P 5334 ADVANCED PHARMACOLOGY EXAM 2 QUESTIONS AND ANSWERS| A GRADED
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N 5334
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University Of Texas, Arlington
N 5334 ADVANCED PHARMACOLOGY EXAM 2
Exam (elaborations) NURS 5334 ADVANCED PHARMACOLOGY EXAM 2 (NURS 5334 ADVANCED PHARMACOLOGY EXAM 2)
Study Questions and Answers Exam 2
What are the basic mechanisms by which neuropharmocologic agents act?
o Can modify the disease process
o Act at...
p 5334 advanced pharmacology exam 2 questions and answers| a graded
n 5334 advanced pharmacology
study questions and answers exam 2
what are the basic mechanisms by which neuropharmocologic agents act
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P 5334 ADVANCED PHARMACOLOGY EXAM 2 QUESTIONS AND
ANSWERS| A GRADED
Study Questions and Answers Exam 2
What are the basic mechanisms by which neuropharmocologic agents act?
o Can modify the disease process
o Act at the sites of actions which is the axons versus synapses and steps in synaptic
transmission and effects of drugs on the steps of synaptic transmission
Transmittter synthesis is the first step in transmission. What are the other 4 steps?
o Transmitter storage, transmitter release, receptor binding, and termination of the
transmission
True or False: Neuropharmacologic drugs have high selectivity.
o True—the nervous system uses many different receptor types
Information needed:
o Type of receptors—through which the drug acts
Alpha and beta
o Normal responses to the activation of those receptors
Agonists vs. antagonists
o What the drug in questions does to the receptor function
What are the 3 functions of ANS?
o Regulates the heart
o Regulates the secretory glands, saliva glands, gastric, sweat, and bronchial
o It regulates smooth muscles: bronchi, blood vessels, urogenital system, and the GI tract
What are the regulatory functions of the parasympathetic NS?
o Seven regulatory functions
Slowing the heart rate
Increasing the gastric secretions
Emptying the bladder
Emptying the bowel
Focusing the eye for near vision,
Constricting the pupil
Contracting the bronchial smooth muscle
o It also regulates the digestion of food, excretion of waste, control of vision and
conservation of energy
What are the functions of the sympathetic NS?
o Regulation of the cardiovascular system
Maintaining blood flow to the brain
Redistributing blood and compensating for the loss of blood
o Regulation of body temperature
Regulates blood flow to the skin
Promotes the secretion of sweat
Induces piloerection (erection of the hair)
o Implementation of the fight or flight reaction
Increase HR and BP
Blood shuts away from the skin and visera
Bronchi dilate
1
, Pupils dilate
Use energy that had been stored
What is the baroreceptor reflex?
o The receptors near the heart monitor BP changes and send the information to the brain
o The brain then activates the Autonomic NS to restore blood pressure to normal
o When BP falls, this reflex causes vasoconstriction and increases cardiac output.
o When BP rises, it causes vasodilation and reduces cardiac output
Where is acetylcholine employed?
o Most junctions at the peripheral nervous system
Where is epinephrine and norepinephrine released?
o Norepinephrine—postganglionic neurons
o Epinephrine—adrenal medulla
What are the cholinergic receptors mediated by? What are the subtypes?
o Receptors that mediate responses to acetylcholine
o Subtypes:
Nicotinic
Muscarinic
Whare are adrenergic receptors mediated by? What are the subtypes?
o Mediate responses to epinephrine and norepinephrine
o Subtypes:
Alphas
Betas
Dopamine
What are the functions of each adrenergic subtype?
o Alpha 1—vasoconstriction, ejaculation and contraction of the bladder neck, and prostate
o Alpha 2—(located in presynaptic junction)—minimal clinical significance
o Beta 1—control the heart
Increase HR, increase force of contraction and velocity of conduction in the AV
node; stimulate renin released in the kidney
o Beta 2—bronchial dilation, relaxation of the uterine muscle, vasodilation, glycogenolysis
o Dopamine—dilates renal blood vessels
Epinephrine can activate all alpha and beta receptors but not dopamine receptors
Norepinephrine can activate alpha1, alpha2, and beta receptors but not beta2 or dopamine
receptors
Dopamine can activate alpha1, beta1 and dopamine receptors
Muscarinic agonists mimic the effects of acetylcholine at muscarinic receptors
Muscarinic antagonists selectively blood the effects of acetylcholine (and other muscarinic
agonists) at muscarinic receptors
What are therapeutic uses of Bethanechol?
