Pha - Autonomic Nervous System Drugs

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| By Sgallagher87

Sgallagher87

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Quizzes Created: 9 | Total Attempts: 16,182

Questions: 36 | Attempts: 286 | Updated: Mar 22, 2023

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Autonomic Nervous System Quizzes & Trivia

Questions and Answers

1.

Increases effect/agonist. binds to postsynaptic axon receptor directly and mimicks the effects of NE/neurotransmitter. manipulates adrenergic receptors.
- A.
  
  Direct Sympathomimetics
- B.
  
  Indirect Sympathomimetics
- C.
  
  Mixed Sympathomimetics
Correct Answer
A. Direct Sympathomimetics

Explanation
Direct sympathomimetics increase the effect of the agonist by binding directly to the postsynaptic axon receptor and mimicking the effects of the neurotransmitter NE. They manipulate adrenergic receptors to produce a sympathomimetic response.

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2.

Increases effect/agonist. works on presynaptic axon, increases release of NE/neurotransmitter. manipulates adrenergic receptors.
- A.
  
  Direct Sympathomimetics
- B.
  
  Indirect Sympathomimetics
- C.
  
  Mixed Sympathomimetics
Correct Answer
B. Indirect Sympathomimetics

Explanation
Indirect sympathomimetics increase the effect of the agonist by working on the presynaptic axon and increasing the release of neurotransmitters like NE. They manipulate adrenergic receptors to enhance the sympathetic response.

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3.
- Mechanism of Action:
  - Alpha and Beta receptor agonist
- Vascular Effects:
  - Vasoconstriction via a1 and vasodilation via b2
- Cardiac Effects:
  - Increased heart rate, increased contractility (via b1)
- Pulmonary Effects:
  - Bronchodilation (b2) and decreased secretions (a1)
- Special Characteristics:
  - Is injected with local anesthetics to delay distribution away from the injection site through vasoconstriction.**
- A.
  
  Epinephrine
- B.
  
  Norepinephrine
- C.
  
  Isoproterenol
- D.
  
  Dobutamine
- E.
  
  Dopamine
- F.
  
  Phenylephrine
- G.
  
  Albuterol
- H.
  
  Salmeterol
- I.
  
  Levalbuterol
Correct Answer
A. EpinepHrine

Explanation
Epinephrine is a medication that acts as an alpha and beta receptor agonist. It has vascular effects such as vasoconstriction through alpha-1 receptors and vasodilation through beta-2 receptors. It also has cardiac effects including increased heart rate and increased contractility through beta-1 receptors. In terms of pulmonary effects, epinephrine causes bronchodilation through beta-2 receptors and decreased secretions through alpha-1 receptors. Additionally, epinephrine is often injected with local anesthetics to delay distribution away from the injection site through vasoconstriction.

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4.
- Mechanism of Action:
  - Alpha>Beta-1>>Beta-2 agonist
- Vascular Effects:
  - Intense vasoconstriction via a1 leading to an increase in MAP (mean artery pressure)
  - Vasoconstriction is unopposed because it doesn’t bind to the b2 receptors
- Cardiac Effects:
  - Reflex slowing of the heart due to vasoconstriction (because blood pressure gets too high)
- Pulmonary Effects:
  - No b2 effect
- Special Characteristics:
  - Used in septic shock (intense blood pressure drop) when intense vasoconstriction is needed***
- A.
  
  Norepinephrine
- B.
  
  Levalbuterol
- C.
  
  Salmeterol
- D.
  
  Albuterol
- E.
  
  Phenylephrine
- F.
  
  Dopamine
- G.
  
  Dobutamine
- H.
  
  Isoproterenol
- I.
  
  Epinephrine
Correct Answer
A. NorepinepHrine

Explanation
Norepinephrine is the correct answer because it is an alpha-1 agonist, leading to intense vasoconstriction and an increase in mean artery pressure (MAP). It does not bind to beta-2 receptors, so there is no beta-2 effect. Norepinephrine is used in septic shock when intense vasoconstriction is needed to combat the drop in blood pressure.

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5.
- Mechanism of Action:
  - Only Beta (B2 more than B1)
- Vascular Effects:
  - Intense vasodilation via b2 with no alpha
- Cardiac Effects:
  - Stimulates the heart with greater effect than Epinephrine due to the vasodilation
- Pulmonary Effects:
  - Is the most potent bronchodilator*** (stops wheezing, asthma inhalers)
- Special Characteristics:
  - Used to prevent bronchospasm
- A.
  
  Isoproterenol
- B.
  
  Dobutamine
- C.
  
  Dopamine
- D.
  
  Phenylephrine
- E.
  
  Albuterol
- F.
  
  Salmeterol
- G.
  
  Levalbuterol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. Isoproterenol

Explanation
Isoproterenol is the correct answer because it is a beta-adrenergic agonist that primarily acts on beta-2 receptors, causing intense vasodilation and stimulating the heart. It is the most potent bronchodilator and is used to prevent bronchospasm. It does not have any alpha-adrenergic effects.

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6.
- Mechanism of Action:
  - Beta-1* more than Beta-2 and Alpha
- Vascular Effects:
  - No change in resistance because of low affinity for b2 and a1
- Cardiac Effects:
  - Drug of choice to stimulate heart** (because of its strong effect on b1); Minor change in heart rate but it makes the heart more efficient
- Pulmonary Effects:
  - None
- Special Characteristics:
  - Is a synthetic derivative of dopamine but has no effect on dopamine receptors
- A.
  
  Dobutamine
- B.
  
  Dopamine
- C.
  
  Phenylephrine
- D.
  
  Albuterol
- E.
  
  Salmeterol
- F.
  
  Levalbuterol
- G.
  
  Isoproterenol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. Dobutamine

Explanation
Dobutamine is the correct answer because it has a strong effect on beta-1 receptors, making it the drug of choice to stimulate the heart. It has a minor effect on heart rate but improves the efficiency of the heart. It does not have any pulmonary effects and is a synthetic derivative of dopamine but does not affect dopamine receptors.

