Pharm. Quiz 2.txt

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Pharm. Quiz 2.txt
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2012-02-17 17:56:02
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Pharm Quiz 2
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  1. Nerve impulses are conducted by electrical and chemical means; the chemical protion of nerve transsmission is referred to as a?
    Neurotransmitter
  2. The neurotransmitter at the myoneural(neuromuscular) junction , at ganglia, and at the parasympathetic sites is?
    acetycholine
  3. The neurotransmitter at sympathetic end sites except sweat glands, adrenal medulla?
    norepinephrine
  4. circulating epinephrine stimulates all recptors responding too _______, even if no sympathetic nerves are present.
    norepinephrine
  5. THis system allows discrete control in the body.
    Parasympathetic
  6. This system causes a widespread reaction in the body
    Sympathetic
  7. This nervous system control is essential to life and is concidered a more discrete, finely regulated system. Effects day-to-day bodily functions of digestion, bladder and rectal discharge, and basal secretion of bronchial mucus.
    Parasympathetic
  8. Overstimulation of the parasympathetic branch would render the body incapable of violent action, resulting in what is termed the SLUD syndrome:
    salivation, lacrimation, urination, and defecation
  9. What iss the effect of parasympathetic system on heart rate?
    Slows rate (vagus)
  10. What is thee effect of parasympathetic system on the bronchial smooth muscle?
    constriction
  11. What is the effect of parasympathetic system on the exocrine glands?
    increased secretions
  12. Two additional terms are used to refer to stimulation of receptor sites for Ach; they are derived from the action in the body of two substances:
    muscarine and nicotine
  13. refers to cholinergic receptors at parasympathetic end sites.
    muscarinic
  14. Muscarinic receptors are distinguished into subtypes
    M1-M5
  15. Where are M2 receptors located?
    in the heart
  16. Where are M3 receptors located?
    on airway smooth muscle, mediating bronchoconstriction
  17. a natural product from the mushroom Amanita muscaria, stimulates Ach (cholinergic) receptors at the parasympathetic terminal sites: exocrine glands (lacrimal, salivary, and bronchial mucous glands), cardiac muscle, and smooth muscle (gastrointestinal tract).
    Muscarine
  18. Ach receptor sites that are effected by musarine are termed as
    muscarinic
  19. A muscarinic effect well known to respiratory care clinicians is the increase in airway secretions after administration of Ach-like drugs such as
    Neostigmine
  20. a parasympathomimetic effect is the same as a
    muscarinic effect
  21. a parasympatholytic effect is referred to as an
    antimuscarinic effect
  22. refers to cholinergic receptors on ganglia and at the neuromuscular junction
    nicotinic
  23. a substance in tobacco products, stimulates Ach (cholinergic) receptors at autonomic ganglia (parasympathetic and sympathetic) and at skeletal muscle sites.
    Nicotine
  24. Ach receptors at autonomic ganglia and at the skeletal muscle are termed and as are the effects on these sites of stimulation
    Nicotinic
  25. Parasympathetic receptors and cholinergic receptors in general with or without corresponding nerve fibers are classified further into subtypes. These differences among cholinergic or muscarinic (M) receptors are based on different responses to different drugs, or recognition through use of DNA probes. Five muscarinic receptor subtypes have been identified:
    M1-M5
  26. When using indirect-acting cholinergic agents such as neostigmine to increase nerve function at the neuromuscular junction, Ach activity at parasympathetic sites such as salivary and nasopharyngeal glands also increases. These undesirable muscarinic effects can be blocked by pretreatment with a parasympatholytic or antimuscarinic drug such as
    Atropine
  27. form an irreversible bond with cholinesterase (also called acetylcholinesterase). used as insecticides, and occasionally patients are seen with toxic exposure and absorption. The effects of these agents can be lethal, and because of this, they have also been used as �nerve gas".
    Organophosphates
  28. parathion and malathion and the drug echothiophate are what kind of drug?
