Autonomic Nervous System Drugs

Topics in this chapter

• Autonomic Receptors and Pathways
• Cholinergic Agonists and Anticholinesterases
• Anticholinergic Clinical Applications
• Organophosphate Toxicity and Antidotes
• Adrenergic Agonists and Sympathomimetics
• Adrenergic Antagonists and Alpha-Blockers

Practice questions

1. Question 1Q-3EADFF

   A 35-year-old male with a history of recurrent nephrolithiasis and hypertension is prescribed a medication that decreases intraocular pressure and is also useful in preventing calcium oxalate stones by increasing urinary citrate excretion. Which of the following drugs is most likely responsible?

   1. A.Dorzolamide
   2. B.Pilocarpine
   3. C.Timolol
   4. D.Acetazolamide
   See the answer and solution
2. Question 2Q-F84F3C

   A 45-year-old man undergoes surgery and receives a competitive neuromuscular blocker. At the end of the procedure, the anesthesiologist wishes to reverse the blockade and administers neostigmine along with atropine. What is the primary reason for co-administering atropine?

   1. A.To prevent neostigmine-induced skeletal muscle fasciculations
   2. B.To prevent excessive muscarinic stimulation such as bradycardia and hypersalivation
   3. C.To enhance the neuromuscular blocking reversal effect at the motor endplate
   4. D.To prevent central nervous system depression caused by neostigmine
   See the answer and solution
3. Question 3Q-B6B4C1

   A patient with Parkinson disease is initiated on a selective MAO-B inhibitor. Which of the following drugs belongs to this class and is known to be metabolized to amphetamine and methamphetamine derivatives?

   1. A.Rasagiline
   2. B.Selegiline
   3. C.Entacapone
   4. D.Safinamide
   See the answer and solution
4. Question 4Q-C1FA0F

   A 60-year-old man is brought to the emergency department with acute onset of severe eye pain, blurred vision, and seeing halos around lights. Examination reveals a fixed, mid-dilated pupil and a stony-hard eye. Which of the following classes of drugs is strictly contraindicated in this patient due to the risk of worsening the condition?

   1. A.Direct-acting cholinergic agonists
   2. B.Carbonic anhydrase inhibitors
   3. C.Mydriatic and cycloplegic agents
   4. D.Beta-adrenergic blockers
   See the answer and solution
5. Question 5Q-47A003

   A 28-year-old pregnant female at 34 weeks of gestation presents with preterm labor contractions. To delay delivery and allow for corticosteroid administration, she is given an intravenous drug that acts as a beta-2 adrenergic receptor agonist. Which of the following adverse effects is most commonly observed with this medication?

   1. A.Hypokalemia and hyperglycemia
   2. B.Hyperkalemia and hypoglycemia
   3. C.Bradycardia and hypothermia
   4. D.Miosis and skeletal muscle relaxation
   See the answer and solution