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255 Cards in this Set
- Front
- Back
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What symptoms indicate cholinesterase inhibitor poisoning
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DUMBBELSS: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of the skeletal muscle and the central nervous system, Lacrimation, Sweating, and Salivation
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True or False: Abdominal cramping can be a symptom of cholinesterase inhibitor poisoning
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True
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True or False: Diarrhea can be a symptom of cholinesterase inhibitor poisoning.
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True
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True or False: Urinary incontinence is not a symptom of cholinesterase inhibitor poisoning.
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False; urinary incontinenence is a symptom of cholinesterase poisoning
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True or False: Miosis can be a symptom of cholinesterase inhibitor poisoning.
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True
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True or False: Bronchospasm is not a symptom of cholinesterase inhibitor poisoning.
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False; bronchospasm is a symptom of cholinesterase inhibitor poisoning
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True or False: Bradycardia can be a symptom of cholinesterase inhibitor poisoning.
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True
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True or False: The excitation of skeletal muscle is not a symptom of cholinesterase inhibitor poisoning.
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False; skeletal muscle excitation is a symptom of cholinesterase inhibitor poisoning
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True or False: Central nervous system overactivation can be a result of cholinesterase inhibitor poisoning.
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True
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True or False: Excessive lacrimation is not a symptom of cholinesterase inhibitor poisoning.
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False; excessive lacrimation is a symptom of cholinesterase inhibitor poisoning
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True or False: Sweating can be a symptom of cholinesterase inhibitor poisoning.
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True
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The symptoms of parathion poisoning are caused by the inhibition of what enzyme?
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Acetylcholinesterase
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The symptoms of organophosphate poisoning are caused by the inhibition of what enzyme?
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Acetylcholinesterase
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What antidote can be given to a patient who presents with diarrhea, urinary incontinence, miosis, bronchospasm, bradycardia, lacrimation, sweating, and salivation?
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Atropine and pralidoxime
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Atropine is used as an antidote for what kind of poisoning?
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Organophosphate/anticholinesterase inhibitor poisoning
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Atropine is effective for treating organophosphate poisoning by inhibiting what receptors?
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Muscarinic acetylcholine receptors
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Pralidoxime is used as an antidote for what kind of poisoning?
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Organophosphate/cholinesterase inhibitor poisoning
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Pralidoxime is effective for treating organophosphate poisoning via what mechanism?
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The regeneration of active acetylcholinesterase
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What type of receptors does atropine antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does homatropine antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does tropicamide antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does benztropine antagonize?
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Muscarinic acetylcholine receptors, CNS
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What type of receptors does scopolamine antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does ipratropium antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does methscopolamine antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does oxybutin antagonize?
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Muscarinic acetylcholine receptors
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What type of receptors does glycopyrrolate antagonize?
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Muscarinic acetylcholine receptors, decrease airway secretion in anesthisiology
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What type of receptors does propantheline antagonize?
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Muscarinic acetylcholine receptors
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True or False: Atropine drops can be used in the eyes.
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True, mydriasis and cyclolpegia
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What organ system is the target of homatropine?
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The eye
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What organ system is the target of tropicamide?
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The eye
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What organ system is the target of benztropine?
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The central nervous system, parkinson
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What organ system is the target of scopolamine?
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The central nervous system
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What organ system is the target of ipratropium?
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The respiratory system
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What organ system is the target of methscopolamine?
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The gastrointestinal system
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What organ system is the target of oxybutin?
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The genitourinary system
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What organ system is the target of glycopyrrolate?
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The genitourinary system
also respiratory |
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What organ system is the target of propantheline?
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The gastrointestinal system
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What is the effect of atropine on the eye?
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It produces mydriasis and cycloplegia
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What is the effect of homatropine on the eye?
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It produces mydriasis and cycloplegia
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What is the effect of tropicamide on the eye?
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It produces mydriasis and cycloplegia
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For what disease of the central nervous system is benztropine used?
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Parkinson's disease (PARK my BENZ)
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The effect of scopolamine on the central nervous system is useful for treating what condition?
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Motion sickness
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Ipratropium is used to treat what two respiratory conditions?
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Asthma and chronic obstructive pulmonary disease
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True or False: Oxybutynin can be used to reduce urgency in patients with mild cystitis.
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True
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True or False: Oxybutynin can be used to reduce bladder spasms.
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True
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True or False: Oxybutynin is used to treat motion sickness.