    Organophosphates
  29. The bonding of irreversible inhibitors with cholinesterase is slow, taking up to 24 hours. Once formed, however, the duration is limited only by the body's ability to produce new cholinesterase, which takes
    1-2 weeks
  30. block Ach receptors and act as cholinergic antagonists. Parasympatholytic (antimuscarinic) agents such as atropine and drug classes such as neuromuscular blockers and ganglionic blockers
    Anticholinergic agents
  31. is usually considered the prototype parasympatholytic, occurs naturally as the levo isomer in Atropa belladonna, the nightshade plant, and in Datura stramonium, or jimsonweed. The drug is referred to as a belladonna alkaloid.
    Atropine
  32. is a competitive antagonist to Ach at muscarinic receptor sites (glands, gastrointestinal tract, heart, and eyes) and can form a reversible bond with these cholinergic receptors. It is nonspecific for muscarinic receptor subtypes and blocks M1, M2, and M3 receptors.
    Atropine
  33. Atropine blocks salivary secretion and causes
    dry mouth
  34. atropine decreases secretion by mucous glands and relaxes bronchial smooth muscle by blocking parasympathetically maintained
    basal tone
  35. Sympathetic effects on the cardiopulmonary system include:
    Increased heart rate/contractile force/BP/secretions in airway
  36. The primary method of terminating the action of norepinephrine at the postsynaptic membrane is through a reuptake process, back into the presynaptic neuron. This is termed
    Uptake - 1
  37. The neurotransmitter action can be ended by two other mechanisms as well: uptake into tissue sites around the nerve terminal, a process termed
    Uptake-2
  38. norepinephrine can stimulate autoreceptors on the presynaptic neuron, which inhibits further neurotransmitter release. These autoreceptors have been identified as
    Alpha 2 receptors
  39. This process is a mediated uptake of exogenous amines (chemicals such as norepinephrine) in nonneuronal tissues.
    Uptake - 2
  40. Agent that stimulates sympathetic nervous fibers, which allow relaxation of smooth muscle in the airway. Also known as sympathomimetic bronchodilator or �2 agonist.
    Adrenergic bronchodialtor
  41. Causes vasoconstriction and vasopressor effect; in the upper airway (nasal passages), this can provide decongestion.
    Alpha-recptor stimulation
  42. Refers to the increasing incidence of asthma morbidity, and especially asthma mortality, despite advances in the understanding of asthma and availability of improved drugs to treat asthma.
    Asthma paradox
  43. Causes increased myocardial conductivity and increased heart rate as well as increased contractile force.
    Beta 1- receptor stimulation
  44. Causes relaxation of bronchial smooth muscle, with some inhibition of inflammatory mediator release and stimulation of mucociliary clearance.
    Beta 2 - receptor stimulation
  45. Narrowing of the bronchial airways, caused by contraction of smooth muscle.
    Bronchospasm
  46. Group of similar compounds having sympathomimetic action; they mimic the actions of epinephrine.
    Catecholamines
  47. Nucleotide produced by Beta2 -receptor stimulation; it affects many cells, but causes relaxation of bronchial smooth muscle.
    Cyclic adenosine 3�, 5�-monophosphate (cAMP)
  48. Nucleotide producing the opposite effect of cAMP; that is, it causes bronchoconstriction.
    Cyclic guanosine monophosphate (cGMP)
  49. Long-term desensitization of Beta receptors to Beta 2 agonists, caused by a reduction in the number of Beta receptors.
    Downregulation
  50. Drug that exhibits its pharmacologic activity when it is converted, inside the body, to its active form
    prodrug
  51. Producing effects similar to those of the sympathetic nervous system.
    Sympathomimetic
  52. The adrenergic bronchodilator group is used for the treatment of reversible airway obstruction in diseases such as
    Asthma and COPD
  53. adrenergic bronchodilators produce bronchodialation by stimulating?
