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Pharmacology Exam 2 pt 2

Total questions: 104

Worksheet time: 1hrs 8mins

Name
Class
Date
1.

What are the three endogenous monoamine neurotransmitters?

a)

dopamine

b)

norepinephrine

c)

epinephrine

d)

acetylcholine

2.

What is the only neurotransmitter that is synthesized in synaptic vesicles instead of being transported into the vesicle after its synthesis?

a)

epinephrine

b)

norepinephrine

c)

dopamine

3.

Put the steps of monoamine neurotransmitter synthesis in order:

1. dopamine converted to NE

2. tyrosine to dopa by tyrosine hydroxylase (TH)

3. influx of Ca2+ into the nerve terminal trigger the release of MAs

4. dopa to dopamine by dopadecrobxylase

5. dopamine transported from the cytoplasm into vesicles by a vesicular monoamine transporter (VMAT)

6. action termination by reuptake, diffusion, degradation, feedback mechanism

7. action potential arrives at terminal and activates voltage-gated Ca++ channels

a)

2, 4, 5, 1, 7, 3, 6

b)

1, 4, 5, 6, 7, 3, 2

c)

6, 7, 3, 2, 4, 5, 1

4.

What blocks monoamine neurotransmitters via synthesis inhibition?

a)

metyrosine

b)

reserpine

c)

bretylium guanethidine

d)

cocaine and TCAs

5.

What blocks monoamine neurotransmitters via storage inhibition?

a)

metyrosine

b)

reserpine

c)

bretylium guanethidine

d)

cocaine and TCAs

6.

What blocks monoamine neurotransmitters via release inhibition?

a)

metyrosine

b)

reserpine

c)

bretylium guanethidine

d)

cocaine and TCAs

7.

What blocks monoamine neurotransmitters via reuptake inhibitors?

a)

metyrosine

b)

reserpine

c)

bretylium guanethidine

d)

cocaine and TCAs

8.

How are monoamine neurotransmitters released from vesicles?

a)

direct: calcium dependent pathway

b)

indirect: calcium independent pathway

c)

direct: calcium independent pathway

d)

indirect: calcium dependent pathway

9.

What is the MOA of the indirect calcium independent pathway of monamine neurotransmitters being released from vesicles?

a)

displacing NE

b)

displacing epinephrine

c)

displacing dopamine

10.

Most monamine NTs do not bind to adrenergic receptor and some are weak agonists.

a)

true

b)

false

11.

Is the following mechanism of signal termination primary or secondary: reuptake into the presynaptic neurons via NE transporter (NET) or simple diffusion away from the cleft to the circulation then metabolized

a)

primary

b)

secondary

12.

Is the following mechanism of signal termination primary or secondary: catabolism via monoamine oxidase which is highly active in mitochondria in the nerve terminal or methylation via catechol-O-methyltransferase (COMT)

a)

primary

b)

secondary

13.

Which drugs are inhibited by COMT?

a)

entacapone

b)

tolcapone

c)

nitacapone

d)

selegilline

e)

moclobemide

14.

Which drugs are inhibited by MAO?

a)

selegilline

b)

moclobemide

c)

entacapone

d)

tolcapone

e)

nitacapone

15.

Choose the characteristics of alpha 1 adrenoceptors (excitatory):

a)

coupled via Gq proteins to activate PLC

b)

leading to the formation of IP3 and DAG

c)

mobilizes intracellular Ca2+ stores and activates PKC

d)

activate Gi inhibitory proteins to inhibit adenylyl cyclase and decrease cAMP

e)

regulate other ion channels activities

16.

