Katzung & Trevor's Pharmacology Examination & Board Review -
10E - Part II (Autonomic Drugs) Exam Qs & As.
A 3-year-old child has swallowed the contents of 2 bottles of a nasal decongestant
whose primary ingredient is a potent, selective α-adrenoceptor agonist drug. Which of
the following is a sign of α-receptor activation that may occur in this patient?
(A) Bronchodilation
(B) Cardiac acceleration (tachycardia
(C) Pupillary dilation (mydriasis)
(D) Renin release from the kidneys
(E) Vasodilation of the splanchnic vessels - Correct Answer (C) Pupillary dilation
(mydriasis)
Mydriasis can be caused by contraction of the radial fibers of the iris; these smooth
muscle cells have α receptors. All the other responses are mediated by β adrenoceptors
(Table 6-4).
Ms Green is a 60-year-old woman with poorly controlled hypertension of 170/110 mm
Hg. She is to receive minoxidil. The active metabolite of minoxidil is a powerful arteriolar
vasodilator that does not act on autonomic receptors. Which of the following effects will
be observed if no other drugs are used?
(A) Tachycardia and increased cardiac contractility
(B) Tachycardia and decreased cardiac output
(C) Decreased mean arterial pressure and decreased cardiac
contractility
(D) Decreased mean arterial pressure and increased salt and
water excretion by the kidney
(E) No change in mean arterial pressure and decreased
cardiac contractility - Correct Answer (A) Tachycardia and increased cardiac contractility
Because of the compensatory responses, a drug that directly decreases blood pressure
through a decrease in peripheral vascular resistance will cause a reflex increase in
sympathetic outflow, an increase in renin release, and a decrease in para- sympathetic
outflow. As a result, heart rate and cardiac force will increase. In addition, salt and water
retention will occur.
3. Full activation of the sympathetic nervous system, as in the fight-or-flight reaction,
may occur during maximal exercise. Which of the following effects is likely to occur?
(A) Bronchoconstriction
(B) Increased intestinal motility
(C) Decreased renal blood flow
(D) Miosis
(E) Decreased heart rate (bradycardia) - Correct Answer (C) Decreased renal blood
flow
,Sympathetic discharge causes constriction of the renal resis- tance vessels and a fall in
renal blood flow. This is the typical response in severe exercise or hypotension. The
other effects are parasympathomimetic actions.
For these questions, use the accompanying diagram. Assume that the diagram can
represent either the sympathetic or the parasympathetic system.
Norepinephrine acts at which of the following sites in the diagram?
(A) Sites 1 and 2
(B) Sites 3 and 4
(C) Sites 5 and 6 - Correct Answer (C) Sites 5 and 6
Norepinephrine acts at presynaptic α2 regulatory receptors (site 5) and postsynaptic α1
adrenoceptors (site 6). It may be metabolized by enzymes outside the synapse or
transported back into the nerve terminal.
For these questions, use the accompanying diagram. Assume that the diagram can
represent either the sympathetic or the parasympathetic system.
If the effector cell in the diagram is a thermoregulatory sweat gland, which of the
following transmitters is released from structure 5?
Both types of ganglia and the skeletal muscle neuromuscular junction have nicotinic
cholinoceptors, as does the adrenal medulla (a modified form of sympathetic
postganglionic neuron tissue). Bronchial smooth muscle contains muscarinic
cholinoceptors and noncholinergic receptors.
, Several children at a summer camp were hospitalized with symptoms thought to be due
to ingestion of food containing botulinum toxin. Which one of the following signs or
symptoms is consistent with the diagnosis of botulinum poisoning?
Botulinum toxin impairs all types of cholinergic transmission, including transmission at
ganglionic synapses and somatic motor nerve endings. Botulinum toxin prevents
discharge of vesicular transmitter content from cholinergic nerve endings. All of the
signs listed except cycloplegia indicate increased muscle contraction; cycloplegia
(paralysis of accommodation) results in blurred near vision.
Which one of the following is the neurotransmitter agent normally released in the
sinoatrial node of the heart in response to a blood pressure increase?
Acetylcholine is the transmitter at parasympathetic nerve end- ings innervating the sinus
node (nerve endings of the vagus nerve). When blood pressure increases, the
parasympathetic system is activated and heart rate slows.
Assume that the diagram below represents a sympathetic postganglionic nerve ending.
Which of the following blocks the carrier represented by "y" in the diagram?
The vesicular carrier in the diagram transports dopamine and norepinephrine into the
vesicles for storage. It can be blocked by reserpine.
Assume that the diagram below represents a sympathetic postganglionic nerve ending.
Which of the following inhibits the carrier denoted "z" in the diagram?
(A) Cocaine
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