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False; oxybutynin is used to treat bladder spasm and reduce urgency in mild cystitis
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True or False: Oxybutin is used to reduce bladder spasms.
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True
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True or False: Glycopyrrolate is used to reduce bladder spasms.
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True
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What is the clinical application of scopolamine?
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Treatment of motion sickness
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What is the clinical application of benztropine?
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Treatment of Parkinson's disease
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Propantheline is used to treat what gastrointestinal condition?
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Peptic ulcer disease
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What type of acetylcholine receptors does atropine antagonize?
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Muscarinic acetylcholine receptors
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Atropine is used for therapeutic effect in which four organ systems?
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Eyes, gastrointestinal system, respiratory system, urinary system
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What are the two effects of atropine on the eye?
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Pupil dilation, cycloplegia
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What is the effect of atropine on the airway mucosa?
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It decreases secretions
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What is the effect of atropine on the stomach?
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It decreases acid secretion
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What is the effect of atropine on gastrointestinal motility?
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It decreases motility
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What is the effect of atropine on the bladder in a patient with cystitis?
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It decreases urgency
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According to the mnemonic SLUD, what four major physiologic processes are blocked by atropine?
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Salivation, Lacrimation, Urination, and Defecation
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True or False: Increased body temperature is a sign of atropine toxicity.
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True (ie, "hot as a hare")
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True or False: Rapid pulse is a sign of atropine toxicity.
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True
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True or False: Dry mouth is a sign of atropine toxicity.
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True (ie, "dry as a bone")
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True or False: Dry, flushed skin is a sign of atropine toxicity.
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True (ie, "dry as a bone, red as a beet")
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True or False: Cycloplegia is a sign of atropine toxicity.
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True (ie, "blind as a bat")
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True or False: Constipation is a sign of atropine toxicity.
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True
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True or False: Disorientation is a sign of atropine toxicity.
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True (ie, "mad as a hatter")
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True or False: Atropine toxicity can cause acute angle-closure glaucoma in elderly patients.
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True
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True or False: Atropine toxicity can cause urinary retention in men with prostatic hypertrophy.
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True
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True or False: Atropine toxicity can cause hyperthermia in infants.
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True
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True or False: Atropine toxicity frequently causes respiratory distress.
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False; atropine toxicity does not cause respiratory distress
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True or False: Atropine toxicity can cause urinary incontinence.
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False; atropine toxicity can cause urinary retention in men with prostatic hypertrophy
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True or False: Atropine toxicity can cause fecal incontinence.
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False; atropine toxicity causes constipation, not fecal incontinence
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What type of acetylcholine receptors does hexamethonium antagonize?
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Nicotinic acetylcholine receptors
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Is hexamethonium a preganglionic, ganglionic, or postganglionic blocker?
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Ganglionic
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What effect does hexamethonium have on heart rate?
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Prevents vagal responses to blood pressure
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What drug can prevent the reflex bradycardia that is caused by norepinephrine?
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Hexamethonium
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Name four toxicities of hexamethonium.
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Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
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Isoproterenol, dobutamine, and phenylephrine are _____ (direct/indirect) sympathomimetics.
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Direct
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Epinephrine, norepinephrine, and dopamine are _____ (direct/indirect) sympathomimetics.
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Direct
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Albuterol, terbutaline, and ritodrine are _____ (direct/indirect) sympathomimetics.
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Direct
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What four types of receptors are activated by epinephrine?
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α1, α2, β1, and β2 receptors
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Low doses of epinephrine are selective for _____ (α1, α2, β1, β2) adrenergic receptors.
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β1
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What three types of receptors are activated by norepinephrine?
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α1, α2, and β1 receptors
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Does norepinephrine have greater affinity for α-adrenergic receptors or β1-receptors?
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α-Adrenergic receptors
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Is the effect of isoproterenol on β1-receptors greater than, equal to, or less than its effect on β2-receptors?
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Equal to
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Is the effect of dopamine on D1-receptors greater than, equal to, or less than its effect on D2-receptors?
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Equal to
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Is the effect of dopamine on dopamine receptors greater than, equal to, or less than its effect on β-receptors?
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Greater than
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Does dopamine have a greater affinity for α-receptors or for dopamine receptors?
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Dopamine receptors
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Is the effect of dopamine on β-receptors greater than, equal to, or less than its effect on α-receptors?
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Greater than
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Is the effect of dobutamine on β1-receptors greater than, equal to, or less than its effect on β2-receptors?