Choose the characteristics of Alph a2 adrenoceptors (inhibitory):

a)

coupled via Gq proteins to activate PLC

b)

leading to the formation of IP3 and DAG

c)

mobilizes intracellular Ca2+ stores and activates PKC

d)

activate Gi inhibitory proteins to inhibit adenylyl cyclase and decrease cAMP

e)

regulate other ion channels activities

17.

alpha 1 receptors (1A, 1B, 1D)

a)

increase IP3 and DAG

b)

widely expressed in vascular beds

c)

Gq protein/ PLC pathway

d)

arterial and venous vasoconstriction

e)

cardiac function is of relatively less importance

18.

alpha 2 receptors (2A, 2B, 2C)

a)

lower cAMP

b)

present in the vasculature: local activation leads to vasoconstriction

c)

CNS centrally: inhibition of sympathetic tone and reduced blood pressure

d)

can be used to treat HTN

e)

increases BP

19.

beta 1 agonists:

a)

increase BP

b)

increase heart rate and contractility

c)

cause vasodilation

d)

lipolysis

20.

beta 2 agonists:

a)

lower peripheral resistance

b)

increase bronchodilation

c)

increase BP

d)

increase heart rate

21.

beta 3 receptor:

a)

lipolysis

b)

mirabegron (induce detrusor muscle relaxation in bladder- overactive bladder)

c)

increase BP

d)

lower heart rate

22.

Where are beta 1 receptors found?

a)

heart

b)

juxtaglomerular cells

c)

respiratory smooth muscle

d)

human liver

e)

fat cells

23.

Where are beta 2 receptors found?

a)

respiratory, uterine, and vascular smooth muscle

b)

juxtaglomerular cells

c)

skeletal muscle

d)

human liver

e)

fat cells

24.

Where are beta 3 receptors found?

a)

fat cells

b)

heart

c)

skeletal muscle

d)

human liver

25.

What do beta 1 receptors in the heart and juxtaglomerular cells do?

a)

increase force and rate of contraction

b)

increase renin release

c)

promote smooth muscle relaxation

d)

promote potassium uptake

e)

activates glycogenolysis

26.

What do beta 2 receptors in the respiratory, uterine, and vascular smooth muscle do?

a)

promote smooth muscle relaxation

b)

promote potassium uptake

c)

activates glycogenolysis

d)

activates lipolysis

27.

What do beta 2 receptors in the skeletal muscle do?

a)

promote potassium uptake

b)

activates glycogenolysis

c)

activates lipolysis

d)

promotes smooth muscle relaxation

28.

What do beta 2 receptors in the human liver do?

a)

activates glycogenolysis

b)

activates lipolysis

c)

promotes smooth muscle relaxation

d)

increases force and rate of contraction; increases renin release

29.

What do beta 3 receptors in the fat cells do?

a)

activates lipolysis

b)

activates glycogenolysis

c)

promote smooth muscle relaxation

d)

promotes potassium uptake

30.

Norepinephrine

a)

agonist at a1, a2, b1 receptors

b)

positive inotropic

c)

the baroreflex activation compensate for the chrontropic effect

d)

activates both alpha and beta receptors

31.

Epinephrine

a)

activate both alpha and beta receptors

b)

agonist at both a1, a2, b1 receptors

32.

Where are D1 receptors?

a)

smooth muscle

b)

nerve endings

33.

What do D1 receptors do?

a)

dilates renal blood vessels

b)

modulates transmitter release

34.

Where are D2 receptors?

a)

nerve endings

b)

smooth muscle

35.

What do D2 receptors do?

a)

dilate renal blood vessels

b)

modulates transmitter release

36.

Choose the alpha agonists with a higher affinity for alpha 1

a)

phenylephrine

b)

methoxamine

c)

clonidine

d)

methylnorepinephrine

37.

Choose the alpha agonists with a higher affinity for alpha 2

a)

phenylephrine

b)

methoxamine

c)

clonidine

d)

methylnorepinephrine

38.

Choose the mixed alpha and beta agonists that are equal affinity in alpha receptors but beta 1 is greater than beta 2

a)

norepinephrine

b)

epinephrine

39.

Choose the mixed alpha and beta agonists that are equal affinity in alpha AND beta receptors

a)

norepinephrine

b)

epinephrine

40.

Choose the beta agonist with greater affinity for beta 1

a)

dobutamine

b)

isoproterenol

c)

albuterol

d)

dopamine

41.