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7.
- Mechanism of Action:
  - Dopamine receptors and Beta-1
- Vascular Effects:
  - **Low dose: constricts vessels in sites other than the kidneys or brain
  - High Dose: constricts all vessels
- Cardiac Effects:
  - Increases contractility and increase in systolic blood pressure*
- Pulmonary Effects:
  - None
- Special Characteristics:
  - Used to treat *shock related to underperfusion (not enough fluids in blood vessels) and reflex vasoconstriction
- A.
  
  Dopamine
- B.
  
  Phenylephrine
- C.
  
  Albuterol
- D.
  
  Salmeterol
- E.
  
  Levalbuterol
- F.
  
  Dobutamine
- G.
  
  Isoproterenol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. Dopamine

Explanation
Dopamine is the correct answer because it acts on dopamine receptors and beta-1 receptors. At low doses, it constricts blood vessels in sites other than the kidneys or brain, while at high doses, it constricts all blood vessels. Dopamine also increases contractility and systolic blood pressure. It does not have any pulmonary effects. Dopamine is commonly used to treat shock related to underperfusion and reflex vasoconstriction.

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8.
- Mechanism of Action:
  - Alpha
- Vascular Effects:
  - Intense vasoconstriction with an increased MAP (mean artery pressure)
- Cardiac Effects:
  - Decreases heart rate due to a reflex reaction to the increase arterial pressure
- Pulmonary Effects:
  - None
- Special Characteristics:
  - **Used to treat SVT (supraventrical tachycardia)
  - **Is included in cold remedies as a decongestant due to nasal vasoconstriction
- A.
  
  Phenylephrine
- B.
  
  Albuterol
- C.
  
  Salmeterol
- D.
  
  Levalbuterol
- E.
  
  Dopamine
- F.
  
  Dobutamine
- G.
  
  Isoproterenol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. pHenylepHrine

Explanation
Phenylephrine is the correct answer because it is a medication that acts as an alpha-adrenergic agonist. It causes intense vasoconstriction, leading to an increased mean arterial pressure (MAP). It also decreases heart rate due to a reflex reaction to the increase in arterial pressure. Phenylephrine does not have any pulmonary effects. It is used to treat supraventricular tachycardia (SVT) and is included in cold remedies as a nasal decongestant because it causes nasal vasoconstriction.

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9.
- Mechanism of Action:
  - Beta-2
- Vascular Effects:
  - Vasodilation
- Cardiac Effects:
  - None but may have reflex tachycardia
- Pulmonary Effects:
  - bronchodilation
- Special Characteristics:
  - Used to treat acute asthma exacerbations**
- A.
  
  Albuterol
- B.
  
  Salmeterol
- C.
  
  Levalbuterol
- D.
  
  Phenylephrine
- E.
  
  Dopamine
- F.
  
  Dobutamine
- G.
  
  Isoproterenol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. Albuterol

Explanation
Albuterol is a beta-2 adrenergic agonist that works by stimulating beta-2 receptors in the smooth muscles of the airways, causing bronchodilation. It does not have any direct cardiac effects, but it may cause reflex tachycardia as a result of its vasodilatory effects. It is commonly used to treat acute asthma exacerbations.

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10.
- Mechanism of Action:
  - Beta-2
- Vascular Effects:
  - Vasodilation
- Cardiac Effects:
  - None but may have reflex tachycardia
- Pulmonary Effects:
  - Bronchodilation
- Special Characteristics:
  - Is long acting**
- A.
  
  Salmeterol
- B.
  
  Levalbuterol
- C.
  
  Albuterol
- D.
  
  Phenylephrine
- E.
  
  Dopamine
- F.
  
  Dobutamine
- G.
  
  Isoproterenol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. Salmeterol

Explanation
Salmeterol is a beta-2 agonist that works by binding to and activating beta-2 adrenergic receptors in the smooth muscles of the airways. This leads to bronchodilation, making it an effective treatment for asthma and chronic obstructive pulmonary disease (COPD). Unlike other beta-2 agonists, such as albuterol, salmeterol has a long duration of action, allowing for twice-daily dosing. It does not have significant cardiac effects, but it may cause reflex tachycardia as a result of its vasodilatory effects. Therefore, the correct answer is salmeterol.

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11.
- Mechanism of Action:
  - Beta-2
- Vascular Effects:
  - vasodilation
- Cardiac Effects:
  - None but may have reflex tachycardia
- Pulmonary Effects:
  - Bronchodilation
- Special Characteristics:
  - Less cardiac side effects than albuterol**
- A.
  
  Levalbuterol
- B.
  
  Salmeterol
- C.
  
  Albuterol
- D.
  
  Phenylephrine
- E.
  
  Dopamine
- F.
  
  Dobutamine
- G.
  
  Isoproterenol
- H.
  
  Norepinephrine
- I.
  
  Epinephrine
Correct Answer
A. Levalbuterol

Explanation
Levalbuterol is a beta-2 agonist that works by causing vasodilation and bronchodilation. It does not have any cardiac effects, but it may cause reflex tachycardia. What sets levalbuterol apart from albuterol is that it has fewer cardiac side effects.

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12.
- Bind to alpha-1, alpha-2, beta-1 and beta 2 receptors
- Turn on second messengers which mediate the various effects associated with each receptor
- Drugs include:
  - Epinephrine
  - Norepinephrine
  - Isoproterenol
  - Dobutamine
  - Dopamine
  - Phenylephrine
  - Albuterol
  - Salmeterol
  - Levalbuterol
- A.
  
  Direct Sympathomimetics
- B.
  
  Indirect Sympathomimetics
- C.
  
  Mixed Sympathomimetics
Correct Answer
A. Direct Sympathomimetics

Explanation
The given correct answer suggests that the drugs listed in the question bind to alpha-1, alpha-2, beta-1, and beta-2 receptors. This means that they directly stimulate these receptors, leading to the activation of second messengers that mediate the various effects associated with each receptor. These drugs are classified as direct sympathomimetics because they directly mimic the effects of the sympathetic nervous system.

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13.
- Cause norepinephrine release but do not bind to adrenergic receptors.
- They enter the presynaptic terminal and displace NE from storage vesicles.
- Drugs include:
  - Amphetamine
  - Methamphetamine
- A.
  