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Greater than
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Dopamine is _____ (ionotropic/not ionotropic) and _____ (chronotropic/not chronotropic), while dobutamine is _____ (ionotropic/not ionotropic) and _____ (chronotropic/not chronotropic).
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Ionotropic; chronotropic; ionotropic; not chronotropic
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Phenylephrine has _____ (greater/lesser/equal) effect on α1-adrenergic receptors compared to α2-adreneric receptors.
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Greater
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Terbutaline has _____ (greater/lesser/equal) effect on β1-adrenergic receptors compared to β2-adreneric receptors.
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Lesser
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Albuterol has _____ (greater/lesser/equal) effect on β2-adrenergic receptors compared to β1-adreneric receptors.
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Greater
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Ritodrine acts on _____ (α1, α2, β1, β2)-adrenergic receptors.
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β2
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What are the clinical applications of epinephrine?
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Anaphylaxis, open-angle glaucoma, asthma, hypotension
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True or False: Norepinephrine can be used to treat hypotension.
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True
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What effect does norepinephrine have on renal perfusion?
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It decreases renal perfusion
It decreases renal perfusion |
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True or False: Isoproterenol can be used to treat atrioventricular block.
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True
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True or False: Isoproterenol is used to treat anaphylaxis.
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False; epinephrine is used to treat anaphylaxis, not isoproterenol
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True or False: Dopamine is used to treat anaphylaxis.
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False; epinephrine is used to treat anaphylaxis, not dopamine
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True or False: Dobutamine is used to treat anaphylaxis.
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False; epinephrine is used to treat anaphylaxis, not dobutamine
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True or False: Dopamine can be used to treat shock.
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True
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What role does dopamine have in treating shock?
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Increases blood pressure while maintaining renal perfusion
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True or False: Dopamine can be used to treat heart failure.
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True
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True or False: Dobutamine can be used to treat shock.
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True
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True or False: Dobutamine can be used to treat heart failure.
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True
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What are the clinical applications of phenylephrine?
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Treats nasal decongestion; causes vasoconstriction; dilates pupils
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True or False: Albuterol is a treatment for acute asthma.
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True
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True or False: Terbutaline and ritodrine can be used to treat premature uterine contractions.
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True
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Amphetamine, ephedrine, and cocaine are (direct/indirect) sympathomimetics.
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Indirect
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By what mechanism does amphetamine exert its sympathomimetic effect?
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It stimulates the release of stored catecholamines
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By what mechanism does ephedrine exert its sympathomimetic effect?
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It stimulates the release of stored catecholamines
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By what mechanism does cocaine exert its sympathomimetic effect?
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It inhibits catecholamine uptake in the nerve terminal
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What type of adrenergic receptors does clonidine act on?
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Central α-2 receptors
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What is the effect of clonidine on central adrenergic outflow?
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It decreases central adrenergic outflow
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True or False: Amphetamine can be used to treat narcolepsy.
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True
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True or False: Amphetamine can be used to treat obesity.
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True
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True or False: Amphetamine can be used to treat attention deficit disorder.
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True True
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True or False: Amphetamine can be used to treat nasal congestion.
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False; ephedrine can be used to treat nasal congestion
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True or False: Amphetamine can be used to treat urinary incontinence.
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False; ephedrine can be used to treat urinary incontinence
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What are the clinical applications of ephedrine?
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Treats nasal congestion, urinary incontinence, and hypotension
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True or False: Ephedrine is used to treat asthma.
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False; albuterol is used to treat asthma
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True or False: Ephedrine is used to treat obesity.
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False; amphetamines are used to treat obesity
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True or False: Ephedrine is used to treat narcolepsy.
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False; amphetamines are used to treat narcolepsy
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True or False: Phenylephrine can be used to dilate pupils.
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True
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True or False: Phenylephrine can be used for vasoconstriction.
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True
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True or False: Phenylephrine can be used to treat nasal congestion.
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True
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True or False: Albuterol is used to treat nasal congestion.
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False; ephedrine and phenylepherine are used to treat nasal congestion
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True or False: Terbutaline can be used to treat nasal congestion.
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False; ephedrine and phenylepherine are used to treat nasal congestion
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True or False: Cocaine can cause vasoconstriction.
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True
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True or False: Cocaine can cause local anesthesia.
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True
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True or False: Clonidine can be used to treat hypertension.
