Chapter 32- Cholinergic Agonists.txt

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miscella
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162101
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Chapter 32- Cholinergic Agonists.txt
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2012-07-11 14:18:47
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chollinergic agonist
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pharm chollinergic agonist
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  1. 1.
    • Your patient has had cevimeline (Evoxac) prescribed. What would be an appropriate dosing schedule for a patient taking cevimeline (Evoxac)?
    • A)
    • Once a day
    • B)
    • Twice a day
    • C)
    • Three times a day
    • D)
    • Every four hours
  2. 2.
    • A student asks the pharmacology instructor to describe the function of a cholinergic agonist. What would the instructor reply?
    • A)
    • Cholinergic agonists increase the activity of dopamine receptor sites throughout the brain and spinal cord.
    • B)
    • Cholinergic agonists decrease the activity of GABA receptor sites throughout the body.
    • C)
    • Cholinergic agonists increase the activity of acetylcholine receptor sites throughout the body.
    • D)
    • Cholinergic agonists decrease the activity of norepinephrine receptor sites throughout the brain and spinal cord.
  3. 3.
    • A 10-year-old child with spina bifida is receiving bethanechol (Urecholine) for treatment of neurogenic bladder. What adverse effect will the nurse be sure to assess for?
    • A)
    • Constipation
    • B)
    • Loss of bowel and bladder control
    • C)
    • Decrease salivation
    • D)
    • Increased appetite
  4. 4.
    • A nurse is writing a plan of care for a patient who is taking bethanechol (Urecholine). What would be an appropriate outcome for this patient?
    • A)
    • Pupillary dilation
    • B)
    • Increased blood pressure
    • C)
    • Improved bladder function
    • D)
    • Decreased secretions
  5. 5.
    • Which of the following drugs would be used to diagnose myasthenia gravis in a child?
    • A)
    • Atropine (Generic)
    • B)
    • Bethanechol (Urecholine)
    • C)
    • Edrophonium (Tensilon)
    • D)
    • Neostigmine (Prostigmine)
  6. 6.
    • A patient is brought to the Emergency Department having a cholinergic reaction, which includes a severe drop in blood pressure. What drug will you expect to administer?
    • A)
    • Atropine (Generic)
    • B)
    • Edrophonium (Tensilon)
    • C)
    • Propranolol (Inderal)
    • D)
    • Succinylcholine (Anectine)
  7. 7.
    • Memantine hydrochloride (Namenda) has been prescribed for a 63-year-old patient who has a confirmed diagnosis of Alzheimer's disease. What would be the target dose for this patient?
    • A)
    • 5 mg/d
    • B)
    • 10 mg b.i.d.
    • C)
    • 15 mg/d
    • D)
    • 20 mg b.i.d.
  8. 8.
    • An Alzheimer's patient taking donepezil (Aricept) has a complete blood count that indicates they are anemic. What drug taken by the patient could be the cause of the anemia?
    • A)
    • Cimetidine (Tagamet)
    • B)
    • Ibuprofen (Advil)
    • C)
    • Diltiazem (Cardizem)
    • D)
    • Furosemide (Lasix)
  9. 9.
    • Military personnel who have been exposed to particular nerve gases have what drug approved to treat them?
    • A)
    • Neostigmine (Prostigmine)
    • B)
    • Pyridostigmine (Mestinon)
    • C)
    • Ambenonium (Mytelase)
    • D)
    • Endrophonium (Tensilon)
  10. 10.
    • A patient with postoperative abdominal distention is given neostigmine (Prostigmine) for abdominal distention. What outcome will the nurse assess for?
    • A)
    • Absence of flatus through the rectum
    • B)
    • Increased urination
    • C)
    • Presence of bowel sounds
    • D)
    • Absence of bowel movements
  11. 11.
    • You are caring for a 49-year-old patient, who has been receiving bethanechol (Duvoid) for 1 week. Your patient develops progressive muscle weakness and respiratory difficulty. What would you suspect is happening with your patient?
    • A)
    • Myasthenic crisis
    • B)
    • Cholinergic overdose
    • C)
    • Anaphylactic reaction
    • D)
    • Pulmonary edema
  12. 12.
    • A 70-year-old female patient has just been diagnosed with Alzheimer's disease. What cholinergic drug is used for the treatment of Alzheimer's disease?
    • A)
    • Bethanechol (Duvoid)
    • B)
    • Neostigmine (Prostigmine)
    • C)
    • Donepezil (Aricept)
    • D)
    • Endrophonium (Tensilon)
  13. 13.
    • Your 38-year-old client has just been administered edrophonium (Tensilon). You will know if this patient has myasthenia gravis if the patient exhibits what within 30 minutes after receiving the medication?
    • A)
    • Increased muscle strength
    • B)
    • Decreased adventitious breath sounds
    • C)
    • Decreased muscle spasms
    • D)
    • Increased urinary output
  14. 14.
    • The nursing instructor is discussing cholinergic drugs with his clinical group. What system would the instructor tell his students is stimulated by cholinergic drugs?
    • A)
    • Sympathetic nervous system
    • B)
    • Parasympathetic nervous system
    • C)
    • Cardiac system
    • D)
    • Respiratory system
  15. 15.
    • A patient, 78-years-old, is admitted to the Emergency Department (ED) and is diagnosed with bradycardia. The patient tells the nurse he is taking donepezil (Aricept), a cholinergic agent, for Alzheimer's disease. The nurse knows that the drug of choice for this bradycardia is what?
    • A)
    • Atropine
    • B)
    • Pseudoephedrine
    • C)
    • Propranolol
    • D)
    • Bethanechol
  16. 16.
    • What condition is the cholinergic drug bethanechol (Duvoid) used to treat?