  Indirect Sympathomimetics
- B.
  
  Mixed Sympathomimetics
- C.
  
  Direct Sympathomimetics
Correct Answer
A. Indirect Sympathomimetics
14.
- Mechanism of Action:
  - Enter presynaptic terminal and displace NE from storage vesicles
- Vascular Effects:
  - vasoconstriction
- Cardiac Effects:
  - Increase in contraction with a reflex bradycardia from increased MAP (mean artery pressure)
- CNS Effects:
  - Wakefulness, euphoria
- Unwanted Side Effects:
  - Hypertension, cerebral hemorrhage, convulsions, tremor
- Special Characteristics:
  - Used for narcolepsy, ADD, Parkinson’s**
- A.
  
  Amphetamine/Methamphetmaine
- B.
  
  Ephedrine
- C.
  
  Methyldopa
- D.
  
  Clonidine
Correct Answer
A. AmpHetamine/MethampHetmaine

Explanation
Amphetamine/Methamphetamine enters the presynaptic terminal and displaces norepinephrine (NE) from storage vesicles. This leads to vasoconstriction, an increase in cardiac contraction, and a reflex bradycardia due to increased mean artery pressure (MAP). In the CNS, it causes wakefulness and euphoria. However, it also has unwanted side effects such as hypertension, cerebral hemorrhage, convulsions, tremor. It is used for conditions like narcolepsy, attention deficit disorder (ADD), and Parkinson's disease.

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15.
- Both displace NE from storage vesicles and bind to adrenergic receptors
- Drugs Include:
  - Ephedrine
- A.
  
  Mixed Sympathomimetics
- B.
  
  Central Adrenergic Nerve Blockers
- C.
  
  Adrenergic Antagonists
- D.
  
  Indirect Sympathomimetics
Correct Answer
A. Mixed Sympathomimetics

Explanation
Mixed sympathomimetics are drugs that have both direct and indirect sympathomimetic effects. They can displace norepinephrine (NE) from storage vesicles and also bind to adrenergic receptors. This means that they can increase the release of NE from storage vesicles and also directly stimulate adrenergic receptors. Ephedrine is an example of a mixed sympathomimetic drug.

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16.
- Mechanism of Action:
  - Displaces NE from storage vesicles and binds to adrenergic receptors
- Vascular Effects:
  - Vasoconstriction with an increased MAP (mean artery pressure) via a1
- Cardiac Effects:
  - Similar to epinephrine but with no change in heart rate
- CNS Effects:
  - Stimulation
- Special Characteristics:
  - Used to treat narcolepsy**
  - Causes bronchodilation**
  - Used to treat asthma and nasal congestion**
  - Used to dilate pupils
- A.
  
  Ephedrine
- B.
  
  Methyldopa
- C.
  
  Clonidine
- D.
  
  Amphetamine/Methamphetmaine
Correct Answer
A. EpHedrine

Explanation
Ephedrine is a medication that works by displacing norepinephrine (NE) from storage vesicles and binding to adrenergic receptors. This mechanism of action leads to vasoconstriction, resulting in an increased mean arterial pressure (MAP) through the activation of alpha-1 receptors. In terms of cardiac effects, ephedrine is similar to epinephrine but does not cause a change in heart rate. It also has stimulating effects on the central nervous system. Ephedrine is commonly used to treat narcolepsy and can cause bronchodilation, making it useful in the treatment of asthma and nasal congestion. Additionally, it is used to dilate pupils.

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1
0
17.
- Bind to alpha-2 receptors on neurons and prevent the release of NE from nerves**
- Drugs include:
  - Clonidine
  - Methyldopa
- A.
  
  Central Adrenergic Nerve Blockers
- B.
  
  Mixed Sympathomimetics
- C.
  
  Indirect Sympathomimetics
- D.
  
  Adrenergic Antagonists
Correct Answer
A. Central Adrenergic Nerve Blockers

Explanation
Central Adrenergic Nerve Blockers, such as Clonidine and Methyldopa, bind to alpha-2 receptors on neurons and prevent the release of NE (norepinephrine) from nerves. This action leads to a decrease in sympathetic outflow from the central nervous system, resulting in a decrease in blood pressure. These drugs are commonly used to treat hypertension and other conditions related to increased sympathetic activity.

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18.
- Blockade Mechanism:
  - Potent alpha-2 agonist
- Actions:
  - Decreases preganglionic sympathetic outflow which results in a decreased blood pressure**
- Side Effects:
  - Orthostatic hypotension
  - Sedation
  - Rebound hypertension
- Clinical Use:
  - Hypertension***
- A.
  
  Clonidine
- B.
  
  Methyldopa
- C.
  
  Ephedrine
- D.
  
  Amphetamine/Methamphetmaine
Correct Answer
A. Clonidine

Explanation
Clonidine is a potent alpha-2 agonist that decreases preganglionic sympathetic outflow, leading to a decrease in blood pressure. It is used for the treatment of hypertension. However, it can cause side effects such as orthostatic hypotension, sedation, and rebound hypertension. Therefore, Clonidine is the correct answer.

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19.
- Blockade Mechanism:
  - Metabolized to alpha-methylnorepinephrine which is a potent alpha-2 agonist
- Actions:
  - Decreases sympathetic outflow causing a rapid decrease in blood pressure**
- Side Effects:
  - Sedation, mild orthostatic hypotension, coombs positive RBC (can cause allergies), rebound HTN
- Clinical Use:
  - Hypertension**
- A.
  
  Methyldopa
- B.
  
  Clonidine
- C.
  
  Ephedrine
- D.
  
  Amphetamine/Methamphetmaine
Correct Answer
A. Methyldopa

Explanation
Methyldopa is a medication that is metabolized to alpha-methylnorepinephrine, which acts as a potent alpha-2 agonist. This mechanism of action leads to a decrease in sympathetic outflow, resulting in a rapid decrease in blood pressure. Methyldopa is primarily used for the treatment of hypertension. However, it can also cause side effects such as sedation, mild orthostatic hypotension, coombs positive RBC (which can cause allergies), and rebound hypertension.