o Urinary retention
o Investigational GI uses—off label GI reflux
What are actions on smooth muscle, exocrine glands, and eye?
o Smooth muscle—
2
, lung by causing constriction of the bronchi
the GI system by increasing tone and motility
the bladder by contraction of the detrusor muscle
relaxation of the trigone and sphincter
o Exocrine glands—increased sweating salivation, bronchial secretions and secretion of
gastric acid
o Eye—causes miosis and contraction of the ciliary muscle
Adverse Effects?
o Hypotension
o Abdominal cramps
o Diarrhea
o Increased salivation
o Exacerbate asthma
o Can cause dysrhythmias in patients with hyperthyroidism
What are cevimeline, pilocarpine, and acetylcholine used for?
o Cevimeline—treat dry mouth and Sjogren’s syndrome
o Pilocarpine—topical treatment of glaucoma as well as dry mouth from Sjogren’s
syndrome
o Acetylcholine—rapid myosis after delivery and cataract surgery
Anticholinergics
o Competitively block the actions of acetylcholine as muscarinic receptors
o Most muscarinic receptors are on structures innervated by parasympathetic nerves
o Also known as parasympatholytic drugs, antimuscarinic drugs, muscarinic blockers, and
anticholinergic drugs
o Anticholinergic drugs: produce selective blockade of the muscarinic receptors (not all
cholinergic receptors)
o Can’t pee, see, spit or shit
What are the pharmacologic effects of atropine?
o The heart—increases in rate
o The exocrine glands—decrease secretions
o Smooth muscle—relaxes the bronchi, decreases the tone of the urinary bladder detrusor
and decreases the tone motility of the GI tract
o Mydriasis and cycloplegia in the eyes
o Mild excitation to hallucinations and delirium in the Central Nervous system
Therapeutic Uses of Atropine?
o Pre-anesthetic medication to help dry up secretions
o Disorders of the eye
o In codes for bradycardia, intestinal hypertonicity and hypermotility
o Muscarinic agonist poisoning
o Peptic ulcer disease
o Asthma
o Biliary colic
Side effects of Atropine
3
, o Dry mouth
o Blurred vision
o Photophobia
o Elevation of interocular pressure
o Urinary retention
o Constipation anhidrosis
o Tachycardia
o Asthma
Overactive bladder
o Oxybutyin—acts on M3 muscarinic receptors
Highly lipid soluble
Metabolized CYP3A4
Very short ½ life and must be dosed frequently
o Darifenacine—
Can reduce OAB symptoms while having no effect or M1 receptors in the brain
or M2 receptors in the heart
Greatest degree of M3 selectivity
o Solifenacin—at high dose can prolong QT interval
o Tolterodine—nonselective muscarinic antagonist
o Fesoterodine—nonselective muscarinic antagonist
o Trospium-nonselective muscarinic antagonist
Scopalamine
o Uses?
Motion sickness
Production of a cytoplegia and mydriasis for ophthalmic procedures
Production of pre-anesthetic sedation and obstetric amnesia
o Side effects?
Xerostomia (dry mouth)
Blurred vision
Photophobia
Urinary retention
Constipation
Hyperthermia
Tachycardia
Ipratropium Bromide
o Uses?
Treat asthma, COPD and rhinitis caused by allergies or common cold
o Side effects?
Not associated with typical anti-muscarinic side effects
What are mydriatic cycloplegics?
o Atropine, homatropine, scopolamine, cyclopentolate and tropicamide
o Used to produce mydriasis and cyclopedia in ophthalmic procedures
Muscarinic Poisoning
4
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