Questions Review of CNS

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Major neurotransmitter released at end organ effectors of the thoracolumbar division of the autonomic nervous system:

norepinephrine

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Neurotransmitter of preganglionic fibers

acetylcholine

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"Fight or flight" activation of the ANS:

blood flow shifted from cutaneous beds to skeletal muscle

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Dopamine beta hydroxylase catalyzes:

dopamine to norepinephrine

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Most potent at beta adrenergic receptors

isoproterenol (Isuprel)

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Powerful agonist at both alpha and beta adrenergic receptors

epinephrine

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Predominant autonomic tone:

salivary glands: parasympathetic

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Positive inotropic drug that at low doses specifically promotes an increase in renal blood flow:

dopamine (Intropin)

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Preganglionic fibers terminating on adrenal medullary chromaffin cells release:

acetylcholine

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Primary receptor type at autonomic ganglia:

cholinergic: nicotinic

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Enzyme responsible for acetylcholine synthesis:

choline acetyltransferase

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Cholinergic receptor type that mediates the decrease in heart rate:

muscarinic

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Effect of atropine on the heart:

increased rate

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Drugs activating this receptor are used in treating asthma:

beta2 adrenergic

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Epinephrine effects on the heart:

coronary vasodilation

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Receptor activation mainly responsible for positive inotropism:

beta1

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Epinephrine effects by the increased rate of the:

heart

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Epinephrine effects on respiration:

stimulation

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Activates alpha receptors:

phenylephrine (Neo-Synephrine

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Orthostatic (postural) hypotension:

alpha receptor blocker

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Norepinephrine pressor response blocked by:

prazosin (Minipress)

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Bronchodilation

albuterol (Ventolin,Proventil),ipratropium (Atrovent)

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Positive chronotropic effects of epinephrine:

beta1 receptor activation

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Most likely to increase myocardial afterload:

phenylephrine (Neo-Synephrine)

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Decreases blood pressure:

propranolol (Inderal

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Prevents blood pressure reduction seen with isoproterenol (Isuprel):

propranolol (Inderal)

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Beta-2 selective agonist:

(blank)

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Physiological effects associated with isoproterenol (Isuprel):

increased blood glucose

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Immediate biosynthetic precursor of epinephrine

norepinephrine

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Isoproterenol (Isuprel): cardiopulmonary effects:

increases peripheral resistance

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cardiopulmonary effects of Isoproterenol (Isuprel):

positive chronotropism

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Drug causes pupillar dilation with no effect on accommodation:

(blank)

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Albuterol (Ventolin,Proventil):

bronchodilation

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sympathomimetic; at low doses: increases renal blood flow:

dopamine

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beta-1 selective receptor blocker:

metoprolol (Lopressor)

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Effective in reversing respiratory and cardiovascular effects of anaphylactic shock:

eprinephrine

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Major neurotransmitter at sympathetic nerve endings:

norepinephrine, noradrenaline

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The action of sympathomimetic drugs on the liver causes an increase in blood glucose levels by a process called:

glycogenolysis

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Alpha receptor activation of this eye muscle causes mydriasis:

(blank)

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Direct sympathetic effects on the heart are mediated by this receptor type:

beta repeptor

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The dominant autonomic tone in the heart is:

parasympathetic, cholinergic, acetylcholine

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Major neurotransmitter at autonomic ganglia:

nicotinic, acetylcholine

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This drug increases heart rate, contributing to increase blood pressure:

Epinephrine

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alpha-1 adrenergic receptor-mediated affecting precapillary resistance vessels of the skin, kidney, and mucosa

Vasoconstrictive effects of epinephrine

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Rapid administration of epinephrine, with resulting significant systolic pressure elevation will cause this effect on heart rate:

decrease in heart rate

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A decrease in diastolic pressures associated with epinephrine administration would most likely occur in which dosage?

relatively low doses

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Renal effects relatively low epinephrine dose:

