Test Bank For Pharmacology for Nurses, Canadian Edition, 3rd
Edition by Michael Adams (), 9780135493199 / Chapter 1-64 /
All Chapters with Answers and Rationals
What are the major functions of the α1 receptor? - ANSWER: Increase vascular smooth muscle
contraction, increase pupillary dilator muscle contraction (mydriasis), increase intestinal and bladder
sphincter muscle contraction
What are the major functions of the α2 receptor? - ANSWER: Decrease sympathetic outflow, decrease
insulin release, decrease lipolysis, increase platelet aggregation, decrease aqueous humor production
What are the major functions of the β1 receptor? - ANSWER: Increase heart rate, increase
contractility, increase renin release, increase lipolysis
What are the major functions of the β2 receptor? - ANSWER: Vasodilation, bronchodilation, increase
lipolysis, increase insulin release, decrease uterine tone (tocolysis), ciliary muscle relaxation, increase
aqueous humor production
What are the major functions of the M1 receptor? - ANSWER: CNS, enteric nervous system
What are the major functions of the M2 receptor? - ANSWER: Decrease heart rate and contractility of
atria
What are the major functions of the M3 receptor? - ANSWER: Increase exocrine gland secretions (e.g.,
lacrimal, salivary, gastric acid), increase gut peristalsis, increase bladder contraction, increase
bronchoconstriction, pupillary sphincter muscle contraction (miosis), ciliary muscle contraction
(accommodation)
What are the major functions of the D1 receptor? - ANSWER: Relaxes renal vascular smooth muscle
What are the major functions of the D2 receptor? - ANSWER: Modulates transmitter release,
especially in the brain
What are the major functions of the H1 receptor? - ANSWER: Increase nasal and bronchial mucus
production, increase vascular permeability, contraction of bronchioles, pruritis, pain
What are the major functions of the H2 receptor? - ANSWER: Increase gastric acid secretion
What are the major functions of the V1 receptor? - ANSWER: Increase vascular smooth muscle
contraction
What are the major functions of the V2 receptor? - ANSWER: Increase H2O permeability and
reabsorption in collecting tubules of kidney (V2 is found in the "2" kidneys)
What receptors are associate with Gq? - ANSWER: H1, α1, V1, M1, and M3
What receptors are associated with Gs? - ANSWER: H2, B1, B2, V2, D1
What receptors are associated with Gi? - ANSWER: M2, α2, D2
Bethanechol - ANSWER: -Direct cholinergic agonist
-Activates bowel and bladder smooth muscle
-Used in postoperative and neurogenic ileus
-Resistant to AChE
,Carbachol - ANSWER: -Direct cholinergic agonist
-Carbon copy of acetylcholine
-Constricts pupils and relieves intraocular pressure in glaucoma
Methacholine - ANSWER: -Direct cholinergic agonist
-Stimulates muscarinic receptors in airways when inhaled
-Used as a challenge test for diagnosis of asthma
Pilocarpine - ANSWER: -Direct cholinergic agonist
-Contracts ciliary muscle of eye (open angle glaucoma), contracts pupillary sphincter (closed angle
glaucoma)
-Potent stimulator of sweat, tears and saliva
-AChE resistant
Donepezil - ANSWER: -Anticholinesterse - increases ACh
-Alzheimer disease
Galantamine - ANSWER: -Anticholinesterse - increases ACh
-Alzheimer disease
Rivastigmine - ANSWER: -Anticholinesterse - increases ACh
-Alzheimer disease
Edrophonium - ANSWER: -Anticholinesterse - increases ACh
-Historically used to diagnose myasthenia gravis (MG is now diagnosed by anti-AChR Ab test.
