer 48

Reserpine

Question 49

Causes release of norepinephrine from pre-synaptic nerve, therefore indirectly increasing HR and BP

Answer 49

Ephedrine

Question 50

Not effective in someone who is "catecholamine depleted" or who does not have any norepi stored in their vesicles

Answer 50

Ephedrine

Question 51

Examples of patients who would be catecholamine-depleted

Answer 51

Cocaine and methamphetamine use