(MSN) PHARM EXAM 1 QUESTIONS AND CORRECT
ANSWERS WITH COMPLETE VERIFIED SOLUTION, UPDATED
2024.
PNS: cholinergic receptors
1. nicotinic (N): all ANS ganglia and medulla
2. nicotinic (M): neuromuscular junction
3. muscarinic: PNS organs
site of action: PNS rx
-synapse
-rx alters synaptic transmission (AcH)
SNS: Adrenergic receptors
-alpha 1, alpha 2, beta 1, beta 2
-also effects epi/norepi, dopamine
breakdown of AcH
-via AChE or MAO
1. AcH=reuptake into nerve cell
2. degraded by MAO
3. diffusion of waste out of cell
sites where Rx act/influence
1. receptor: rx binds to activate, enhance response, or block
2. synthesis of neurotransmitter: increases or decreases receptor activation/response
3. reuptake/termination cycle: blocking=prevents reuptake, inhibiting=prevents
breakdown of trasmitter
muscarinic receptors: M1 vs M2 vs M3
M1= CNS; salivary glands
M2= HEART ONLY
M3= bladder detrusor, eyes, salivary glands
*most muscarinic agonists (cholinesterase inhibitors) are non-selective; more side
effects!!
agonist vs antagonist
agonist=activate
antagonist=block
epinephrine: secreted and broken down where?
secreted = medulla
broken down = liver
muscarinic agonists/cholinesterase inhibitors
-MOA: prevents breakdown of AcH within SYNAPSE to make more available for
receptor sites
-Rx for: dementia + alzheimer's (both r/t excessive AcH breakdown), MG, neurogenic
bladder, GERD, IBS, post-op
-CI: hyperthyroidism
-ex: rivastigmine, donepizil (aricept), galatamine
Bethanechol (Urecholine)
, MOA: cholinesterase inhibitor; increases detrusor muscle tone to allow strong start to
voiding for clients with postoperative urinary hesitancy.
Precautions/interactions: PO ONLY ON EMPTY STOMACH; do not administer IV or IM
CI: hypotension or decreased CO, hyperthyroidism
SE: excessive saliva, increased urinary output
Cevimeline (Evoxac)
-MOA: muscarinic receptor agonist; admin PO only
-CI: narrow eye glaucoma d/t increased pupillary constriction
-also rx for sjorgen's
Pilocarpine (Pilocar)
-Direct-Acting Cholinergic Agonists; fewer SE, admin to eyes only; safe for
kids/pregnant/breastfeeding
-Use: constrict pupils (glaucoma; NOT NARROW ANGLE)
cholinesterase inhibitors/agonists: common SE
-bradycardia, hypotension
-miosis/blurred vision
-ABD cramping, diarrhea, increased gastric acid and salivation
-bronchoconstriction (AVOID IN ASTHMASTICS IF ABLE)
*most SE are reversible
myasthenia gravis (MG): Rx
-chronic disease characterized by muscle weakness and thought to be caused by a
defect in the transmission of AcH
-cholinesterase inhibitors used to increase AcH availability
-assess for swallowing prior to giving PO; may need to be parenteral
-can develop into MG crisis; treat w/ Neostigmine (AcH inhibitor)
treating cholinesterase inhibitor overdose
1. atropine: muscarinic antagonist
2. benzo to decrease seizure risk
3. pralidoxime: reverse binding on enzyme cholinesterase
**too much AcH=bradycardia, hypotension, flaccid muscles
muscarinic antagonists/anticholinergics
-MOA: block receptor to decrease availability of AcH or prevent reuptake
-s/s of toxicity=hot temp/skin/dry mucous membranes, increased anx/agitation,
decreased vision
-CI: hx prolonged QT, hx MG (can cause crisis), hx myocardial ischemia, BPH/urinary
retention, elderly (R/O dementia and alzheimer's), pregnancy (less blood flow to fetus).
*safe for children tho!
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ACADEMICAIDSTORE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