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20.
- Block NE from binding to the postsynaptic adrenergic receptors
- Drugs include:
  - Phenoxybenzamine
  - Phentolamine
  - Prazosin
  - Doxazosin
  - Labetalol
  - Propranolol
  - Timilol
  - Metoprolol
- A.
  
  Adrenergic Antagonists
- B.
  
  Central Adrenergic Nerve Blockers
- C.
  
  Mixed Sympathomimetics
- D.
  
  Indirect Sympathomimetics
Correct Answer
A. Adrenergic Antagonists

Explanation
Adrenergic antagonists are drugs that block the action of adrenergic receptors, preventing the binding of neurotransmitters such as norepinephrine and epinephrine. In this case, the correct answer suggests that the drugs listed, including Phenoxybenzamine, Phentolamine, Prazosin, Doxazosin, Labetalol, Propranolol, Timilol, and Metoprolol, all belong to the class of adrenergic antagonists. These drugs block the binding of norepinephrine and epinephrine to the postsynaptic adrenergic receptors, thereby reducing the effects of the sympathetic nervous system.

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1
0
21.
- Receptor:
  - Alpha-1 and alpha-2
- Actions:
  - Vasodilation, blocks sympathetic outflow from the brain
- Clinical Use:
  - Pheochromocytoma (adrenal gland tumor)**
- Controls Hypertension**
- Side Effects:
  - Postural hypotension, reflex tachycardia, sexual dysfunction**
- Special Features:
  - none
- A.
  
  Phenoxybenzamine
- B.
  
  Phentolamine
- C.
  
  Prazosin
- D.
  
  Doxazosin
- E.
  
  Labetalol
- F.
  
  Propranolol
- G.
  
  Timilol
- H.
  
  Metroprolol
Correct Answer
A. pHenoxybenzamine

Explanation
Phenoxybenzamine is the correct answer because it is an alpha-blocker that acts on both alpha-1 and alpha-2 receptors. It causes vasodilation and blocks sympathetic outflow from the brain, making it effective in treating hypertension and pheochromocytoma. However, it can also cause side effects such as postural hypotension, reflex tachycardia, and sexual dysfunction.

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22.
- Receptor:
  - Alpha-1, alpha-2
- Actions:
  - Vasodilation
- Clinical Use:
  - Pheochromocytoma (adrenal gland tumor)**
    - To control HTN and is the pharmacological test
- Side Effects:
  - Tachycardia, arrhythmias, hypotensive episodes**
- Special Features:
  - None
- A.
  
  Phentolamine
- B.
  
  Phenoxybenzamine
- C.
  
  Prazosin
- D.
  
  Doxazosin
- E.
  
  Labetalol
- F.
  
  Propranolol
- G.
  
  Timilol
- H.
  
  Metroprolol
Correct Answer
A. pHentolamine

Explanation
Phentolamine is the correct answer because it is an alpha-blocker that acts on both alpha-1 and alpha-2 receptors. It is used in the clinical setting for the treatment of pheochromocytoma, a tumor in the adrenal glands, to control hypertension. Its main action is vasodilation, which helps to lower blood pressure. However, it can also cause side effects such as tachycardia, arrhythmias, and hypotensive episodes. Phentolamine does not have any special features distinguishing it from other alpha-blockers.

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23.
- Receptor:
  - Alpha-1
- Actions:
  - vasodilation
- Clinical Use:
  - Hypertension
- Side Effects:
  - Postural hypotension with first dose**
- Special Features:
  - None
- A.
  
  Prazosin
- B.
  
  Phentolamine
- C.
  
  Phenoxybenzamine
- D.
  
  Doxazosin
- E.
  
  Labetalol
- F.
  
  Propranolol
- G.
  
  Timilol
- H.
  
  Metroprolol
Correct Answer
A. Prazosin

Explanation
Prazosin is the correct answer because it is an alpha-1 receptor antagonist. Alpha-1 receptors are found in smooth muscle, including the blood vessels, and their blockade leads to vasodilation. Prazosin is commonly used in the treatment of hypertension. One of the side effects of prazosin is postural hypotension, especially with the first dose. There are no special features or unique characteristics mentioned for prazosin.

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24.
- Receptor:
  - Alpha-1
- Actions:
  - vasodilation
- Clinical Use:
  - HTN, Benign Prostate Hyperplasia
    - Relaxes smooth muscle in the bladder neck
- Side Effects:
  - Postural hypotension with first dose
- Special Features:
  - None
- A.
  
  Doxazosin
- B.
  
  Labetalol
- C.
  
  Propranolol
- D.
  
  Timilol
- E.
  
  Metroprolol
- F.
  
  Prazosin
- G.
  
  Phentolamine
- H.
  
  Phenoxybenzamine
Correct Answer
A. Doxazosin

Explanation
Doxazosin is a medication that belongs to the class of drugs known as alpha-1 blockers. It acts on the alpha-1 receptors and causes vasodilation, which helps in reducing blood pressure. It is commonly used in the treatment of hypertension (HTN) and benign prostate hyperplasia (BPH). In addition to its vasodilatory effects, doxazosin also relaxes smooth muscle in the bladder neck, making it useful in relieving symptoms associated with BPH. One of the side effects of doxazosin is postural hypotension, especially with the first dose. It does not have any special features that distinguish it from other alpha-1 blockers.

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25.
- Receptor:
  - Alpha-1, Beta-1, Beta-2
- Actions:
  - Decreases BP from alpha 1 blockade without a reflex tachycardia from b1 blockade**
- Clinical Use:
  - Hypertension**
- Side Effects:
  - Suppresses a failing heart, impotence, orthostatic HTN**
- Special Features:
  - Contraindicated in patients with asthma or bradycardia**
- A.
  
  Labetalol
- B.
  
  Propranolol
- C.
  
  Timilol
- D.
  
  Metroprolol
- E.
  
  Doxazosin
- F.
  
  Prazosin
- G.
  
  Phentolamine
- H.
  
  Phenoxybenzamine
Correct Answer
A. Labetalol

Explanation
Labetalol is the correct answer because it is a non-selective beta blocker with alpha-1 blocking activity. It decreases blood pressure by blocking the alpha-1 receptors, without causing reflex tachycardia due to its beta-1 blocking activity. Labetalol is commonly used to treat hypertension. However, it is contraindicated in patients with asthma or bradycardia. Side effects of labetalol include suppression of a failing heart, impotence, and orthostatic hypotension.

