ECPI Pharmacology Final
Exam||Latest Exam Questions And
Correct Answers||
Nicotinic N (neuronal) Location -CORRECT ANSWER All autonomic nervous system
ganglia and the adrenal medulla
Nicotinic N (neuronal) response -CORRECT ANSWER Stimulation of parasympathetic
and sympathetic post-ganglionic nerves and release of epinephrine from adrenal
medulla
Nicotinic M (muscle) Location -CORRECT ANSWER Neuromuscular junction
Nicotinic M (muscle) Response -CORRECT ANSWER contraction of skeletal muscle
Muscarinic Locations -CORRECT ANSWER Eye, Heart, Lung, Bladder, GI tract Sweat
glands, Sex organs, Blood vessels
Muscarinic Responses by location -CORRECT 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 -CORRECT ANSWER Eye, Arterioles (Skin, viscera, mucus
membranes), Veins, Sex organs, Prostatic capsule, Bladder
Alpha 1 Response by location -CORRECT 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 -CORRECT ANSWER Peripheral nervous system
,-Inhibition of transmitter release
Beta 1 Locations (2) & Response -CORRECT ANSWER - Heart: Increased rate and
velocity
- Kidney: Release of renin (elevates BP)
Beta 2 Responses by location -CORRECT ANSWER - Arterioles (heart, lung, skeletal
muscle): Dilation
- Bronchi: Dilation
- Uterus: Relaxation
- Liver: Glycogenolysis
- Skeletal muscle: Enhanced contraction
Dopamine Response in kidneys -CORRECT ANSWER - Kidney: Dilation of kidney
vasculature
Bethanechol Treats... -CORRECT ANSWER Urinary Retention
Bethanechol investigational uses -CORRECT ANSWER Gastroesophageal reflux , treat
disorders associated with GI paralysis
Bathanechol Contraindications -CORRECT 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 -CORRECT ANSWER
Administer 1 hr before or 2 hrs after eating. Can cause nausea and vomiting if taken
with food
Pilocarpine treats... -CORRECT 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 -CORRECT 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 -CORRECT ANSWER spasm of bronchial smooth muscle producing
narrowing of the bronchi
Bronchorrhea -CORRECT ANSWER the production of more than 100 mL per day of
watery sputum
How to treat Cholinergic Crisis -CORRECT ANSWER manage with mechanical
ventilation & atropine (muscarinic receptor antagonist), suctioning may be needed
prior to administering anything orally to a patient with Myasthenia Gravis... -CORRECT
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 -CORRECT 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 -CORRECT 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 -CORRECT ANSWER Weakness, rapid fatigue
- Treated with Neostigmine (parasympathomimetic)
, Dopamine: Nursing assessment post administration for shock would include monitoring
what? -CORRECT 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 -CORRECT ANSWER Necrosis - if the IV
line is extravasated, necrosis may result. Infiltrate region with phentolamine
Adverse effects of Dopamine -CORRECT 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 -CORRECT 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
Pre-assessment for Beta-blockers -CORRECT ANSWER require pre-assessment of the
heart rate prior to administration. If the HR is regular and 60 bpm or less, the dose
should be held and notify the prescriber.
Baseline ECG should be obtained.
If you were going to administer propranolol, what would you assess for and what would
you do based on your findings? -CORRECT ANSWER concerning HR - Propranolol is a
beta blocker, blocks both beta 1 and 2 since it is non selective
- Can cause bradycardia ---> heart rate should be assessed before each dose, if heart
rate is below normal <60, drug should be held and prescriber notified. If necessary heart
rate can be increased by administering atropine and isoproterenol
- Can cause AV heart block ---> contraindicated for patients with preexisting AV block
(first degree)
- Heart failure --- inform patients about early signs of heart failure and notify prescriber.
Contraindicated for patients with preexisting heart failure.
-Rebound cardiac excitation ---> withdraw slowly to avoid rebound cardiac excitation
(tachycardia and ventricular dysrhythmias)
therapeutic uses of clonidine (alpha 2 agonist) -CORRECT ANSWER - Hypertension ---
clonidine causes bradycardia and decrease in CO and promote vasodilatation. The net
result is cardiac suppression and therefore decreased BP.
- Severe pain
- ADHD
- Investigational use in the management of opioid withdrawal, facilitating smoking
cessation, treating Tourette's disease.