Neostigmine - ANSWER: -Anticholinesterse - increases ACh
-Used in postoperative and neurogenic ileus and urinary retention, myasthenia gravis, and
postoperative reversal of neuromuscular junction blockade
Physostigmine - ANSWER: -Anticholinesterse - increases ACh
-Used in anticholinergic toxicity
-Crosses the blood-brain barrier (CNS)
Pyridostigmine - ANSWER: -Anticholinesterse - increases ACh
-Increases muscle strength
-Used in myasthenia gravis (long acting)
-Does not penetrate CNS
Atropine - ANSWER: -Muscarinic antagonist
-Used in bradycardia and for ophthalmic applications
-Also used as antidote for cholinesterase inhibitor poisoning
-Actions include increase pupil dilation, cycloplegia, decreased airway secretions, decreased acid
secretions, decreased gut motility, decreased bladder urgency in cystitis
-Toxicity: increased body temp (due to decreased sweating), rapid pulse, dry mouth, dry and flushed
skin, cycloplegia, constipation, disorientation;
-Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with
prostatic hyperplasia, and hyperthermia in infants
-See also homatropine and tropicamide
Benztropine - ANSWER: -Muscarinic antagonist
-Works in CNS
-Used in Parkinson disease and acute dystonia
Glycopyrrolate - ANSWER: -Muscarinic antagonist
-Parental use: preoperative use to reduce airway secretions
,-Oral use: drooling, peptic ulcer
Hyoscyamine - ANSWER: -Muscarinic antagonist
-Antispasmodics for IBS
Dicyclomide - ANSWER: -Muscarinic antagonist
-Antispasmodics for IBS
Ipratropium - ANSWER: -Muscarinic antagonist
-Used in COPD and asthma
Tiotropium - ANSWER: -Muscarinic antagonist
-Used in COPD and asthma
Oxybutynin - ANSWER: -Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Solifenacin - ANSWER: -Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Tolterodine - ANSWER: -Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Scopalamine - ANSWER: -Muscarinic antagonist
-Motion sickness
Tetrodotoxin - ANSWER: -Poisoning can result from ingestion of poorly prepared puffer fish (exotic
sushi)
-Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing
depolarization - blocks action potential without changing resting potential (same mechanism as
Lidocaine)
-Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes.
-Treatment is primarily supportive.
Ciguatoxin - ANSWER: -Consumption of reef fish (e.g. barracuda, snapper, eel...)
-Causes ciguatera fish poisoning.
-Opens Na+ channels causing depolarization. Symptoms easily confused with cholinergic poisoning.
-Temperature-related dysesthesia (e.g., "cold feels hot; hot feels cold") is regarded as a specific
finding of ciguatera.
-Treatment is primarily supportive.
Scombroid poisoning - ANSWER: -Caused by consumption of dark-meat fish (e.g., bonito, mackerel,
mahi-mahi, tuna) improperly stored at warm temperature.
-Bacterial histidine decarboxylase converts histidine to histamine. Histamine is not degraded by
cooking.
-Acute-onset burning sensation of the mouth, flushing of face, erythema, urticaria, pruritus,
headache. May cause anaphylaxis-like presentation (i.e., bronchospasm, angioedema, hypotension).
-Frequently misdiagnosed as allergy to fish.
-Treat supportively with antihistamines; if needed, antianaphylactics (e.g., bronchodilators,
epinephrine).
Albuterol - ANSWER: -β2 > β1 direct agonist
-Acute asthma
Salmterol - ANSWER: -β2 > β1 direct agonist
-Long term asthma or COPD control
, Dobutamine - ANSWER: -β1 > β2, α direct agonist
-Uses: heart failure (HF) (inotropic > chronotropic), cardiac stress testing.
Dopamine - ANSWER: -D1 = D2 > β > α direct agonist
-Uses: unstable bradycardia, HF, shock; inotropic and chronotropic α effects predominate at high
doses.
Epinephrine - ANSWER: -β > α direct agonist
-Uses: anaphylaxis, asthma, open-angle glaucoma;
α effects predominate at high doses. Significantly stronger effect at β2-receptor than norepinephrine.
Isoprterenol - ANSWER: -β1 = β2 direct agonist
-Uses: electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia
Norepinephrine - ANSWER: -α1 > α2 > β1 direct agonist
-Hypotension (butrenal perfusion). Significantly weaker effect at β2-receptor than epinephrine.