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26.
- Receptor:
  - Beta-1 and Beta-2
- Actions:
  - Decreases inotropy (force/strength of heart beating) and chronotropy (rate of heart beating) and O2 demand, decreased release of renin
- Clinical Use:
  - HTN, angina pectoris, SVT (supraventricular tachycardia), ventricular arrhythmias, MI (myocardial infarction), Migraine prophylaxis**
- Side Effects:
  - Suppression of a failing heart, CNS sedation and depression, rebound HTN, impotence**
- Special Features:
  - Contraindicated in patients with asthma**
- A.
  
  Propranolol
- B.
  
  Labetalol
- C.
  
  Timilol
- D.
  
  Metroprolol
- E.
  
  Doxazosin
- F.
  
  Prazosin
- G.
  
  Phentolamine
- H.
  
  Phenoxybenzamine
Correct Answer
A. Propranolol

Explanation
Propranolol is a non-selective beta blocker that acts on both beta-1 and beta-2 receptors. It decreases the force and rate of heart beating, reducing the oxygen demand of the heart and also decreases the release of renin. It is used in the treatment of hypertension, angina pectoris, supraventricular tachycardia, ventricular arrhythmias, myocardial infarction, and migraine prophylaxis. However, it can have side effects such as suppressing a failing heart, CNS sedation and depression, rebound hypertension, and impotence. It is contraindicated in patients with asthma.

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27.
- Receptor:
  - Beta-1 and Beta-2
- Actions:
  - Decreases inotropy and chronotropy and O2 demand, decreased release of renin
- Clinical Use:
  - HTN, MI, migraine prophylaxis, decrease intraocular pressure***
- Side Effects:
  - Suppression of a failing heart, CNS sedation and depression, rebound HTN, impotence
- Special Features:
  - Contraindicated in patients with asthma
- A.
  
  Timilol
- B.
  
  Metroprolol
- C.
  
  Propranolol
- D.
  
  Labetalol
- E.
  
  Doxazosin
- F.
  
  Prazosin
- G.
  
  Phentolamine
- H.
  
  Phenoxybenzamine
Correct Answer
A. Timilol

Explanation
Timilol is a beta-blocker that acts on both beta-1 and beta-2 receptors. It decreases inotropy and chronotropy, reducing the workload and oxygen demand of the heart. It also decreases the release of renin, which helps to lower blood pressure. Timilol is clinically used for the treatment of hypertension, myocardial infarction, and migraine prophylaxis. Additionally, it can decrease intraocular pressure, making it useful in the treatment of glaucoma. However, timilol is contraindicated in patients with asthma due to its potential to cause bronchoconstriction. Some of the side effects of timilol include suppression of a failing heart, CNS sedation and depression, rebound hypertension, and impotence.

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28.
- Receptor:
  - Beta-1
- Actions:
  - Same as propranolol but with less bronchospasm in asthmatics**
- Clinical Use:
  - HTN, angina pectoris, MI
- Side Effects:
  - Lower toxicity than propranolol**
- Special Features:
  - Safe for patients with asthma***
- A.
  
  Metoprolol
- B.
  
  Timilol
- C.
  
  Propranolol
- D.
  
  Labetalol
- E.
  
  Doxazosin
- F.
  
  Prazosin
- G.
  
  Phentolamine
- H.
  
  Phenoxybenzamine
Correct Answer
A. Metoprolol

Explanation
Metoprolol is the correct answer because it has the same actions as propranolol, such as treating hypertension, angina pectoris, and myocardial infarction, but with less bronchospasm in asthmatics. It also has lower toxicity compared to propranolol, making it a safer option. This makes metoprolol a suitable choice for patients with asthma.

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29.
- Drugs include:
  - Carbachol
  - Bethanechol
  - Pilocarpine
- A.
  
  Cholinergic Agonist
- B.
  
  Cholinergic Antagonists
- C.
  
  Adrenergic Antagonists
Correct Answer
A. Cholinergic Agonist

Explanation
The correct answer is "Cholinergic Agonist" because the drugs listed - Carbachol, Bethanechol, and Pilocarpine - are all known to stimulate or activate cholinergic receptors in the body. Cholinergic agonists mimic the effects of acetylcholine, a neurotransmitter involved in various bodily functions including muscle contractions, digestion, and the regulation of heart rate. These drugs are commonly used to treat conditions such as glaucoma, urinary retention, and dry mouth.

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30.
- Receptor:
  - M1, M2, M3, Nicotinic
- Clinical Uses:
  - Glaucoma, miosis for surgery, cataract surgery**
- Contraindications:
  - Where constriction is undesirable
- A.
  
  Carbachol
- B.
  
  Bethanecol
- C.
  
  Pilocarpine
Correct Answer
A. Carbachol

Explanation
Carbachol is the correct answer because it is a cholinergic agonist that acts on both muscarinic (M1, M2, M3) and nicotinic receptors. It is commonly used in clinical settings for conditions such as glaucoma, miosis for surgery, and cataract surgery. It is contraindicated in situations where constriction is undesirable.

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31.
- Receptor:
  - M1, M2 M3, Nicotinic
- Clinical Uses:
  - Induce evacuation of a non-obstructed bladder**
  - Increase GI motility after surgery**
- Contraindications:
  - Bradycardia, parkinsonism, epilepsy, hypo/hyper tension
- A.
  
  Bethanecol
- B.
  
  Carbachol
- C.
  
  Pilocarpine
Correct Answer
A. Bethanecol

Explanation
Bethanecol is the correct answer because it is a muscarinic receptor agonist that can stimulate M1, M2, and M3 receptors. It is used clinically to induce evacuation of a non-obstructed bladder and increase GI motility after surgery. However, it is contraindicated in patients with bradycardia, parkinsonism, epilepsy, and hypo/hypertension. Carbachol and pilocarpine are also muscarinic receptor agonists, but they are not specifically indicated for the clinical uses mentioned in the question.