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True
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True or False: Clonidine can be used to treat hypertension in patients with renal disease.
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True; clonidine does not reduce blood flow to kidney
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True or False: α-Methyldopa can be used to treat hypertension.
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True
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True or False: α-Methyldopa causes hypoperfusion to the kidneys.
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False; α-metyldopa does not decrease blood flow to the kidneys
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What are two patient populations for which methyldopa is indicated (as an anti-hypertensive)?
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Renal failure patients, pregnant patients
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True or False: α-Methyldopa can be used to treat hypertension in patients with renal disease.
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True
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Is the effect of norepinephrine on β-receptors greater than, equal to, or less than its effect on α-receptors?
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Less than
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Is the effect of epinephrine on β-receptors greater than, equal to, or less than its effect on α-receptors?
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Equal to
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Is the effect of isoproterenol on β-receptors greater than, equal to, or less than its effect on α-receptors?
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Greater than
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What effect does norepinephrine have on systolic blood pressure?
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It increases systolic blood pressure
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What effect does norepinephrine have on diastolic blood pressure?
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It increases diastolic blood pressure
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Does pulse pressure increase, decrease, or remain unchanged when norepinephrine is administered?
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It increases slightly, because systolic pressure rises more than diastolic pressure
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What effect does norepinephrine have on the heart rate?
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It reduces heart rate by causing reflex bradycardia
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What effect does epinephrine have on systolic blood pressure?
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It increases systolic blood pressure
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What effect does epinephrine have on diastolic blood pressure?
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It decreases diastolic blood pressure
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Does pulse pressure increase, decrease, or remain unchanged when epinephrine is administered?
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It increases significantly because systolic blood pressure rises while diastolic blood pressure drops
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What effect does epinephrine have on the heart rate?
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It increases the heart rate because it is a β1 agonist
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What effect does isoproterenol have on systolic blood pressure?
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Isoproterenol causes little change in systolic blood pressure
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What effect does isoproterenol have on diastolic blood pressure?
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It decreases diastolic blood pressure because it is a β2 agonist
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Does pulse pressure increase, decrease, or remain unchanged when isoproterenol is administered?
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It increases
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What effect does isoproterenol have on the heart rate?
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It increases the heart rate significantly; it is used for cardiac stress testing
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Why does norepinephrine administration result in reflex bradycardia?
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Norepinephrine raises blood pressure, causing a vagal response that leads to reflex bradycardia via increased parasympathetic input to the heart
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Epinephrine causes an increase in heart rate via which receptor subtype?
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β1 receptors; although epinephrine exhibits affinity for both β subtypes, it is selective for β1 at low doses, leading to tachycardia
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What effect does isoproteronol have on pulse pressure and heart rate?
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Increases pulse pressure and heart rate
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Name four selective β2-agonists.
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Metaproterenol, Albuterol, Salmeterol, Terbutaline (MAST)
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What endocrine disease is an indication for treatment with phenoxybenzamine?
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Pheochromocytoma
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Is phenoxybenzamine a reversible or irreversible α-blocker?
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Irreversible
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Is phentolamine a reversible or irreversible α-blocker?
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Reversible
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Is phenoxybenzamine a selective or nonselective α-blocker?
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Nonselective
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Is phentolamine a selective or nonselective α-blocker?
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Nonselective
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What two α-blockers can be used to treat pheochromocytoma?
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Phenoxybenzamine or phentolamine
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True or False: Orthostatic hypotension is a side effect of phenoxybenzamine.
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True
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True or False: Orthostatic hypotension is a side effect of phentolamine.
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True
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True or False: Reflex tachycardia is a toxicity of phenoxybenzamine.
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True
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True or False: Hypertension is a sign of phentolamine toxicity.
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False; orthostatic hypotension is a sign of phenoxybenzamine toxicity
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True or False: Prazosin is used to treat pheochromocytoma.
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False; prazosin is used to treat hypertension and urinary retention in benign prostatic hyperplasia
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At what point in treatment is phenoxybenzamine used in a patient who will be undergoing surgery to remove a pheochromocytoma?
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It is administered before the surgery to block effects of high levels of cathecholamines that may be released from the tumor
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True or False: Doxazosin is used to treat pheochromocytoma.
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False; doxazosin is used to treat hypertension and urinary retention in benign prostatic hyperplasia
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True or False: Prazosin is used to treat hypertension.
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True
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True or False: Doxazosin is used to treat hypertension.
