Autonomic Semester 2

Front 1

1)    Which of the following drugs is a direct-acting muscarinic agonist?

Back 1

Bethanechol, Cevimeline, Carbachol, Pilocarpine, Acetylcholine

Front 2

1)    A 48-year-old male recovering from an abdominal operation is suffering from an abdominal obstruction produced by an ileus paralysis. Conservative therapy has not worked and a muscarinic agonist is used to stimulate the gut wall. Which of the following drugs when administered stimulate gut peristalsis?

Back 2

Direct-Acting Muscarinic Agonist, bethanechol, cevimiline

Front 3

1)    A 50-year-old patient with open angle glaucoma is given a drug that is a direct agonist to both nicotinic and muscarinic cholinergic receptors. Which drug was used?

Back 3

Acetylcholine and Carbachol are the two drugs that are agonist for both nicotinic and cholinergic receptors. If I wanted to ramp up the level I would ask you to distinguish between tertiary (acetylcholine) and quaternary amine (carbachol)

Front 4

4) A 45-year-old male patient is being evaluated because of his symptoms of diplopia and muscle weakness that is worse with repeated activity and improves with rest. His neurologic signs are normal. Laboratory testing demonstrates the presence of anti-nicotinic-acetylcholine receptor antibodies in his serum confirming a diagnosis for myasthenia gravis. He is given a drug that increases acetylcholine at the neuromuscular junction by preventing its breakdown by acetylcholinesterase. Which medication would most likely be given?

Back 4

Ambenonium, Neostigmine, and Pyridostigmine.

Front 5

1)    34-year-old farm worker is brought into the emergency room with symptoms cholinergic excess including, respiratory distress, profuse sweating and salivation, pupillary miosis and is starting to convulse. He had been spraying insecticides on artichoke field when a drum of insecticide spilled onto him. You suspect organophosphate poisoning. Which drug would you administer to prevent permanent inhibition of the acetylcholine esterase enzymes in this patient?

Back 5

Pralidoxime (2-Pam)

Front 6

1)    Which of the following drugs is a muscarinic antagonist?

Back 6

Atropine, Dicyclomine, Oxybutynin, Scopolamine, Tolterodine, Tridihexethyl. Benztropine, Biperiden, Trihexyphenidyl, Clidinium, Cyclopentolate, Darifenacin, Glycopyrrolate, Ipratropium, Tiotropium, Mepenzolate, Methantheline, Methscopolamine, Propantheline

Front 7

1)    A 45-year-old male is planning to go sailing with his father. He suffers from motion sickness. His clinician prescribes to him a tertiary-amine (good CNS penetration) muscarinic-antagonist to treat his symptoms of motion sickness. Which drug fits this profile?

Back 7

Scopolamine

Front 8

1)    A 50-year-old patient with the bronchoconstrictive disease--chronic obstructive pulmonary disease is treated with a drug to block parasympathetic influences on the lungs. The drug used should be an inhaled quaternary-amine compound so it has poor oral bioavailability plus limited CNS penetration and be a muscarinic receptor antagonist. Which drug could be used?

Back 8

Ipratropium and Tiotropium

Front 9

1)    A 60-year-old patient with severe hypertension is treated with a drug that blocks nicotinic receptors on autonomic ganglia. Which drug was used?

Back 9

Trimethaphan, Mecamylamine, hexamethonium

Front 10

1)    An 8-year-old female with a previous history of bee-sting allergies is brought to the emergency department with symptoms of anaphylactic shock including; laryngeal edema, bronchial constriction (tightness in chest with audible wheezing), discrete cutaneous urticarial eruptions and edema. She is administered a drug that can alleviate her bronchial symptoms and prevent vascular collapse by activating b1, b2, and a1 adrenoceptors. Which drug was used?

Back 10

Epinephrine

Front 11

1)    Which of the following drugs increases systolic blood pressure by activating b1 adrenergic receptors and elevates diastolic blood pressure by activating a1 adrenoceptors without appreciable effect on b2 adrenoceptors--when given IV?

Back 11

Norepinephrine

Front 12

1)    A 25-year-old female patient presents with dyspnea and wheezing, which often wakes her up at night. A diagnosis of asthma is established and she is administered a b2-selective adrenergic agonist that is administered via an inhaler. Which drug was given?

Back 12

Albuterol, Terbutaline, Metaproterenol, Pirbuterol, Salmeterol, Formoterol

Front 13

1)     Nasal decongestants are often alpha-adrenoceptor agonist because they constrict vessels in the nasal mucosa. Which of the following drugs is an alpha-adrenoceptor agonist?

Back 13

Phenylephrine, Methoxamine, Midodrine

Front 14

1)     Alpha-2 adrenoceptors are located on pre-synaptic neurons and when activated by an alpha-2 selective drug decreases the release of norepinephrine and can be used to treat hypertension as well as many disease states associated with excess norepinephrine release. Which drug fits this category:

Back 14

Clonidine, Apraclonidine, Brimonidine, Dexmedetomidine, alpha-methyl-dopa

Front 15

1)    A 52-year-old man with urinary hesitancy caused by his benign prostatic hyperplasia is given an alpha-1-specific receptor antagonist to treat his symptoms. The drug is also associated with orthostatic hypotension especially on the first dose. Which drug fits this description?

Back 15

Prazosin, Alfuzosin, Doxazosin, Terazosin, Tamsulosin

Front 16

1)     Which of the following drugs is a beta-adrenergic-receptor antagonist?

Back 16

Propranolol, Timolol, Carteolol, Carvedilol, Labetalol, Nadolol, Penbutolol, Pindolol, Sotalol, Timolol, Acebutolol, Betaxolol or Bisoprolol, Esmolol (short acting) Atenolol. Metoprolol

Front 17

1)     Which of the following drugs is a beta-1 selective adrenergic receptor antagonist?

Back 17

Beta 1 selective blockers (less lung effects). Select A BEAM: Acebutolol, Betaxolol or Bisoprolol, Esmolol (short acting) Atenolol. Metoprolol