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32.
- Receptor:
  - M1, M2, M3
- Clinical Uses:
  - Cystic fibrosis sweat test, glaucoma (miosis/constriction), xerostomia (dry mouth)**
- Contraindications:
  - Bradycardia, parkinsonism, epilepsy, hypo/hyper tension
- A.
  
  Pilocarpine
- B.
  
  Bethanecol
- C.
  
  Carbachol
Correct Answer
A. Pilocarpine

Explanation
Pilocarpine is the correct answer because it is a muscarinic receptor agonist that can activate M1, M2, and M3 receptors. It is used clinically for various purposes including the cystic fibrosis sweat test, glaucoma (to induce miosis or constriction of the pupil), and xerostomia (to treat dry mouth). However, it is contraindicated in patients with bradycardia, parkinsonism, epilepsy, and hypo/hypertension.

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33.
- Drugs include:
  - Atropine
  - Scopolamine
  - Oxybutynin
  - Side effects are Red, Hot, Dry, Mad
    - Red as a beet, hot as an oven, dry as a bone, mad as a hatter
- A.
  
  Cholinergic Antagonists
- B.
  
  Cholinergic Agonist
- C.
  
  Adrenergic Antagonists
Correct Answer
A. Cholinergic Antagonists

Explanation
The drugs listed in the question, Atropine, Scopolamine, and Oxybutynin, are all examples of cholinergic antagonists. Cholinergic antagonists block the action of acetylcholine, a neurotransmitter that is involved in the transmission of nerve impulses. These drugs are commonly used to treat conditions such as overactive bladder, motion sickness, and certain eye conditions. The side effects described, "Red as a beet, hot as an oven, dry as a bone, mad as a hatter," are commonly associated with cholinergic antagonists due to their effects on the autonomic nervous system.

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34.
- Action at Organ:
  - Low dose: bradycardia
  - High Dose: Tachycardia
  - Bronchodilation and decreased secretions
  - Decreased GI motility
  - Decreased salivation and sweating
  - Mydriasis (dilates pupils)
- Clinical Uses:
  - Preanesthetic to prevent respiratory secretions, low dose for tachycardia, high dose for bradycardia, dilates eyes for eye exam**
- Side Effects:
  - Dry mouth, urinary retention, tachycardia
- Special Notes:
  - Contraindicated in glaucoma, BpH, obstructive bowel disease and asthma patients**
- A.
  
  Atropine
- B.
  
  Scopolamine
- C.
  
  Oxybutynin
Correct Answer
A. Atropine

Explanation
Atropine is a medication that acts on various organs in the body. At low doses, it can cause bradycardia (slow heart rate), while at high doses it can cause tachycardia (fast heart rate). It also has bronchodilatory effects and decreases secretions, GI motility, salivation, and sweating. Atropine can also cause mydriasis, which is the dilation of pupils. Clinically, it is used as a preanesthetic to prevent respiratory secretions, and low doses can be used for tachycardia while high doses can be used for bradycardia. However, it is important to note that atropine can cause side effects such as dry mouth, urinary retention, and tachycardia. It is contraindicated in patients with glaucoma, BPH, obstructive bowel disease, and asthma.

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35.
- Action at Organ:
  - More potent at eye, and glands than atropine but less potent in the heart, lungs and GI
- Clinical Uses:
  - Prevention of motion sickness**
- Side Effects:
  - CNS depression in low doses
  - Like atropine in high doses
- Special Notes:
  - Contraindication if hypersensitive to belladonna (plant) or barbiturates**
- A.
  
  Scopolamine
- B.
  
  Oxybutynin
- C.
  
  Atropine
Correct Answer
A. Scopolamine

Explanation
Scopolamine is more potent than atropine in affecting the eye and glands, but less potent in affecting the heart, lungs, and gastrointestinal system. It is used for the prevention of motion sickness. In low doses, it can cause CNS depression, while in high doses, it has similar side effects to atropine. It should not be used in individuals who are hypersensitive to belladonna (plant) or barbiturates.

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36.
- Action at Organ:
  - Direct antispasmodic effect on smooth muscle
- Clinical Uses:
  - Relief of bladder spasms that result in urinary leakage and incontinence**
- Side Effects:
  - Decreased sweating, rash, decreased lacrimation, mydriasis**
- Special Notes: None
- A.
  
  Oxybutynin
- B.
  
  Scopolamine
- C.
  
  Atropine
Correct Answer
A. Oxybutynin

Explanation
Oxybutynin is the correct answer because it has a direct antispasmodic effect on smooth muscle. It is used for relieving bladder spasms that result in urinary leakage and incontinence. Some of the side effects of oxybutynin include decreased sweating, rash, decreased lacrimation, and mydriasis. There are no special notes mentioned about oxybutynin.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

Current Version
Mar 22, 2023

Quiz Edited by
ProProfs Editorial Team
Jan 09, 2013

Quiz Created by
Sgallagher87

Pha - Autonomic Nervous System Drugs

Increases effect/agonist. binds to postsynaptic axon receptor directly and mimicks the effects of NE/neurotransmitter. manipulates adrenergic receptors.

Increases effect/agonist. works on presynaptic axon, increases release of NE/neurotransmitter. manipulates adrenergic receptors.

Mechanism of Action:

Beta-2

Vascular Effects:

Vasodilation

Cardiac Effects:

None but may have reflex tachycardia

Pulmonary Effects:

bronchodilation

Special Characteristics:

Used to treat acute asthma exacerbations**

Mechanism of Action:

Beta-2

Vascular Effects:

Vasodilation

Cardiac Effects:

None but may have reflex tachycardia

Pulmonary Effects:

Bronchodilation

Special Characteristics:

Is long acting**

Mechanism of Action:

Beta-2

Vascular Effects:

vasodilation

Cardiac Effects:

None but may have reflex tachycardia

Pulmonary Effects:

Bronchodilation

Special Characteristics:

Less cardiac side effects than albuterol**

Bind to alpha-1, alpha-2, beta-1 and beta 2 receptors

Turn on second messengers which mediate the various effects associated with each receptor

Drugs include:

Epinephrine

Norepinephrine

Isoproterenol

Dobutamine

Dopamine

Phenylephrine

Albuterol

Salmeterol

Levalbuterol

Cause norepinephrine release but do not bind to adrenergic receptors.

