CRNA Pharm Sympathomimetic Short Review

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Sympathomimetic stimulants are drugs, which mimic the effects of endogenous agonists of the nervous system. The CRNA Pharm Sympathomimetic Short Review quiz below is set to gauge your understanding on this and more. All the best.


Questions and Answers
  • 1. 

    Which of the following are NOT naturally occurring catecholamines?

    • A.

      Epinephrine

    • B.

      Norepinephrine

    • C.

      Dopamine

    • D.

      Isoproterenol

    • E.

      Dobutamine

    Correct Answer(s)
    D. Isoproterenol
    E. Dobutamine
    Explanation
    Isoproterenol and dobutamine are synthetic catecholamines

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  • 2. 

    The activation of beta-2 receptors causes glycogenolysis, lipolysis, gluconeogenesis and ______ secretion from the pancreas.

    Correct Answer(s)
    insulin
    Explanation
    Activation of beta-2 receptors stimulates the release of insulin from the pancreas. Insulin is a hormone that plays a crucial role in regulating blood sugar levels. It promotes the uptake of glucose by cells, inhibits glycogenolysis (breakdown of glycogen into glucose), and enhances the storage of glucose as glycogen in the liver and muscles. Therefore, the activation of beta-2 receptors leads to an increase in insulin secretion, which helps to lower blood sugar levels and maintain glucose homeostasis in the body.

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  • 3. 

    Regarding increased acetylcholine, the muscarinic effect on the heart is bradycardia, on the pulmonary system is bronchospasm and increased secretions, and can also cause diffuse EEG activity neurologically.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Bradycardia can progress to sinus arrest.

    When reversing nondepolarizers---- goal is to maximize nicotinic transmission and minimize muscarinic side effects

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  • 4. 

    Which of the following is decreased during a fight or flight reaction?

    • A.

      Plasma glucose levels

    • B.

      Cardiovascular function

    • C.

      Metabolic function

    • D.

      Gastrointestinal and genitourinary function

    Correct Answer
    D. Gastrointestinal and genitourinary function
    Explanation
    All others are increased.

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  • 5. 

    The indirect affects of dopamine are due to the release of __________.

    Correct Answer
    Norepinephrine
    Explanation
    The indirect effects of dopamine are caused by the release of norepinephrine. Norepinephrine is a neurotransmitter that is released in response to dopamine. It plays a role in various physiological processes such as regulating blood pressure, heart rate, and mood. The release of norepinephrine can have an impact on the body and brain, leading to changes in arousal, attention, and overall functioning. Therefore, the release of norepinephrine is responsible for the indirect effects of dopamine.

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  • 6. 

    Beta1 stimulation via epinephrine increases cardiac output, contractility, and heart rate; it therefore _________ myocardial oxygen demand

    Correct Answer
    increases
    Explanation
    Stimulation of Beta1 receptors by epinephrine leads to an increase in cardiac output, contractility, and heart rate. These effects result in an increased demand for oxygen by the myocardium, as the heart needs more oxygen to meet the increased workload. Therefore, the correct answer is "increases."

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  • 7. 

    According to Greg's ppt, the continuous infusion dose of epinephrine is 2-20 mcg/min.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    According to N/P
    Beta stimulation @ 0.01-0.03 mcg/kg/min
    Beta/A1 @ 0.03-0.15 mcg/kg/min
    A1 @ 0.15-0.3 mcg/kg/min

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  • 8. 

    When using epinephrine, the B2 stimulation causes vasodilation of skeletal muscle and causes _________ diastolic blood pressure.

    Correct Answer
    decreased
    Explanation
    Epinephrine is a hormone that stimulates B2 receptors, leading to vasodilation of skeletal muscles. Vasodilation refers to the widening of blood vessels, which results in decreased resistance to blood flow. As a result, the diastolic blood pressure, which is the pressure in the arteries when the heart is at rest, is decreased. Therefore, when using epinephrine, the B2 stimulation causes a decrease in diastolic blood pressure.

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  • 9. 

