Katzung pharmacology chap8 questions

1. Probable signs of atropine overdose include which one of the following?
(A) Gastrointestinal smooth muscle cramping (B) Increased heart rate (C) Increased gastric secretion (D) Pupillary constriction (E) Urinary frequency

Tachycardia is a characteristic atropine overdose effect. Bradycardia is sometimes observed after small doses.

2. Which of the following is the most dangerous effect of belladonna alkaloids"anticholenergic family of plant toxins" in infants and toddlers?
(A) Dehydration (B) Hallucinations (C) Hypertension (D) Hyperthermia (E) Intraventricular heart block

Choices B, D, and E are all possible effects of the atropine group.In infants, however, the most dangerous effect is
hyperthermia
.Deaths with body temperatures in excess of 42�C have occurred after the use of atropine-containing eye drops in children.

3. Which one of the following can be blocked by atropine?
(A) Decreased blood pressure caused by hexamethonium (B) Increased blood pressure caused by nicotine (C) Increased skeletal muscle strength caused by neostigmine (D) Tachycardia caused by exercise

Atropine blocks muscarinic receptors and inhibits parasympathomimetic effects
. Nicotine can induce both parasympathomimetic and sympathomimetic effects by virtue of its ganglion-stimulating action. Hypertension and exercise induced tachycardia reflect sy

4. Drug X caused a 50 mm Hg rise in mean blood pressure in the control animal, no blood pressure change in the ganglionblocked animal, and a 75 mm mean blood pressure rise in the atropine-pretreated animal. Drug X is probably a drug similar to
(A) Acetylc

Drug X causes an increase in blood pressure that is blocked by a ganglion blocker but not by a muscarinic blocker. The pressor response is actually increased by pretreatment with atropine, a muscarinic blocker, suggesting that compensatory vagal discharge

6. Which of the following signs would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker?
(A) Blurred vision (B) Dry mouth, constipation (C) Mydriasis (D) Postural hypotension (E) Tachycardia

Both ganglion blockers and muscarinic blockers can cause mydriasis, increase resting heart rate, blur vision, and cause dry mouth and constipation, because these are determined largely by parasympathetic tone.
Postural hypotension
, on the other hand, is

7. Accepted therapeutic indications for the use of antimuscarinic drugs include all of the following except:
(A) Atrial fibrillation (B) Motion sickness (C) Parkinson's disease (D) Postoperative bladder spasm (E) To antidote parathion poisoning

Atrial fibrillation
and other arrhythmias are not responsive to antimuscarinic agents.

8. Which of the following is an expected effect of a therapeutic dose of an antimuscarinic drug?
(A) Decreased cAMP (cyclic adenosine monophosphate) in cardiac muscle (B) Decreased DAG (diacylglycerol) in salivary gland tissue (C) Increased IP3 (inositol

Muscarinic M1 and M3 receptors mediate increases in IP3 and DAG in target tissues (intestine, salivary glands). M2 receptors (heart) mediate a decrease in cAMP and an increase in potassium permeability. Antimuscarinic agents block these effects.
Answer is

9. Which one of the following drugs causes vasodilation that can be blocked by atropine?
(A) Benztropine (B) Bethanechol (C) Botulinum (D) Cyclopentolate (E) Edrophonium (F) Neostigmine (G) Pralidoxime

Bethanechol
causes vasodilation by activating muscarinic receptors on the endothelium of blood vessels. This effect can be blocked by atropine.

10. Which one of the following drugs has a very high affinity for the phosphorus atom in parathion and is often used to treat life-threatening insecticide toxicity?
(A) Atropine (B) Benztropine (C) Bethanechol (D) Botulinum (E) Cyclopentolate (F) Neostigm

Pralidoxime
has a very high affinity for the phosphorus atom in organophosphate insecticides.