They enter the presynaptic terminal and displace NE from storage vesicles.

Drugs include:

Amphetamine

Methamphetamine

Both displace NE from storage vesicles and bind to adrenergic receptors

Drugs Include:

Ephedrine

Bind to alpha-2 receptors on neurons and prevent the release of NE from nerves**

Drugs include:

Clonidine

Methyldopa

Blockade Mechanism:

Potent alpha-2 agonist

Actions:

Decreases preganglionic sympathetic outflow which results in a decreased blood pressure

Side Effects:

Orthostatic hypotension

Sedation

Rebound hypertension

Clinical Use:

Hypertension*

Block NE from binding to the postsynaptic adrenergic receptors

Drugs include:

Phenoxybenzamine

Phentolamine

Prazosin

Doxazosin

Labetalol

Propranolol

Timilol

Metoprolol

Receptor:

Alpha-1 and alpha-2

Actions:

Vasodilation, blocks sympathetic outflow from the brain

Clinical Use:

Pheochromocytoma (adrenal gland tumor)

Controls Hypertension

Side Effects:

Postural hypotension, reflex tachycardia, sexual dysfunction**

Special Features:

none

Receptor:

Alpha-1, alpha-2

Actions:

Vasodilation

Clinical Use:

Pheochromocytoma (adrenal gland tumor)

To control HTN and is the pharmacological test

Side Effects:

Tachycardia, arrhythmias, hypotensive episodes

Special Features:

None

Receptor:

Alpha-1

Actions:

vasodilation

Clinical Use:

Hypertension

Side Effects:

Postural hypotension with first dose**

Special Features:

None

Receptor:

Alpha-1

Actions:

vasodilation

Clinical Use:

HTN, Benign Prostate Hyperplasia

Relaxes smooth muscle in the bladder neck

Side Effects:

Postural hypotension with first dose

Special Features:

None

Receptor:

Beta-1

Actions:

Same as propranolol but with less bronchospasm in asthmatics

Clinical Use:

HTN, angina pectoris, MI

Side Effects:

Lower toxicity than propranolol

Special Features:

Safe for patients with asthma***

Drugs include:

Carbachol

Bethanechol

Pilocarpine

Receptor:

M1, M2, M3, Nicotinic

Clinical Uses:

Glaucoma, miosis for surgery, cataract surgery**

Contraindications:

Where constriction is undesirable

Receptor:

M1, M2 M3, Nicotinic

Clinical Uses:

Induce evacuation of a non-obstructed bladder

Increase GI motility after surgery

Contraindications:

Bradycardia, parkinsonism, epilepsy, hypo/hyper tension

Receptor:

M1, M2, M3

Clinical Uses:

Cystic fibrosis sweat test, glaucoma (miosis/constriction), xerostomia (dry mouth)**

Contraindications:

Bradycardia, parkinsonism, epilepsy, hypo/hyper tension

Drugs include:

Atropine

Scopolamine

Oxybutynin

Side effects are Red, Hot, Dry, Mad

Red as a beet, hot as an oven, dry as a bone, mad as a hatter

Action at Organ:

Direct antispasmodic effect on smooth muscle

Clinical Uses:

Relief of bladder spasms that result in urinary leakage and incontinence

Side Effects:

Decreased sweating, rash, decreased lacrimation, mydriasis

Special Notes: None

Pha - Autonomic Nervous System Drugs

Increases effect/agonist. binds to postsynaptic axon receptor directly and mimicks the effects of NE/neurotransmitter. manipulates adrenergic receptors.

Increases effect/agonist. works on presynaptic axon, increases release of NE/neurotransmitter. manipulates adrenergic receptors.

Mechanism of Action: Beta-2 Vascular Effects: Vasodilation Cardiac Effects: None but may have reflex tachycardia Pulmonary Effects: bronchodilation Special Characteristics: Used to treat acute asthma exacerbations**

Mechanism of Action: Beta-2 Vascular Effects: Vasodilation Cardiac Effects: None but may have reflex tachycardia Pulmonary Effects: Bronchodilation Special Characteristics: Is long acting**

Mechanism of Action: Beta-2 Vascular Effects: vasodilation Cardiac Effects: None but may have reflex tachycardia Pulmonary Effects: Bronchodilation Special Characteristics: Less cardiac side effects than albuterol**

Bind to alpha-1, alpha-2, beta-1 and beta 2 receptors Turn on second messengers which mediate the various effects associated with each receptor Drugs include: Epinephrine Norepinephrine Isoproterenol Dobutamine Dopamine Phenylephrine Albuterol Salmeterol Levalbuterol

Cause norepinephrine release but do not bind to adrenergic receptors. They enter the presynaptic terminal and displace NE from storage vesicles. Drugs include: Amphetamine Methamphetamine

Both displace NE from storage vesicles and bind to adrenergic receptors Drugs Include: Ephedrine

Bind to alpha-2 receptors on neurons and prevent the release of NE from nerves** Drugs include: Clonidine Methyldopa

Blockade Mechanism: Potent alpha-2 agonist Actions: Decreases preganglionic sympathetic outflow which results in a decreased blood pressure** Side Effects: Orthostatic hypotension Sedation Rebound hypertension Clinical Use: Hypertension***

Block NE from binding to the postsynaptic adrenergic receptors Drugs include: Phenoxybenzamine Phentolamine Prazosin Doxazosin Labetalol Propranolol Timilol Metoprolol

Receptor: Alpha-1 and alpha-2 Actions: Vasodilation, blocks sympathetic outflow from the brain Clinical Use: Pheochromocytoma (adrenal gland tumor)** Controls Hypertension** Side Effects: Postural hypotension, reflex tachycardia, sexual dysfunction** Special Features: none

Receptor: Alpha-1, alpha-2 Actions: Vasodilation Clinical Use: Pheochromocytoma (adrenal gland tumor)** To control HTN and is the pharmacological test Side Effects: Tachycardia, arrhythmias, hypotensive episodes** Special Features: None