An adverse effect of Clonidine -CORRECT ANSWER drowsiness
Exam||Latest Exam Questions And
Correct Answers||
Nicotinic N (neuronal) Location -CORRECT ANSWER All autonomic nervous system
ganglia and the adrenal medulla
Nicotinic N (neuronal) response -CORRECT ANSWER Stimulation of parasympathetic
and sympathetic post-ganglionic nerves and release of epinephrine from adrenal
medulla
Nicotinic M (muscle) Location -CORRECT ANSWER Neuromuscular junction
Nicotinic M (muscle) Response -CORRECT ANSWER contraction of skeletal muscle
Muscarinic Locations -CORRECT ANSWER Eye, Heart, Lung, Bladder, GI tract Sweat
glands, Sex organs, Blood vessels
Muscarinic Responses by location -CORRECT 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 -CORRECT ANSWER Eye, Arterioles (Skin, viscera, mucus
membranes), Veins, Sex organs, Prostatic capsule, Bladder
Alpha 1 Response by location -CORRECT 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 -CORRECT ANSWER Peripheral nervous system
,-Inhibition of transmitter release
Beta 1 Locations (2) & Response -CORRECT ANSWER - Heart: Increased rate and
velocity
- Kidney: Release of renin (elevates BP)
Beta 2 Responses by location -CORRECT ANSWER - Arterioles (heart, lung, skeletal
muscle): Dilation
- Bronchi: Dilation
- Uterus: Relaxation
- Liver: Glycogenolysis
- Skeletal muscle: Enhanced contraction
Dopamine Response in kidneys -CORRECT ANSWER - Kidney: Dilation of kidney
vasculature
Bethanechol Treats... -CORRECT ANSWER Urinary Retention
Bethanechol investigational uses -CORRECT ANSWER Gastroesophageal reflux , treat
disorders associated with GI paralysis
Bathanechol Contraindications -CORRECT 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 -CORRECT ANSWER
Administer 1 hr before or 2 hrs after eating. Can cause nausea and vomiting if taken
with food
Pilocarpine treats... -CORRECT 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 -CORRECT 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 -CORRECT ANSWER spasm of bronchial smooth muscle producing
narrowing of the bronchi
Bronchorrhea -CORRECT ANSWER the production of more than 100 mL per day of
watery sputum
How to treat Cholinergic Crisis -CORRECT ANSWER manage with mechanical
ventilation & atropine (muscarinic receptor antagonist), suctioning may be needed
prior to administering anything orally to a patient with Myasthenia Gravis... -CORRECT
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 -CORRECT 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 -CORRECT 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 -CORRECT ANSWER Weakness, rapid fatigue
- Treated with Neostigmine (parasympathomimetic)
, Dopamine: Nursing assessment post administration for shock would include monitoring
what? -CORRECT 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 -CORRECT ANSWER Necrosis - if the IV
line is extravasated, necrosis may result. Infiltrate region with phentolamine
Adverse effects of Dopamine -CORRECT 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 -CORRECT 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
Pre-assessment for Beta-blockers -CORRECT ANSWER require pre-assessment of the
heart rate prior to administration. If the HR is regular and 60 bpm or less, the dose
should be held and notify the prescriber.
Baseline ECG should be obtained.
If you were going to administer propranolol, what would you assess for and what would
you do based on your findings? -CORRECT ANSWER concerning HR - Propranolol is a
beta blocker, blocks both beta 1 and 2 since it is non selective
- Can cause bradycardia ---> heart rate should be assessed before each dose, if heart
rate is below normal <60, drug should be held and prescriber notified. If necessary heart
rate can be increased by administering atropine and isoproterenol
- Can cause AV heart block ---> contraindicated for patients with preexisting AV block
(first degree)
- Heart failure --- inform patients about early signs of heart failure and notify prescriber.
Contraindicated for patients with preexisting heart failure.
-Rebound cardiac excitation ---> withdraw slowly to avoid rebound cardiac excitation
(tachycardia and ventricular dysrhythmias)
therapeutic uses of clonidine (alpha 2 agonist) -CORRECT ANSWER - Hypertension ---
clonidine causes bradycardia and decrease in CO and promote vasodilatation. The net
result is cardiac suppression and therefore decreased BP.
- Severe pain
- ADHD
- Investigational use in the management of opioid withdrawal, facilitating smoking
cessation, treating Tourette's disease.
An adverse effect of Clonidine -CORRECT ANSWER drowsiness