Choose the beta agonist with equal affinity in the beta receptors

a)

dobutamine

b)

isoproterenol

c)

albuterol

d)

dopamine

42.

Choose the beta agonists with greater affinity for beta 2 receptors

a)

albuterol

b)

terbutaline

c)

metaproterenol

d)

ritodrine

e)

dopamine

43.

Choose the dopamine agonist with equal affinity between D receptors, and greater beta affinity than alpha

a)

dopamine

b)

fenoldopam

44.

Choose the dopamine agonist with greater D1 affinity than D2

a)

dopamine

b)

fenoldopam

45.

Direct-Acting Sympathomimetics: Phenylephrine

a)

almost pure alpha 1 agonist

b)

not a catechol derivative- resistant to inactivation by COMT, longer duration of action than catecholamines

c)

can be used as: mydriatic (pupil dilator), decongestant, BP increase

d)

treats orthostatic hypotension

e)

pro-drug

46.

Direct-Acting Sympathomimetics: Midodrine (oral)

a)

pro-drug

b)

selective alpha 1 receptor agonist

c)

treats orthostatic hypotension

d)

almost pure alpha 1 agonist

e)

not a catechol derivative

47.

Choose the alpha 2 selective agonists (centrally acting)

a)

clonidine

b)

methyldopa (preferred in pregnancy)

c)

guanfacine

d)

guanabenz

e)

midodrine

48.

How do alpha 2-selective agonists (centrally acting) work?

a)

stimulates alpha 2 adrenoceptors in the brain stem activating inhibitory neuron which result in reduced sympathetic outflow from the CNS

b)

topical decongestant

49.

Dobutamine (beta 1 selective agents)

a)

positive inotropic

b)

positive chronotopic

c)

negative inotropic

d)

negative chronotropic

50.

Choose the short acting beta 2 selective drugs (direct-acting sympathomimetics):

a)

albuterol (salbutamol)

b)

terbutaline

c)

metaproterenol

d)

indacterol

e)

salmeterol

51.

Choose the long acting beta 2 selective drugs (direct-acting sympathomimetics):

a)

formoterol

b)

salmeterol

c)

terbutaline

d)

indacterol

52.

Choose the ultralong acting beta 2 selective drugs:

a)

indacterol

b)

olodaterol

c)

vilanterol

d)

formoterol

e)

salmeterol

53.

How are indirect-acting sympathomimetics amphetamine-like?

a)

they enter the sympathetic nerve ending and displace stored catecholamine

b)

stimulant effect

54.

Which drugs are amphetamine-like indirect-acting sympathomimetics?

a)

amphetamine

b)

methamphetamine

c)

methylphenidate

d)

modafanil

e)

tyramine

55.

Which of the following drugs are catecholamine reuptake inhibitors used for ADD?

a)

atomoxetine

b)

reboxetine

c)

sibutramine

d)

duloxetine

e)

venlafaxine

56.

Which of the following drugs is a catecholamine reuptake inhibitor and used to be used as an appetite suppressant?

a)

sibutramine

b)

duloxetine

c)

venlafaxine

d)

desvenlafaxine

57.

Which of the following drugs are catecholamine reuptake inhibitors and SNRIscused for depression and treatment of pain in fibromyalgia?

a)

duloxetine

b)

venlafaxine

c)

desvenlafaxine

d)

atomoxetine

e)

sibutramine

58.

Which of the following drugs is a catecholamine reuptake inhibitors can be used as a local anesthetic and inhibits transmitter reuptake at noradrenergic synapses?

a)

cocaine

b)

levodopa

c)

fenoldopam

59.

Which of the following dopamine agonists (catecholamine reuptake inhibitors) is converted to dopamine in the body and used in the treatment of Parkinson's disease and prolactinemia?

a)

levodopa

b)

fenoldopam

60.