Receptor: Alpha-1 Actions: vasodilation Clinical Use: Hypertension Side Effects: Postural hypotension with first dose** Special Features: None

Receptor: Alpha-1 Actions: vasodilation Clinical Use: HTN, Benign Prostate Hyperplasia Relaxes smooth muscle in the bladder neck Side Effects: Postural hypotension with first dose Special Features: None

Receptor: Beta-1 Actions: Same as propranolol but with less bronchospasm in asthmatics** Clinical Use: HTN, angina pectoris, MI Side Effects: Lower toxicity than propranolol** Special Features: Safe for patients with asthma***

Drugs include: Carbachol Bethanechol Pilocarpine

Receptor: M1, M2, M3, Nicotinic Clinical Uses: Glaucoma, miosis for surgery, cataract surgery** Contraindications: Where constriction is undesirable

Receptor: M1, M2 M3, Nicotinic Clinical Uses: Induce evacuation of a non-obstructed bladder** Increase GI motility after surgery** Contraindications: Bradycardia, parkinsonism, epilepsy, hypo/hyper tension

Receptor: M1, M2, M3 Clinical Uses: Cystic fibrosis sweat test, glaucoma (miosis/constriction), xerostomia (dry mouth)** Contraindications: Bradycardia, parkinsonism, epilepsy, hypo/hyper tension

Drugs include: Atropine Scopolamine Oxybutynin Side effects are Red, Hot, Dry, Mad Red as a beet, hot as an oven, dry as a bone, mad as a hatter

Action at Organ: Direct antispasmodic effect on smooth muscle Clinical Uses: Relief of bladder spasms that result in urinary leakage and incontinence** Side Effects: Decreased sweating, rash, decreased lacrimation, mydriasis** Special Notes: None

Mechanism of Action:

Beta-2

Vascular Effects:

Vasodilation

Cardiac Effects:

None but may have reflex tachycardia

Pulmonary Effects:

bronchodilation

Special Characteristics:

Used to treat acute asthma exacerbations**

Mechanism of Action:

Beta-2

Vascular Effects:

Vasodilation

Cardiac Effects:

None but may have reflex tachycardia

Pulmonary Effects:

Bronchodilation

Special Characteristics:

Is long acting**

Mechanism of Action:

Beta-2

Vascular Effects:

vasodilation

Cardiac Effects:

None but may have reflex tachycardia

Pulmonary Effects:

Bronchodilation

Special Characteristics:

Less cardiac side effects than albuterol**

Bind to alpha-1, alpha-2, beta-1 and beta 2 receptors

Turn on second messengers which mediate the various effects associated with each receptor

Drugs include:

Epinephrine

Norepinephrine

Isoproterenol

Dobutamine

Dopamine

Phenylephrine

Albuterol

Salmeterol

Levalbuterol

Cause norepinephrine release but do not bind to adrenergic receptors.

They enter the presynaptic terminal and displace NE from storage vesicles.

Drugs include:

Amphetamine

Methamphetamine

Both displace NE from storage vesicles and bind to adrenergic receptors

Drugs Include:

Ephedrine

Bind to alpha-2 receptors on neurons and prevent the release of NE from nerves**

Drugs include:

Clonidine

Methyldopa

Blockade Mechanism:

Potent alpha-2 agonist

Actions:

Decreases preganglionic sympathetic outflow which results in a decreased blood pressure

Side Effects:

Orthostatic hypotension

Sedation

Rebound hypertension

Clinical Use:

Hypertension*

Block NE from binding to the postsynaptic adrenergic receptors

Drugs include:

Phenoxybenzamine

Phentolamine

Prazosin

Doxazosin

Labetalol

Propranolol

Timilol

Metoprolol

Receptor:

Alpha-1 and alpha-2

Actions:

Vasodilation, blocks sympathetic outflow from the brain

Clinical Use:

Pheochromocytoma (adrenal gland tumor)

Controls Hypertension

Side Effects:

Postural hypotension, reflex tachycardia, sexual dysfunction**

Special Features:

none

Receptor:

Alpha-1, alpha-2

Actions:

Vasodilation

Clinical Use:

Pheochromocytoma (adrenal gland tumor)

To control HTN and is the pharmacological test

Side Effects:

Tachycardia, arrhythmias, hypotensive episodes

Special Features:

None

Receptor:

Alpha-1

Actions:

vasodilation

Clinical Use:

Hypertension

Side Effects:

Postural hypotension with first dose**

Special Features:

None

Receptor:

Alpha-1

Actions:

vasodilation

Clinical Use:

HTN, Benign Prostate Hyperplasia

Relaxes smooth muscle in the bladder neck

Side Effects:

Postural hypotension with first dose

Special Features:

None

Receptor:

Beta-1

Actions:

Same as propranolol but with less bronchospasm in asthmatics

Clinical Use:

HTN, angina pectoris, MI

Side Effects:

Lower toxicity than propranolol

Special Features:

Safe for patients with asthma***

Drugs include:

Carbachol

Bethanechol

Pilocarpine

Receptor:

M1, M2, M3, Nicotinic

Clinical Uses:

Glaucoma, miosis for surgery, cataract surgery**

Contraindications:

Where constriction is undesirable

Receptor:

M1, M2 M3, Nicotinic

Clinical Uses:

Induce evacuation of a non-obstructed bladder

Increase GI motility after surgery

Contraindications:

Bradycardia, parkinsonism, epilepsy, hypo/hyper tension

Receptor:

M1, M2, M3

Clinical Uses:

Cystic fibrosis sweat test, glaucoma (miosis/constriction), xerostomia (dry mouth)**

Contraindications:

Bradycardia, parkinsonism, epilepsy, hypo/hyper tension

Drugs include:

Atropine

Scopolamine

Oxybutynin

Side effects are Red, Hot, Dry, Mad

Red as a beet, hot as an oven, dry as a bone, mad as a hatter

Action at Organ:

Direct antispasmodic effect on smooth muscle

Clinical Uses:

Relief of bladder spasms that result in urinary leakage and incontinence

Side Effects:

Decreased sweating, rash, decreased lacrimation, mydriasis

Special Notes: None