A student ask the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?

They increase norepinephrine at the neuromuscular junction

They act to block the effects of the parasympathetic nervous system

They compete with serotonin for muscarinic acetylcholine receptor sites

They block nicotinic receptors

Answer and Explanation

The Correct Answer is B

A) They increase norepinephrine at the neuromuscular junction: Anticholinergic agents do not directly increase norepinephrine at the neuromuscular junction. Instead, they work by blocking acetylcholine receptors (specifically muscarinic receptors) in the parasympathetic nervous system, which reduces parasympathetic activity. Norepinephrine is primarily involved in the sympathetic nervous system, not the action of anticholinergics.

B) They act to block the effects of the parasympathetic nervous system: This is the correct explanation. Anticholinergic agents work by inhibiting the action of acetylcholine at muscarinic receptors, which are part of the parasympathetic nervous system. By blocking these receptors, anticholinergics reduce parasympathetic effects such as slowing of the heart rate, increased glandular secretions, and smooth muscle contraction, leading to effects like increased heart rate, dry mouth, and bronchodilation.

C) They compete with serotonin for muscarinic acetylcholine receptor sites: Anticholinergic drugs do not interact with serotonin receptors. They specifically target muscarinic acetylcholine receptors, which are involved in parasympathetic responses. Serotonin is a different neurotransmitter, and while some drugs may affect both serotonin and acetylcholine pathways, anticholinergic agents do not compete with serotonin at these receptor sites.

D) They block nicotinic receptors: Anticholinergics typically block muscarinic receptors, not nicotinic receptors. Nicotinic receptors are involved in the transmission of signals at the neuromuscular junction and in the autonomic ganglia, while muscarinic receptors are primarily involved in parasympathetic functions. Blocking nicotinic receptors would have different effects and is not the action of anticholinergic agents.

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Correct Answer is A

Explanation

A) Increased intraocular pressure: Sympathomimetic drugs stimulate the sympathetic nervous system and promote "fight or flight" responses, often resulting in vasoconstriction and other effects. Some sympathomimetics, especially those that affect alpha-adrenergic receptors, can lead to increased intraocular pressure, which is a concern in conditions like glaucoma.

B) Decreased blood pressure: Sympathomimetic drugs generally increase blood pressure by stimulating alpha and beta receptors that cause vasoconstriction and increased heart rate. In contrast, drugs that would decrease blood pressure are usually parasympathomimetics or other agents designed to block sympathetic responses.

C) Decreased heart rate: Sympathomimetic drugs typically increase heart rate by stimulating beta-1 adrenergic receptors in the heart. These drugs are used in situations requiring increased cardiac output or to counteract bradycardia. Decreased heart rate would typically occur with parasympathomimetic drugs or medications that block sympathetic activity (e.g., beta blockers).

D) Increased respiration: Sympathomimetic drugs can increase respiratory rate by promoting bronchodilation through beta-2 adrenergic receptor activation in the lungs. However, "increased respiration" as a general effect is not as specific or consistent as the other cardiovascular and ocular effects of these drugs. The primary and most prominent physiological change would be related to the cardiovascular effects.

A. A patient with hypotension B. A patient with a concussion C. A patient 3 days after surgery D. A patient with cancer

Correct Answer is D

Explanation

A) A patient with hypotension:
Patients with hypotension may have reduced blood flow to organs, which could potentially decrease the absorption and effectiveness of many medications, including opioids. As a result, the need for a higher dose is not typical. Instead, careful dosing and monitoring are required to avoid further lowering blood pressure, which could lead to more complications.

B) A patient with a concussion:
Concussions affect the brain and can lead to symptoms like dizziness, confusion, or nausea, which may alter how medications are metabolized or tolerated. However, a concussion does not typically require higher opioid doses. In fact, opioids should be used cautiously in such patients due to the risk of exacerbating neurological symptoms or respiratory depression.

C) A patient 3 days after surgery:
Patients recovering from surgery may require pain management, but the opioid dose typically adjusts based on their pain levels and recovery stage. While some patients may still need opioids for pain control, they may not require higher-than-expected doses. Over time, doses are often tapered as healing progresses, and pain lessens.

D) A patient with cancer:
Cancer patients, particularly those with advanced stages or chronic pain, may develop increased opioid tolerance. This means that over time, they may require higher doses to achieve the same level of pain relief. This phenomenon is known as "opioid tolerance," where the body becomes less responsive to the drug, necessitating dose adjustments.

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A student ask the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?

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Naxlex Comprehensive Predictor Exams

What action do sympathomimetic drugs have in the body?

Correct Answer is A

Explanation

Which patient may require a higher-than-expected dose of an opioid analgesic?

Correct Answer is D

Explanation

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