    Beta 2 receptors on airway smooth muscle
  54. are indicated for relief of acute reversible airflow obstruction in asthma or other obstructive airway diseases. Short-acting agents are termed �rescue� agents
    Short-acting beta 2 agonists such as albuterol, levalbuterol, or pirbuterol
  55. Long-acting agents such as salmeterol, formoterol, and arformoterol are indicated for the maintenance of bronchodilation and control of
    bronchospasms
  56. NAEPP EPR 3 guidelines and GINA consider salmeterol, formoterol, and arformoterol �controllers�; the slow time to peak effect makes long-acting agents ___________?
    poor rescue drugs
  57. is often used, either as an inhaled aerosol or by direct lung instillation, for its strong a-adrenergic vasoconstricting effect to reduce airway swelling after extubation or during epiglottitis, croup, or bronchiolitis or to control airway bleeding during endoscopy
    Racemic epinephrine
  58. There are three subgroups of adrenergic bronchodilators based on distinct differences in duration of action:
    Ultra-short-acting, short-acting, and long-acting
  59. What is the duration of ultra-short-acting adrenergic bronchodilators?
    less than 3hrs
  60. What is the duration of short-acting adernergic bronchodilators?
    4-6hrs
  61. what is the duration of long-acting adernergic bronchodilators?
    12 hours
  62. Some examples of ultra-shor-acting adernergic bronchodilators?
    Epinephrine, and racemic epinephrine
  63. Some examples of short-acting adernergic bronchodilators?
    Albuterol, levalbuterol, metaproterenol, and pirbuterol
  64. Some examples of long-acting adernergic bronchodilators?
    Salmeterol, formmoterol, and arformeterol
  65. is a chemical structure consisting of an aromatic catechol nucleus and a dialiphatic amine side chain
    catecholamine
  66. dopamine, epinephrine, norepinephrine, isoproterenol, and isoetharine are all examples of what?
    catecholamines or sympathomometic amines
  67. mimic the actions of epinephrine more or less precisely, causing tachycardia, elevated blood pressure, smooth muscle relaxation of bronchioles and skeletal muscle blood vessels, glycogenolysis, skeletal muscle tremor, and central nervous system (CNS) stimulation
    sympathomimetic amines
  68. rotation on a central carbon atom, produces two nonsuperimposable mirror images
    enatiomers or isomers
  69. have similar physical and chemical properties but different physiologic effects
    enatiomers
  70. is a potent catecholamine bronchodilator that stimulates alpha and beta receptors. is a high prevalence of side effects such as tachycardia, blood pressure increase, tremor, headache, and insomnia.
    epinephrine
  71. Epinephrine occurs naturally in the adrenal medulla and has a rapid onset but a short duration because of metabolism by
    catechol O-methyltransferase (COMT)
  72. The theory that explains the shift from alpha activity to Beta 2 specificity. The larger the side chain attachment to a catechol base, the greater the Beta 2 specificity. If the catecholamine structural pattern is seen as a keylike shape, then the larger the �key� (side chain), the more Beta 2 specific the drug
    Keyhole Theory
  73. catecholamines are rapidly inactivated by the cytoplasmic enzyme
    COMT
  74. Catecholamines are also unsuitable for oral administration because they are inactivated in the gut and liver by conjugation with
    sulfate or glucuronide at the carbon-4 site
  75. Catecholamines are also readily inactivated to inert adrenochromes by
    heat, light, or air
  76. racemic epinephrine is stored in an
    amber-colored bottle or a foil-protected wrapper
  77. Nebulizer rainout (i.e., nebulized particles that condense and fall, under the influence of gravity) in the tubing may appear pinkish after treatment, and a patient's sputum may even appear pink-tinged after using aerosols of
    catecholamines
  78. The basic catecholamine structure, consisting of a catechol ring connected to an amine side chain, directly influences activity. �2-receptor specificity is considered to be due to side chain bulk. What is the name of this Theory?
    Keyhole theory
  79. The short duration of action of catecholamines is due to metabolism by the enzyme
    COMT
  80. Because metaproterenol is not inactivated by COMT, it has a significantly longer duration of action of
    4-6 hours
  81. is the pure (R)-isomer of racemic albuterol
    Levalbuterol
  82. is the single (R)-isomer form of racemic albuterol and is available in an HFA-propelled MDI, with nebulization solution in three strengths: 0.31-mg, 0.63-mg, and 1.25-mg unit doses.
    Levalbuterol
  83. Levalbuterol is also available as a concentrate, __________.
    1.25 mg in 0.5 mL.
  84. The 1.25-mg levalbuterol dose showed a higher peak effect on forced expiratory volume in 1 second (FEV1) with an 8-hour duration compared with
    racemic epinephrine

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