Phenylephrine - ANSWER: -α1 > α2 direct agonist
-Uses: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
Amphetamine - ANSWER: -Indirect general sympathetic agonist
-reuptake inhibitor; also releases stored catecholamines
-Narcolepsy, obesity, ADHD.
Cocaine - ANSWER: -Indirect general sympathetic agonist
-Reuptake inhibitor
-Causes vasoconstriction and local anesthesia.
-Never give β-blockers if cocaine intoxication is
suspected (can lead to unopposed α1 activation and extreme hypertension).
Ephedrine - ANSWER: -Indirect general sympathetic agonist
-Releases stored catecholamines
-Nasal decongestion, urinary incontinence, hypotension.
Norepinephrine vs. isoproterenol - ANSWER: -Norepinephrine increases systolic and diastolic
pressures as a result of α1-mediated vasoconstriction causing increased in mean arterial pressure and
reflex bradycardia. -However, isoproterenol (no longer commonly used) has little α effect but causes
β2-mediated vasodilation, resulting in decreased mean arterial pressure and increased heart rate
through β1 and reflex activity.
Clonidine - ANSWER: -α2-agonist
-Uses: hypertensive urgency (limited situations); does not decrease renal blood flow; ADHD, Tourette
syndrome
-Toxicity: CNS depression, bradycardia, hypotension, respiratory depression, miosis
α-methyldopa - ANSWER: -α2-agonist
-Used for hypertension in pregnancy
-Toxicity: Direct Coombs ⊕ hemolysis, SLE-like syndrome
Phenoxybenzamine - ANSWER: -Nonselective α-blocker
-Irreversible
-Used preoperatively for pheochromocytoma to prevent catecholamine (hypertensive) crisis
-Toxicity: orthostatic hypotension, reflex tachycardia
Phentolamine - ANSWER: -Nonselective α-blocker
-Give to patients on MAO inhibitors who eat tyramine containing foods
-Toxicity: orthostatic hypotension, reflex tachycardia
Edition by Michael Adams (), 9780135493199 / Chapter 1-64 /
All Chapters with Answers and Rationals
What are the major functions of the α1 receptor? - ANSWER: Increase vascular smooth muscle
contraction, increase pupillary dilator muscle contraction (mydriasis), increase intestinal and bladder
sphincter muscle contraction
What are the major functions of the α2 receptor? - ANSWER: Decrease sympathetic outflow, decrease
insulin release, decrease lipolysis, increase platelet aggregation, decrease aqueous humor production
What are the major functions of the β1 receptor? - ANSWER: Increase heart rate, increase
contractility, increase renin release, increase lipolysis
What are the major functions of the β2 receptor? - ANSWER: Vasodilation, bronchodilation, increase
lipolysis, increase insulin release, decrease uterine tone (tocolysis), ciliary muscle relaxation, increase
aqueous humor production
What are the major functions of the M1 receptor? - ANSWER: CNS, enteric nervous system
What are the major functions of the M2 receptor? - ANSWER: Decrease heart rate and contractility of
atria
What are the major functions of the M3 receptor? - ANSWER: Increase exocrine gland secretions (e.g.,
lacrimal, salivary, gastric acid), increase gut peristalsis, increase bladder contraction, increase
bronchoconstriction, pupillary sphincter muscle contraction (miosis), ciliary muscle contraction
(accommodation)
What are the major functions of the D1 receptor? - ANSWER: Relaxes renal vascular smooth muscle
What are the major functions of the D2 receptor? - ANSWER: Modulates transmitter release,
especially in the brain
What are the major functions of the H1 receptor? - ANSWER: Increase nasal and bronchial mucus
production, increase vascular permeability, contraction of bronchioles, pruritis, pain
What are the major functions of the H2 receptor? - ANSWER: Increase gastric acid secretion
What are the major functions of the V1 receptor? - ANSWER: Increase vascular smooth muscle
contraction
