Medical Pharmacology: Autonomic Pharmacology Practice

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Preload and Contractility

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As blood volume returning one
to the heart
increases, preload increases
and there is enhanced
filling with ventricular 1. Most likely to reduce
dilation. blood pressure by
According to Starling's Law, directly decreasing
heart rate:
increased
ventricular stretch usually A. ?
leads to increased phentolamine
contractility. Increased (Regitine)
preload and B. :-) propranolol
increased contractility lead (Inderal)
to increased stroke volume
and ultimately an increase in C. ?
nitroprusside
arterial pressure, all
sodium (Nipride)
other factors remaining
equal. D. ?
Some antihypertensive phenylephrine
(Neo-
drugs decrease
Synephrine)
preload.
Heart rate: Since the product
of heart rate and
stroke volume equals
2. From the point of
cardiac output, an increase view of Starling's law
in heart which
rate will increase arterial antihypertensive
would be most likely
blood pressure, all other to reduce contractility.
factors remaining equal.
Some antihypertensive A. ?
agents decrease heart rate methoxamine
(Vasoxyl)
(ß-adrenergic receptor
antagonists, e.g.). B. :-)
For a given cardiac output, nitroprusside
blood pressure sodium (Nipride)
depends only on peripheral C. ?
resistance. Some propranolol
antihypertensive drugs act to (Inderal)
reduce peripheral
D. ?
resistance.
metoprolol
(Lopressor)

3. Negative inotropism

A. ?
isoproterenol
(Isuprel)

B. ?
epinephrine
 C. :-) diltiazem
(Cardiazem)

D. ?
norepinephrine

4. Increases pulmonary
congestion in
congestive heart
failure (CHF)

A. X dopamine
(Intropin)

B. :-) metoprolol
(Lopressor)

C. ?
nitroprusside
sodium (Nipride)

D. ? digoxin
(Lanoxin,
Lanoxicaps)

5. Major
neurotransmitter
released at end organ
effectors of the
 thoracolumbar
division of the
autonomic nervous
system:

A. ? dopamine
(Intropin)

B. X epinephrine

C. :-)
norepinephrine

D. X
acetylcholine

6. Neurotransmitter of
preganglionic fibers:

A. ?
norepinephrine

B. ? substance
P

C. ?
epinephrine
 D. :-)
acetylcholine

7. "Fight or flight"
activation of the ANS:

A. ? pupillary
constriction

B. :-) blood flow

shifted from
cutaneous beds
to skeletal
muscle

C. ? blood
glucose falls

D. ?
bronchiolar
constriction

8. Methoxamine
(Vasoxyl)-induced
bradycardia would be
prevented by:

A. ?
phentolamine
 (Regitine)

B. ?
mecamylamine
(Inversine)

C. ? atropine

D. :-) all of the

above

9. Dopamine beta
hydroxylase catalyzes:

A. ? tyrosine to
DOPA

B. ? DOPA to
dopamine

C. :-) dopamine to
norepinephrine

D. ?
norepinephrine
to epinephrine

10. Primary mechaism for

termination of
 norepinephrine and
epinephrine action:

A. ? metabolic
transformation
catalyzed by
MAO

B. ? metabolic
transformation
catalyzed by
COMT

C. ? diffusion
away from the
synaptic cleft and
uptake at
extraneuronal
sites

D. :-) reuptake
into nerve
terminals

11. Most potent at beta

adrenergic receptors

A. X epinephrine

B. ?
isoproterenol
 (Isuprel)

C. X
norepinephrine

D. X dopamine

12. Interferes with

norepinephrine
release:

A. ? alpha-
methyltyrosine
by preventing
synthesis of a
protein that
promotes fusion
of the vesicle and
the presynaptic
membrane

B. :-) bretylium
(Bretylol)
following a
transient
stimulation of
release by
displacement
 C. ? reserpine

13. alpha-2 receptor

agonist; peripheral
sympathomimetic

A. ?
yohimbine
(Yocon)

B. X dobutamine
(Dobutrex)

C. :-) clonidine
(Catapres)

D. X
phenylephrine

14. Primary
antihypertensive
effect due to nitric
oxide mediation of
smooth muscle
relaxation.

A. ? atropine
 B. :-)
nitroprusside
sodium (Nipride)

C. ?
mecamylamine
(Inversine)

D. ? captopril
(Capoten)

15. Inhibits
neurotransmitter
enzymic degradation:

A. ?
tubocurarine

B. X
phenoxybenzamine
(Dibenzyline)

C. :-)
physostigmine
(Antilirium)

D. X bretylium
(Bretylol)
16. Cardiac effects not
like to be directly
affected by the
presence of an
anticholinesterase:

A. ?
acetylcholine

B. X
methacholine
(Provocholine)

C. X vagal
stimulation

D. :-)
carbamylcholine
(carbachol)

17. Pilocarpine (Pilocar):

A. X dry mouth

B. X pupillary
dilation

C. ? increased
gastrointestinal
tone
 D. X bronchiolar
relaxation

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