Exam (elaborations)
PHARMACOLOGY (ECPI) EXAM #2 QUESTIONS WITH CORRECT ANSWERS
PHARMACOLOGY (ECPI) EXAM #2 QUESTIONS WITH CORRECT ANSWERS
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PHARMACOLOGY ECPI FINAL EXAMQUESTIONS AND ANSWERS
Nicotinic N (neuronal) Location - Answer-All autonomic nervous system ganglia and the
adrenal medulla
Nicotinic N (neuronal) response - Answer-Stimulation of parasympathetic and
sympathetic post-ganglionic nerves and release of epinephrine from adrenal medulla
Nicotinic M (muscle) Location - Answer-Neuromuscular junction
Nicotinic M (muscle) Response - Answer-contraction of skeletal muscle
Muscarinic Locations - Answer-Eye, Heart, Lung, Bladder, GI tract Sweat glands, Sex
organs, Blood vessels
Muscarinic Responses by location - Answer-a) Eye: Contraction of ciliary muscle
focuses lens for near vision. Contraction of iris sphincter causes miosis (constriction)
b) Heart: Decreased rate
c) Lung: Constriction of bronchi
Promotions of secretions
d) Bladder: Detrusor contraction increases bladder pressure
Relaxation of trigone and sphincter allows urine to leave the bladder. Both effects
causes voiding of bladder
e) GI tract: Salivation, Increased gastric secretion, Increased intestinal tone and motility,
Defecation
f) Sweat glands: Generalized sweating
g) Sex organs: Erection
h) Blood vessels: vasodilation
Alpha 1 Locations - Answer-Eye, Arterioles (Skin, viscera, mucus membranes), Veins,
Sex organs, Prostatic capsule, Bladder
Alpha 1 Response by location - Answer-- Eye: Mydriasis (dilation)
- Arterioles (Skin, viscera, mucus membranes): Constriction
- Veins: Constriction
,- Sex organs, male: Ejaculation
- Prostatic capsule: Contraction
- Bladder: Contraction of trigone and sphincter
Alpha 2 Location & Response - Answer-Peripheral nervous system
-Inhibition of transmitter release
Beta 1 Locations (2) & Response - Answer-- Heart: Increased rate and velocity
- Kidney: Release of renin (elevates BP)
Beta 2 Responses by location - Answer-- Arterioles (heart, lung, skeletal muscle):
Dilation
- Bronchi: Dilation
- Uterus: Relaxation
- Liver: Glycogenolysis
- Skeletal muscle: Enhanced contraction
Dopamine Response in kidneys - Answer-- Kidney: Dilation of kidney vasculature
Bethanechol Treats... - Answer-Urinary Retention
Bethanechol investigational uses - Answer-Gastroesophageal reflux , treat disorders
associated with GI paralysis
Bathanechol Contraindications - Answer-Do not use with patients with latent or active
asthma and urinary tract obstruction or bladder weakness
special instructions for taking or administering Bethanechol - Answer-Administer 1 hr
before or 2 hrs after eating. Can cause nausea and vomiting if taken with food
Pilocarpine treats... - Answer-•lowers intraocular pressure in the eyes used to treat
glaucoma
•Taken orally to treat dry mouth from Sjorgens syndrome
•Can treat salivary gland damage associated with head and neck cancer
Cholinergic Crisis - Answer-Cholinesterase inhibitor Poisoning. Leads to SLUDGE &
killer B's. Salivation, Lacrimation, Urination, Diaphoresis, Diarrhea, GI cramping,
Emesis.
Killer B's: Bradycardia, Bronchospasm, Bronchorrhea
Bronchospasm - Answer-spasm of bronchial smooth muscle producing narrowing of the
bronchi
Bronchorrhea - Answer-the production of more than 100 mL per day of watery sputum
, How to treat Cholinergic Crisis - Answer-manage with mechanical ventilation & atropine
(muscarinic receptor antagonist), suctioning may be needed
prior to administering anything orally to a patient with Myasthenia Gravis... - Answer-
Assess the patients ability to swallow. If patient unable to swallow, parenteral
medication must be substituted for oral medication.
therapeutic uses for neuromuscular blockers - Answer-used to provide muscle
relaxation during surgery, mechanical ventilation endotracheal intubation, and
electroconvulsive or electroshock therapy. Aggravates Myasthenia gravis.
Competitive neuromuscular blockers and electrolyte imbalance - Answer-assess the
electrolyte levels in early morning labs and report any abnormalities to the surgeon.
Hypokalemia would cause concern. Low potassium can enhance paralysis. potassium
imbalances lead to cardiac arrhythmias.
Myasthenia Gravis - Answer-Weakness, rapid fatigue
- Treated with Neostigmine (parasympathomimetic)
Dopamine: Nursing assessment post administration for shock would include monitoring
what? - Answer-the patient's urine output. Dopamine will dilate renal blood vessels,
improve renal perfusion, and increase urine output.
patient's IV when administering dopamine - Answer-Necrosis - if the IV line is
extravasated, necrosis may result. Infiltrate region with phentolamine
Adverse effects of Dopamine - Answer-- Tachycardia
- Dysrhythmias
- Anginal Pain
- IV infiltration can cause necrosis from localized vasoconstriction
Tissue injury can be minimized by local infiltration of phentolamine (alpha adrenergic
antagonist)
-If extravasation may result in necrosis from localized vasoconstriction then this would
require frequent monitoring, assessment and reassessment of an IV site with Dopamine
infusing. If edema was identified immediate action is necessary and prior to pulling the
IV line administration of phentolamine will reduce the tissue injury.
effect of beta-adrenergic blockers on the heart - Answer-- Reduced heart rate
- Reduced force of contraction
- Reduced velocity of impulse conduction through AV node
- Reduced cardiac output
- Decrease rate of sinus nodal discharge
----> Beta blockers are useful in a variety of CVDs
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