Which of the following dopamine agonists (catecholamine reuptake inhibitors) is a D1-receptor agonist that selectively leads to peripheral vasodilation in some vascular beds and is used as an IV treatment of severe HTN?

a)

levodopa

b)

fenoldopam

61.

Which sympathomimetic drugs are used to treat acute hypotension and shock?

a)

norepinephrine

b)

dopamine

c)

midodrine

d)

dobutamine

62.

Which sympathomimetic drug treats chronic orthostatic hypotension?

a)

midodrine

b)

epinephrine

c)

dobutamine

d)

phenylephrine

63.

Which sympathomimetic drug treats cardiac arrest?

a)

epinephrine

b)

dobutamine

c)

phenylephrine

d)

brimonidine

64.

Which sympathomimetic drug is used in cardiac stress tests?

a)

dobutamine

b)

epinephrine

c)

apraclonidine

d)

brimonidine

65.

Which sympathomimetic drugs are used to treat glaucoma?

a)

apraclonidine

b)

brimonidine

c)

phenylephrine

d)

midodrine

66.

What are some examples of reversible alpha receptor antagonists?

a)

phentolamine

b)

prazosin

c)

terazosin

d)

phenoxybenzamine

67.

Choose the example of an irreversible alpha receptor antagonist

a)

phenoxybenzamine

b)

phentolamine

c)

prazosin

d)

terazosin

68.

Which alpha antagonists have strong alpha 1 affinity vs alpha 2?

a)

prazosin

b)

terazosin

c)

doxazosin

d)

phentolamine

e)

yohimbine

69.

Which alpha antagonists have a weak alpha 1 affinity over alpha 2?

a)

phenoxybenzamine

b)

phentolamine

c)

yohimbine

d)

tolazoline

70.

Which alpha antagonists have equal alpha 1 and 2 affinity?

a)

phentolamine

b)

yohimbine

c)

tolazoline

d)

labetolol

71.

Which alpha antagonists have stronger alpha 2 vs alpha 1 affinity?

a)

yohimbine

b)

tolazoline

c)

labetalol

d)

carvedilol

72.

Which mixed antagonists have equal b1 and b2 receptor affinity; b2 affinity is greater than or equal to alpha 1 which is greater than alpha 2?

a)

labetalol

b)

carvedilol

c)

metoprolol

d)

acebutolol

73.

Which alpha antagonists have strong b1 vs b2 affinity?

a)

metoprolol

b)

acebutolol

c)

atenolol

d)

betaxolol

e)

esmolol

74.

Which alpha antagonists have equal b1 and b2 affinity?

a)

propranolol

b)

carteolol

c)

penbutolol

d)

pindolol

e)

timolol

75.

Which alpha antagonist has strong b2 vs b1 affinity?

a)

butoxamine

b)

metoprolol

c)

labetolol

d)

propranolol

76.

Does phenoxybenzamine bind covalently or nah?

a)

hell yeah brother

b)

nope, dope

77.

What does phenoxybenzamine block?

a)

histamine H1

b)

Ach

c)

serotonin receptors

d)

norepinephrine

e)

epinephrine

78.

Alpha receptor antagonist phenoxybenzamine:

a)

low oral bioavailability

b)

high oral bioavailability

c)

long duration of action (14-48 hours)

d)

short duration of action (5-10 minutes)

e)

distribute to CNS

79.

What is phenoxybenzamine used for?

a)

pheochromocytoma: tumor of the adrenal medulla or sympathetic ganglion

b)

increase NE and epinephrine secretion

c)

reverse vasoconstriction in local anesthesia

80.

Alpha receptor antagonist phentolamine:

a)

potent competitive antagonist

b)

non-selective a1 and a2 receptors

c)

little inhibitory effects of serotonin receptors

d)

agonistic activity on muscarinic, H1 and H2 receptors

e)

relaxes smooth muscle in the prostate

81.

Alpha receptor antagonist prazosin:

a)

relaxes both arterial and venous vascular smooth muscle

b)

relaxes smooth muscle in the prostate

c)

highly metabolized by the liver

d)

used for HTN

e)

used for BPH

82.