What are the major functions of the V2 receptor? - ANSWER: Increase H2O permeability and
reabsorption in collecting tubules of kidney (V2 is found in the "2" kidneys)
What receptors are associate with Gq? - ANSWER: H1, α1, V1, M1, and M3
What receptors are associated with Gs? - ANSWER: H2, B1, B2, V2, D1
What receptors are associated with Gi? - ANSWER: M2, α2, D2
Bethanechol - ANSWER: -Direct cholinergic agonist
-Activates bowel and bladder smooth muscle
-Used in postoperative and neurogenic ileus
-Resistant to AChE
,Carbachol - ANSWER: -Direct cholinergic agonist
-Carbon copy of acetylcholine
-Constricts pupils and relieves intraocular pressure in glaucoma
Methacholine - ANSWER: -Direct cholinergic agonist
-Stimulates muscarinic receptors in airways when inhaled
-Used as a challenge test for diagnosis of asthma
Pilocarpine - ANSWER: -Direct cholinergic agonist
-Contracts ciliary muscle of eye (open angle glaucoma), contracts pupillary sphincter (closed angle
glaucoma)
-Potent stimulator of sweat, tears and saliva
-AChE resistant
Donepezil - ANSWER: -Anticholinesterse - increases ACh
-Alzheimer disease
Galantamine - ANSWER: -Anticholinesterse - increases ACh
-Alzheimer disease
Rivastigmine - ANSWER: -Anticholinesterse - increases ACh
-Alzheimer disease
Edrophonium - ANSWER: -Anticholinesterse - increases ACh
-Historically used to diagnose myasthenia gravis (MG is now diagnosed by anti-AChR Ab test.
Neostigmine - ANSWER: -Anticholinesterse - increases ACh
-Used in postoperative and neurogenic ileus and urinary retention, myasthenia gravis, and
postoperative reversal of neuromuscular junction blockade
Physostigmine - ANSWER: -Anticholinesterse - increases ACh
-Used in anticholinergic toxicity
-Crosses the blood-brain barrier (CNS)
Pyridostigmine - ANSWER: -Anticholinesterse - increases ACh
-Increases muscle strength
-Used in myasthenia gravis (long acting)
-Does not penetrate CNS
Atropine - ANSWER: -Muscarinic antagonist
-Used in bradycardia and for ophthalmic applications
-Also used as antidote for cholinesterase inhibitor poisoning
-Actions include increase pupil dilation, cycloplegia, decreased airway secretions, decreased acid
secretions, decreased gut motility, decreased bladder urgency in cystitis
-Toxicity: increased body temp (due to decreased sweating), rapid pulse, dry mouth, dry and flushed
skin, cycloplegia, constipation, disorientation;
-Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with
prostatic hyperplasia, and hyperthermia in infants
-See also homatropine and tropicamide
Benztropine - ANSWER: -Muscarinic antagonist
-Works in CNS
-Used in Parkinson disease and acute dystonia
Glycopyrrolate - ANSWER: -Muscarinic antagonist
-Parental use: preoperative use to reduce airway secretions
,-Oral use: drooling, peptic ulcer
Hyoscyamine - ANSWER: -Muscarinic antagonist
-Antispasmodics for IBS
Dicyclomide - ANSWER: -Muscarinic antagonist
-Antispasmodics for IBS
Ipratropium - ANSWER: -Muscarinic antagonist
-Used in COPD and asthma
Tiotropium - ANSWER: -Muscarinic antagonist
-Used in COPD and asthma
Oxybutynin - ANSWER: -Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Solifenacin - ANSWER: -Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Tolterodine - ANSWER: -Muscarinic antagonist
-Reduced bladder spasms and urge urinary incontinence
Scopalamine - ANSWER: -Muscarinic antagonist
-Motion sickness
Tetrodotoxin - ANSWER: -Poisoning can result from ingestion of poorly prepared puffer fish (exotic
sushi)
-Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing
depolarization - blocks action potential without changing resting potential (same mechanism as
Lidocaine)
-Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes.
-Treatment is primarily supportive.
Ciguatoxin - ANSWER: -Consumption of reef fish (e.g. barracuda, snapper, eel...)