Renal effects relatively low epinephrine dose

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Most probable BP effect of epinephrine, if epinephrine is administered after an alpha-receptor antagonist:

decreased blood-pressure response to epinephrine

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Prominent cardiac beta-adrenergic receptor type:

beta-1

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Significant respiratory tract effects of epinephrine:

beta-2 receptor-mediated bronchodilation

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Examples of epinephrine metabolic effects

free fatty acids: increased

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Epinephrine effects on AV nodall conduction:

increased conduction velocity

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Major adrenergic effects on skin/mucosa arteriole vascular beds:

constriction

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beta-2 adrenergic receptor mediated effects on skeletal muscle arteriole vasculature:

dilation

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Alpha-adrenergic effects on pulmonary arterioles:

constriction

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Beta-adrenergic effects on pulmonary arterioles:

dilation

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Alpha-adrenergic effects on renal arterioles:

constriction

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beta-2 adrenergic receptor effects on systemic veins:

dilation

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Major alpha-adrenergic receptor effect on renin secretion:

decrease

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Decreases bronchial gland secretion:

alpha-1 adrenergic

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Primary neurotransmitter released by postganglionic neurons of the autonomic sympathetic system:

norepinephrine

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Decreased heart rate following norepinephrine infusion is most likely due to:

activation of the baroreceptor system causing a reflex-mediated decrease in heart rate

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Vascular effects of norepinephrine (Levophed):

norepinephrine pressor effects blocked by prazosin (Minipress)

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Immediate synthetic precursor of norepinephrine:

dopamine

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CNS neurotransmitter associated with the basal ganglia and motor control:

dopamine, acetylcholine

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Low doses, this precursor of norepinephrine causes renovascular dilation:

dopamine (Intropin)

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Significant therapeutic use for dopamine:

treatment of cardiogenic/hypovolemic shock

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Has limited action at alpha-adrenergic receptors:

isoproterenol (Isuprel)

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Adverse effects associated with isoproterenol (Isuprel) administration:

arrhythmias, tachycardia, palpitations, palpitations

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Cardiovascular characteristics of patients who might benefit from IV dopamine (Intropin) administration:

high urinary output

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Simultaneous increases in myocardial contractility, glomerular filtration rate, sodium excretion, urine output, and renal blood flow are associated most likely with:

dopamine (Intropin)

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IV dopamine (Intropin) properties:

causes reduced ventilatory response to arterial hypoxemia

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Properties of dobutamine (Dobutrex):

positive inotropic effect is mediated through beta-adrenergic receptor activation

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Examples of beta-2 selective adrenergic agonists:

albuterol (Ventolin,Proventil)

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Primary use for alpha-2-selective adrenergic agonists:

to reduce blood pressure

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Major mechanism of antihypertensive effects associated with alpha-2-selective adrenergic agonists:

reduced sympathetic outflow

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Primary objective sympathomimetic drug use for management of shock:

ensure adequate CNS perfusion

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Most likely to reduce myocardial performance in a damaged heart by increasing afterload:

phenylephrine (Neo-Synephrine)

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Receptor system most likely responsible for improved myocardial contractility when dopamine is administered at low concentrations:

dopamine receptors (D1)

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Beta-adrenergic receptor blockers: effects on the heart:

increased AV nodal refractory period

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Beta-adrenergic receptor blockers are usually effective in reducing blood pressure in both " high-renin" and "low-renin" patients:

true

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Most likely to cause dangerous bronchiolar constriction in asthmatic patients or patients with COPD

propranolol (Inderal)l

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Mechanism(s) for propranolol-decreased amide local anesthetic clearance:

decreased hepatic blood flow

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Choline ester most susceptible to hydrolysis by acetylcholinesterase:

acetylcholine

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Associated with parasympathetic activation (direct effects):

decrease cardiac contractility

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Muscarinic agent: enhances transmission through the A-V node:

atropine

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Least likely to be used as a mydriatic because of long-duration of action:

atropine

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Clinically-used to treat sinus bradycardia secondary to acute myocardial infarction:

atropine

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Reflex bradycardia secondary to an abrupt increase in blood pressure may be blocked by:

atropine

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Location(s) of cholinergic synaptic sites:

neuromuscular junction, some CNS synapses

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Cholinergic receptor type primarily localized at skeletal muscle neuromuscular junctions:

nicotinic

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Highly sensitive to the action of acetylcholinesterase:

acetylcholine

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Muscarinic receptor subtype primarily associated with the heart:

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Cardiac muscarinic Type M2-receptor mediated action(s):

Decreased atrial and ventricular contractility

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Tends to cause fast responses:

(blank)

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Cholinergic-mediated vasodilation involves liberation of this substance, a gas, from endothelial cells:

nitric oxide

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Dominating autonomic tone in the ventricle:

sympathetic

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Mydriasis without loss of accommodation

sympathomimetic

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Management of severe bradycardia and A-V block associated with acute myocardial infarction:

atropine

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