    Ephedrine is a catecholamine.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Ephedrine is not a catecholamine. It is a sympathomimetic amine that acts as a decongestant and bronchodilator. Catecholamines, on the other hand, are a class of neurotransmitters that include dopamine, norepinephrine, and epinephrine.

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  • 10. 

    What is the preferred vasopressor for obstetric cases?

    • A.

      Ephedrine

    • B.

      Epinephrine

    • C.

      Norepinephrine

    • D.

      Phenylephrine

    Correct Answer
    A. Ephedrine
    Explanation
    Does not decrease uterine blood flow.

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  • 11. 

    Dosing for ephedrine is 2.5-10 mg for adults and 0.1 mg/kg for children.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    According to ppt, don't know what N/P says

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  • 12. 

    With patients on monoamine oxidase inhibitors, they should not receive ________ as norepinephrine is in abundance in the nerve cleft and administration can cause a hypertensive crisis

    Correct Answer
    ephedrine
    Explanation
    Patients on monoamine oxidase inhibitors should not receive ephedrine because it can cause a hypertensive crisis. This is because ephedrine increases the levels of norepinephrine in the nerve cleft, and since norepinephrine is already in abundance in patients on monoamine oxidase inhibitors, administering ephedrine can lead to a dangerous increase in blood pressure.

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  • 13. 

    Phenylephrine is associated with tachyphylaxis and reflex bradycardia.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Phenylephrine also causes a significant decrease in renal blood flow.

    Dose:
    IV bolus of 50-100 mcg (0.5-1 mcg/kg)
    Continuous: 0.25-1 mcg/kg/min

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  • 14. 

    All of the following describe phosphodiasterase inhibitors except:

    • A.

      Positive inotrope

    • B.

      Vasoconstrictor

    • C.

      Increase cAMP by preventing breakdown

    • D.

      Decrease SVR

    Correct Answer
    B. Vasoconstrictor
    Explanation
    Phosphodiesterase inhibitors have vasodilatory properties.

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  • 15. 

    Ephedrine is commonly given as a continuous infusion.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Incremental doses

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  • 16. 

    Ephedrine's direct action occurs by stimulating adrenergic receptors similar to epinephrine, indirect actions may be due to central stimulation, peripheral postsynaptic norepinephrine release, or inhibition of norepinephrine reuptake

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Ephedrine's direct action occurs by stimulating adrenergic receptors similar to epinephrine. This means that ephedrine activates specific receptors in the body that are typically activated by epinephrine, a hormone involved in the "fight or flight" response. Indirect actions of ephedrine may be due to central stimulation, peripheral postsynaptic norepinephrine release, or inhibition of norepinephrine reuptake. In other words, ephedrine can also affect the release and reuptake of norepinephrine, another hormone involved in regulating various bodily functions.

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  • 17. 

    Albuterol is commonly used for treatment of ________.

    Correct Answer
    asthma
    Explanation
    Albuterol is commonly used for the treatment of asthma. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms such as wheezing, shortness of breath, and coughing. Albuterol is a bronchodilator medication that works by relaxing the muscles in the airways, allowing for easier breathing. It is often prescribed as a quick-relief medication to provide immediate relief during asthma attacks or as a preventive measure before physical activities that may trigger symptoms.

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  • 18. 

    _______ is to beta-blockade overdose as narcan is to opioid overdose.  The likely mechanism of action is the increase of cAMP in the myocardium, in effect bypassing the beta-adrenergic second messenger system.

    Correct Answer
    Glucagon
    Explanation
    According to wikipedia ;)

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  • 19. 

    Remember when I talked in broad generalities about cAMP and cGMP and in general which one might be considered an up regulator and which one might be considered a down regulator. cAMP = up-regulator, cGMP down-regulator?This is my best guess.  cAMP generally increases contractility and cGMP causes smooth muscle relaxation/vasodilation.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that cAMP is generally considered an up-regulator because it increases contractility, while cGMP is considered a down-regulator because it causes smooth muscle relaxation and vasodilation. Therefore, the statement that cAMP is an up-regulator and cGMP is a down-regulator is true.

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