    • A)
    • Hypertension
    • B)
    • Urinary retention
    • C)
    • Bradycardia
    • D)
    • Asthma
  17. 17.
    • The nurse is caring for a patient who has anticholinesterase drugs prescribed. When administering anticholinesterase drugs, the nurse should assess the patient for toxic effects of the drugs. What do these include?
    • A)
    • Paralytic ileus
    • B)
    • Abdominal distension
    • C)
    • Hypertension
    • D)
    • Muscle weakness
  18. 18.
    • Which indirect-acting anticholinesterase medication is recommended as an antidote to neuromuscular junction blockers.
    • A)
    • Pyridostigmine (Mestinon)
    • B)
    • Donespezil (Aricept)
    • C)
    • Rivastigmine (Exelon)
    • D)
    • Ambenonium (Mytelase)
  19. 19.
    • A patient is brought to the Emergency Department after a motor vehicle accident. The patient is diagnosed with multiple injuries including a bladder injury. The patient is taken to surgery and develops a nonobstructive postoperative urinary retention. What drug would the nurse expect to be ordered for this patient?
    • A)
    • Neostigmine
    • B)
    • Bethanechol
    • C)
    • Ambenonium
    • D)
    • Pyridostigmine
  20. 20.
    • A patient is taking memantine for Alzheimer's disease. This drug does not affect what?
    • A)
    • Antiadrenergic receptor sites
    • B)
    • Glucagon receptor sites
    • C)
    • GABA receptor sites
    • D)
    • Antihistamine receptor sites
  21. 21.
    • A patient is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition?
    • A)
    • Atropine
    • B)
    • Epinepherine
    • C)
    • Lidocaine
    • D)
    • Tensilon
  22. 22.
    • A 47-year-old male is suspected of having been exposed to nerve gas. Atropine is given to temporarily block cholinergic activity and to activate acetylcholine sites in the central nervous system. What drug is given with the atropine to free up the acetylcholinesterase to start breaking down acetylcholine?
    • A)
    • Pyridostigmine
    • B)
    • Pralidoxime
    • C)
    • Neostigmine
    • D)
    • Rivastigmine
  23. 23.
    • A 77-year-old male is brought to the Emergency Department with a cholinergic overdose. The nurse knows that older adults are likely to have a greater number of adverse drug effects because why?
    • A)
    • Age-related pathologic events
    • B)
    • Concurrent physiologic events
    • C)
    • Age-related physiologic changes
    • D)
    • Superimposed physiologic events
  24. 24.
    • You are caring for a 45-year-old female patient who is in chronic renal failure. What cholinergic drug is contraindicated for this patient?
    • A)
    • Neostigmine
    • B)
    • Pyridostigmine
    • C)
    • Edrophonium
    • D)
    • Galantamine
  25. 25.
    • A 72-year-old male is newly diagnosed with Alzheimer's disease. The patient's daughter asks you how her father's medication is going to help him. What would be the nurse's best response?
    • A)
    • “The drugs work by increasing ACh levels in the brain and slowing the progression of the disease.”
    • B)
    • “The drugs work by crossing the blood-brain barrier and decreasing ACh levels in the brain.”
    • C)
    • “The drugs work by decreasing ACh levels in the brain and slowing the progression of the disease.”
    • D)
    • “The drugs work by crossing the blood-brain barrier and decreasing ACh levels in the neuromuscular junctions.”
  26. 26.
    • A patient has been newly diagnosed with myasthenia gravis. What is important advice for the family?
    • A)
    • If one dose of medication is missed double the next dose
    • B)
    • Have one or more family members learn the warning signs of drug overdose
    • C)
    • Teach family how to help patient walk with cane
    • D)
    • Teach the patient how to do CPR
  27. 27.
    • A new patient has come to the clinic. The patient tells the nurse they take Aricept. Why would it be important for the nurse to assess the patient's medical and medication history?
    • A)
    • Because of the many bodily functions affected by the cholinergic medications' ability to stimulate the autonomic nervous system
    • B)
    • Because of the many bodily functions affected by the anti-cholinergic medications' ability to stimulate the parasympathetic nervous system
    • C)
    • Because of the many bodily functions affected by the cholinergic medications' ability to stimulate the parasympathetic nervous system
    • D)
    • Because of the many bodily functions affected by the cholinergic medications' ability to stimulate the sympathetic nervous system
  28. 28.
    • What family of drugs is used in the treatment of myasthenia gravis?
    • A)
    • Cholinesterase agents
    • B)
    • Irreversible inhibitors
    • C)
    • Anti-cholinesterase agents
    • D)
    • Irreversible agonists
  29. 29.
    • You are a critical care nurse working in the ICU. You know that cholinergic drugs have very specific uses in critical illness. What is a use for pyridostigmine in critical care?
    • A)
    • Reverse neuromuscular junction blockers
    • B)
    • Reverse smooth muscle blockade
    • C)
    • Reverse cholinergic crisis
    • D)
    • Reverse myasthinic crisis
  30. 30.
    • A patient diagnosed with myasthenia gravis is having trouble swallowing. What anticholinesterase inhibitor would be the drug of choice for this patient because it can be given parenterally?
    • A)
    • Galantamine
    • B)
    • Pyridostigmine
    • C)
    • Neostigmine
    • D)
    • Bethanechol
  31. Answer Key
    1.C2.C3.B4.C5.C6.A7.B8.B9.B10.C11.B12.C13.A14.B15.A16.B17.D18.A19.B20.C21.A22.B23.C24.D25.A26.B27.C28.C29.A30.B 
  32. 27.
    • C
    • 28.
    • C
    • 29.
    • A
    • 30.
    • B

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