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True
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True or False: Doxazosin is used to treat urinary retention in benign prostatic hyperplasia.
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True
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Is prazosin an α1-, α2-, or nonselective α-blocker?
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α1-Selective
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Is terazosin an α1-, α2-, or nonselective α-blocker?
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α1-Selective
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Is doxazosin an α1-, α2-, or nonselective α-blocker?
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α1-Selective
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True or False: Orthostatic hypotension can occur with the initial dose of prazosin.
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True
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True or False: Dizziness is a doxazosin side effect.
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True
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True or False: Headache is a terazosin side effect.
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True
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True or False: Headache is a doxazosin side effect.
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True
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True or False: Increased appetite is a side effect of doxazosin.
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False; increased appetitie is not a side effect of prazosin
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What psychiatric disorder is an indication for treatment with mirtazapine?
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Depression
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Mirtazapine blocks what type of adrenergic receptor?
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α2-Receptor
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Is mirtazapine an α1-, α2-, or nonselective α-blocker?
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α2-Selective
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True or False: Hypercholesterolemia is a side effect of mirtazapine.
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True
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True or False: Sedation is a mirtazapine side effect.
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True
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True or False: Increased appetite is a side effect of mirtazapine.
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True
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True or False: Orthostatic hypotension is a side effect of mirtazapine.
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False; orthostatic hypotension is not a side effect of mirtazapine
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True or False: A large dose of epinephrine has a net pressor effect on blood pressure.
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True
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True or False: Phenylephrine has a net pressor effect on blood pressure.
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True
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True or False: A large dose of epinephrine has a net depressor effect on blood pressure.
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False; epinephrine has a net pressor effect
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True or False: Phenylephrine has a net depressor effect on blood pressure.
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False; phenylephrine has a net pressor effect
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True or False: In the presence of phentolamine, epinephrine has a net pressor effect on blood pressure.
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False; phentolamine (an α-blocker) effectively blocks the pressor effect of epinephrine, which is an agonist of α- and β-receptors, on blood pressure; the β agonist activity dominates leading to a net depressor effect in the presence of phentolamine
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True or False: In the presence of phentolamine, phenylephrine has a net pressor effect on blood pressure.
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False; phentolamine (an α-blocker) effectively blocks the pressor effect of phenylephrine, which is an α-receptor agonist, on blood pressure; since phenylephrine has only α agonist activity, which is blocked by phentolamine, the addition of phentolamine leads to a suppression of pressor effect, but no depressor effect
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True or False: In the presence of phentolamine, epinephrine has a net depressor effect on blood pressure.
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True
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True or False: Phentolamine effectively suppresses the pressor effect of phenylephrine on blood pressure and has no additional depressor effect.
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True
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True or False: Phentolamine effectively suppresses the pressor effect of phenylephrine on blood pressure and has an additional depressor effect.
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False; phentolamine (an α-blocker) effectively blocks the pressor effect of phenylephrine (an α-receptor agonist) on blood pressure; there is no additional depressor effect (as would be the case with epinephrine stimulation) as a result
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The net pressor effect of epinephrine on mean blood pressure is reversed to a net depressor effect when it is given in the presence of phentolamine. The stimulation of what receptor class is responsible for the net pressor effect of epinephrine?
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α-Receptor
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The net pressor effect of epinephrine on mean blood pressure is reversed to a net depressor effect when it is given in the presence of α blockade by phentolamine. Unopposed stimulation of what specific receptor subtype is responsible for the net depressor effect?
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β2-receptor
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True or False: Phenylephrine can be considered a "pure" α-agonist, without β action.
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True
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What is the mechanism of action of propranolol?
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β-Blockade
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What is the mechanism of action of metoprolol?
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β-Blockade
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What is the mechanism of action of atenolol?
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β-Blockade
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What is the mechanism of action of betaxolol?
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β-Blockade
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What is the mechanism of action of timolol?
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β-Blockade
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What is the mechanism of action of pindolol?
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β-Blockade
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What is the mechanism of action of esmolol?
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β-Blockade
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What is the mechanism of action of labetalol?
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β-Blockade, and alpha
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True or False: β-Blockers can be used to treat hypertension.
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True; β-blockers reduce cardiac output and renin secretion
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True or False: β-Blockers can be used to treat angina pectoris.
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True; β-blockers reduce oxygen consumption by the heart
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True or False: Previous myocardial infarction is an indication for the use of β-blockers.
