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NURS 5334 EXAM 2 STUDY QUESTIONS & ANSWERS, ALL 100% CORRECT.What are the basic mechanisms by which neuropharmocologic agents act? o Can modify the disease process o Act at the sites of actions whi... ch is the axons versus synapses and steps in synaptic transmission and effects of drugs on the steps of synaptic transmission  Transmittter synthesis is the first step in transmission. What are the other 4 steps? o Transmitter storage, transmitter release, receptor binding, and termination of the transmission  True or False: Neuropharmacologic drugs have high selectivity. o True—the nervous system uses many different receptor types  Information needed: o Type of receptors—through which the drug acts  Alpha and beta o Normal responses to the activation of those receptors  Agonists vs. antagonists o What the drug in questions does to the receptor function  What are the 3 functions of ANS? o Regulates the heart o Regulates the secretory glands, saliva glands, gastric, sweat, and bronchial o It regulates smooth muscles: bronchi, blood vessels, urogenital system, and the GI tract  What are the regulatory functions of the parasympathetic NS? o Seven regulatory functions  Slowing the heart rate  Increasing the gastric secretions  Emptying the bladder  Emptying the bowel  Focusing the eye for near vision,  Constricting the pupil  Contracting the bronchial smooth muscle o It also regulates the digestion of food, excretion of waste, control of vision and conservation of energy  What are the functions of the sympathetic NS? o Regulation of the cardiovascular system  Maintaining blood flow to the brain  Redistributing blood and compensating for the loss of blood o Regulation of body temperature  Regulates blood flow to the skin  Promotes the secretion of sweat  Induces piloerection (erection of the hair) o Implementation of the fight or flight reaction  Increase HR and BP  Blood shuts away from the skin and visera  Bronchi dilate 1  Pupils dilate  Use energy that had been stored  What is the baroreceptor reflex? o The receptors near the heart monitor BP changes and send the information to the brain o The brain then activates the Autonomic NS to restore blood pressure to normal o When BP falls, this reflex causes vasoconstriction and increases cardiac output. o When BP rises, it causes vasodilation and reduces cardiac output  Where is acetylcholine employed? o Most junctions at the peripheral nervous system  Where is epinephrine and norepinephrine released? o Norepinephrine—postganglionic neurons o Epinephrine—adrenal medulla  What are the cholinergic receptors mediated by? What are the subtypes? o Receptors that mediate responses to acetylcholine o Subtypes:  Nicotinic  Muscarinic  Whare are adrenergic receptors mediated by? What are the subtypes? o Mediate responses to epinephrine and norepinephrine o Subtypes:  Alphas  Betas  Dopamine  What are the functions of each adrenergic subtype? o Alpha 1—vasoconstriction, ejaculation and contraction of the bladder neck, and prostate o Alpha 2—(located in presynaptic junction)—minimal clinical significance o Beta 1—control the heart  Increase HR, increase force of contraction and velocity of conduction in the AV node; stimulate renin released in the kidney o Beta 2—bronchial dilation, relaxation of the uterine muscle, vasodilation, glycogenolysis o Dopamine—dilates renal blood vessels  Epinephrine can activate all alpha and beta receptors but not dopamine receptors  Norepinephrine can activate alpha1, alpha2, and beta receptors but not beta2 or dopamine receptors  Dopamine can activate alpha1, beta1 and dopamine receptors  Muscarinic agonists mimic the effects of acetylcholine at muscarinic receptors  Muscarinic antagonists selectively blood the effects of acetylcholine (and other muscarinic agonists) at muscarinic receptors  What are therapeutic uses of Bethanechol? o Urinary retention o Investigational GI uses—off label GI reflux  What are actions on smooth muscle, exocrine glands, and eye? o Smooth muscle— 2  lung by causing constriction of the bronchi  the GI system by increasing tone and motility  the bladder by contraction of the detrusor muscle  relaxation of the trigone and sphincter o Exocrine glands—increased sweating salivation, bronchial secretions and secretion of gastric acid o Eye—causes miosis and contraction of the ciliary muscle  Adverse Effects? o Hypotension o Abdominal cramps o Diarrhea o Increased salivation o Exacerbate asthma o Can cause dysrhythmias in patients with hyperthyroidism  What are cevimeline, pilocarpine, and acetylcholine used for? o Cevimeline—treat dry mouth and Sjogren’s syndrome o Pilocarpine—topical treatment of glaucoma as well as dry mouth from Sjogren’s syndrome o Acetylcholine—rapid myosis after delivery and cataract surgery  Anticholinergics o Competitively block the actions of acetylcholine as muscarinic receptors o Most muscarinic receptors are on structures innervated by parasympathetic nerves o Also known as parasympatholytic drugs, antimuscarinic drugs, muscarinic blockers, and anticholinergic drugs o Anticholinergic drugs: produce selective blockade of the muscarinic receptors (not all cholinergic receptors) o Can’t pee, see, spit or shit  What are the pharmacologic effects of atropine? o The heart—increases in rate o The exocrine glands—decrease secretions o Smooth muscle—relaxes the bronchi, decreases the tone of the urinary bladder detrusor and decreases the tone motility of the GI tract o Mydriasis and cycloplegia in the eyes o Mild excitation to hallucinations and delirium in the Central Nervous system  Therapeutic Uses of Atropine? o Pre-anesthetic medication to help dry up secretions o Disorders of the eye o In codes for bradycardia, intestinal hypertonicity and hypermotility o Muscarinic agonist poisoning o Peptic ulcer disease o Asthma o Biliary colic  Side effects of Atropine 3 o Dry mouth o Blurred vision o Photophobia o Elevation of interocular pressure o Urinary retention o Constipation anhidrosis o Tachycardia o Asthma [Show More]

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