-Causes ciguatera fish poisoning.
-Opens Na+ channels causing depolarization. Symptoms easily confused with cholinergic poisoning.
-Temperature-related dysesthesia (e.g., "cold feels hot; hot feels cold") is regarded as a specific
finding of ciguatera.
-Treatment is primarily supportive.
Scombroid poisoning - ANSWER: -Caused by consumption of dark-meat fish (e.g., bonito, mackerel,
mahi-mahi, tuna) improperly stored at warm temperature.
-Bacterial histidine decarboxylase converts histidine to histamine. Histamine is not degraded by
cooking.
-Acute-onset burning sensation of the mouth, flushing of face, erythema, urticaria, pruritus,
headache. May cause anaphylaxis-like presentation (i.e., bronchospasm, angioedema, hypotension).
-Frequently misdiagnosed as allergy to fish.
-Treat supportively with antihistamines; if needed, antianaphylactics (e.g., bronchodilators,
epinephrine).
Albuterol - ANSWER: -β2 > β1 direct agonist
-Acute asthma
Salmterol - ANSWER: -β2 > β1 direct agonist
-Long term asthma or COPD control
, Dobutamine - ANSWER: -β1 > β2, α direct agonist
-Uses: heart failure (HF) (inotropic > chronotropic), cardiac stress testing.
Dopamine - ANSWER: -D1 = D2 > β > α direct agonist
-Uses: unstable bradycardia, HF, shock; inotropic and chronotropic α effects predominate at high
doses.
Epinephrine - ANSWER: -β > α direct agonist
-Uses: anaphylaxis, asthma, open-angle glaucoma;
α effects predominate at high doses. Significantly stronger effect at β2-receptor than norepinephrine.
Isoprterenol - ANSWER: -β1 = β2 direct agonist
-Uses: electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia
Norepinephrine - ANSWER: -α1 > α2 > β1 direct agonist
-Hypotension (butrenal perfusion). Significantly weaker effect at β2-receptor than epinephrine.
Phenylephrine - ANSWER: -α1 > α2 direct agonist
-Uses: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
Amphetamine - ANSWER: -Indirect general sympathetic agonist
-reuptake inhibitor; also releases stored catecholamines
-Narcolepsy, obesity, ADHD.
Cocaine - ANSWER: -Indirect general sympathetic agonist
-Reuptake inhibitor
-Causes vasoconstriction and local anesthesia.
-Never give β-blockers if cocaine intoxication is
suspected (can lead to unopposed α1 activation and extreme hypertension).
Ephedrine - ANSWER: -Indirect general sympathetic agonist
-Releases stored catecholamines
-Nasal decongestion, urinary incontinence, hypotension.
Norepinephrine vs. isoproterenol - ANSWER: -Norepinephrine increases systolic and diastolic
pressures as a result of α1-mediated vasoconstriction causing increased in mean arterial pressure and
reflex bradycardia. -However, isoproterenol (no longer commonly used) has little α effect but causes
β2-mediated vasodilation, resulting in decreased mean arterial pressure and increased heart rate
through β1 and reflex activity.
Clonidine - ANSWER: -α2-agonist
-Uses: hypertensive urgency (limited situations); does not decrease renal blood flow; ADHD, Tourette
syndrome
-Toxicity: CNS depression, bradycardia, hypotension, respiratory depression, miosis
α-methyldopa - ANSWER: -α2-agonist
-Used for hypertension in pregnancy
-Toxicity: Direct Coombs ⊕ hemolysis, SLE-like syndrome
Phenoxybenzamine - ANSWER: -Nonselective α-blocker
-Irreversible
-Used preoperatively for pheochromocytoma to prevent catecholamine (hypertensive) crisis
-Toxicity: orthostatic hypotension, reflex tachycardia
Phentolamine - ANSWER: -Nonselective α-blocker
-Give to patients on MAO inhibitors who eat tyramine containing foods
-Toxicity: orthostatic hypotension, reflex tachycardia