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True; β-blockers reduce mortality after MI
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True or False: β-Blockers can be used to treat supraventricular tachycardia.
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True ; specifically propanolol and esmolol
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True or False: β-Blockers can be used to treat congestive heart failure.
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True; β-blockers slow the progression of chronic heart failure
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True or False: β-Blockers can be used to treat glaucoma.
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True; specifically esmolol
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What two β-blockers are frequently used to treat supraventricular tachycardia?
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Propranolol, esmolol
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What β-blocker is frequently used to treat glaucoma?
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Timolol
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True or False: β-Blockers are effective for the treatment of hypertension because they lower cardiac output.
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True
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True or False: β-Blockers are effective for the treatment of hypertension because they increase renin secretion.
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False; β-blockers decrease renin secretion
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How do β-blockers work in the setting of angina pectoris?
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Decrease heart rate and contractility, decrease oxygen consumption
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True or False: β-Blockers are effective for the treatment of angina pectoris because they reduce oxygen consumption.
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True
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True or False: The use of β-blockers in the setting of a myocardial infarction decreases mortality.
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True
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How do β-blockers help in the setting of supraventricular tachycardia?
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Decrease AV conduction velocity
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To which class of antiarrhythmics do β-blockers belong?
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Class II
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True or False: The use of β-blockers slows the progression of congestive heart failure to chronic heart failure.
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True
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True or False: β-Blockers are effective for the treatment of glaucoma because they reduce the secretion of aqueous humor.
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True
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True or False: Impotence is a side effect of β-blockers.
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True
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True or False: β-Blockers can be used to treat asthma.
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False; some β-blockers can exacerbate asthma
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True or False: Tachycardia may be an adverse effect of β-blockers.
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False; bradycardia may be an adverse effect of β-blockers
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True or False: Atrioventricular block may be an adverse effect of β-blockers.
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True
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True or False: Congestive heart failure may be an adverse effect of β-blocker toxicity.
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True; β-blockers reduce cardiac output
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True or False: Sedation may be an adverse effect of β-blockers on the CNS
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True
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True or False: Sleep alteration may be an adverse effect of β-blockers on the CNS
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True
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Why should β-blockers be used with caution in diabetic patients?
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β-Blockers should be used with caution in diabetic patients because they can block initial warning signs of hypoglycemia such as increased heart rate and diaphoresis
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Is propranolol a β1-selective, β2-selective, or nonselective β-blocker?
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Nonselective
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Is timolol a β1-selective, β2-selective, or nonselective β-blocker?
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Nonselective
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Is nadolol a β1-selective, β2-selective, or nonselective β-blocker?
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Nonselective
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Is pindolol a β1-selective, β2-selective, or nonselective β-blocker?
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Nonselective
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Is labetalol a β1-selective, β2-selective, or nonselective β-blocker?
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Nonselective
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Name five nonselective β-blockers.
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Propanolol, timolol, nadolol, pindolol, and labetalol
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Is acebutolol a β1-selective, β2-selective, or nonselective β-blocker?
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β1-Selective
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Is betaxolol a β1-selective, β2-selective, or nonselective β-blocker?
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β1-Selective
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Is esmolol a β1-selective, β2-selective, or nonselective β-blocker?
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β1-Selective
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Is atenolol a β1-selective, β2-selective, or nonselective β-blocker?
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β1-Selective
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Is metoprolol a β1-selective, β2-selective, or nonselective β-blocker?
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β1-Selective
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Name five β1-selective antagonists.
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Acebutolol, Betaxolol, Esmolol, Atenolol, Metoprolol; (A BEAM of β1-blockers)
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True or False: Pindolol is a β-blocker with partial agonist activity.
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True
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True or False: Labetalol is a β-blocker with partial agonist activity.
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False; labetalol is a non-selective α- and β-antagonist
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True or False: Acebutolol is a β-blocker with partial agonist activity.
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True
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True or False: Nadolol is a β-blocker with partial agonist activity.
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False; nadolol is a nonselective β-adrenergic antagonist
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True or False: Atenolol is a β-blocker with partial agonist activity.
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False; atenolol is a β1-selective antagonist
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Which β-blocker is the shortest acting?
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Esmolol
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What β-blockers have partial agonist activity?
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Pindolol, Acebutolol (Partial Agonist)
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What are two nonselective α and β antagonists?
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Carvedilol, labetalol
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What is the mechanism of action of acebutalol?
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β-Blockade
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