Alpha receptor antagonists terazosin and doxazosin:

a)

a1 receptors selective antagonist

b)

relaxes both arterial and venous vascular smooth muscle

c)

relaxes smooth muscle in the prostate

d)

used for HTN

e)

used for BPH

83.

Alpha receptor antagonist tamsulosin:

a)

a1A and a1D >>> a1B subtype

b)

less effect on standing BP in patients

c)

used for BPH

d)

used for HTN

84.

Alpha receptor antagonist yohimbine:

a)

a2-selective antagonist

b)

a1-selective antagonist

c)

promotes NE release in both the CNS and the periphery

d)

increase BP and HR

e)

hepatotoxic

85.

Choose the highly bioavailable beta-receptor antagonist drugs:

a)

propranolol

b)

betaxolol

c)

penbutolol

d)

pindolol

e)

sotalol

86.

Why does propranolol have low bioavailability?

a)

extensive hepatic (first-pass) metabolism

b)

extensive hydrolysis reaction in GI tract

87.

Which 2 beta receptor antagonists are the most lipophilic and readily cross the BBB?

a)

propranolol

b)

penbutolol

c)

esmolol

d)

nadolol

88.

Which beta receptor antagonist has the shortest half life?

a)

esmolol

b)

metoprolol

c)

carvedilol

d)

nadolol

89.

Which beta receptor antagonists are extensively metabolized in the liver by CYP2D6?

a)

propranolol

b)

metoprolol

c)

carvedilol

d)

nadolol

90.

Which beta receptor antagonist is excreted unchanged into the urine and has the longest half life compared to the other drugs in this class?

a)

esmolol

b)

metoprolol

c)

nadolol

d)

carvedilol

91.

Which beta receptor antagonist is non selective?

a)

propranolol

b)

carvedilol

c)

metoprolol

d)

nebivolol

92.

When is propranolol contraindicated?

a)

asthma

b)

COPD

c)

glaucoma

93.

Which beta receptor antagonists have strong b1 affinity?

a)

metoprolol

b)

atenolol

c)

bisoprolol

d)

betaxolol

e)

nebivolol

94.

Which beta receptor antagonist is the most highly selective for b1?

a)

nebivolol

b)

propranolol

c)

metoprolol

d)

atenolol

95.

Which beta receptor antagonists have partial beta agonist activity (intrinsic sympathomimetic activity (ISA)?

a)

pindolol

b)

acebutolol

c)

carteolol

d)

celiprolol

e)

penbutolol

96.

Is timolol a selective or non selective beta receptor antagonist?

a)

selective

b)

non selective

97.

Which beta receptor antagonist is available in a racemic mixture?

a)

labetalol

b)

timolol

c)

pindolol

d)

acebutolol

98.

Which beta receptor antagonist is non selective for beta receptor antagonists with some ability to block a1 adrenergic receptors?

a)

metoprolol

b)

carvedilol

c)

betaxolol

99.

Which beta receptor antagonist is the drug of choice in chronic heart failure?

a)

carvedilol

b)

metoprolol

c)

acebutolol

d)

atenolol

100.

The action of beta receptor antagonists for treatment of HTN is less effective in:

a)

elderly

b)

individuals of African ancestry

c)

children

d)

Asians

101.

What are the clinical applications of beta receptor antagonists?

a)

HTN

b)

ischemic heart disease

c)

myocardial infarction

d)

arrhythmia

e)

hyperthyroidism

102.

Which beta receptor antagonists are the most studied in treatment of MI?

a)

timolol

b)

propranolol

c)

metoprolol

d)

carvedilol

e)

betaxolol

103.

Sotalol is generally used for anti arrhythmic properties- how does it work?

a)

K+ ion channel blocker

b)

Na+ ion channel blocker

c)

Ca+ channel blocker

104.

How do beta receptor antagonists affect hyperthyroidism?

a)

blockade of adrenoreceptors

b)

inhibition of peripheral conversion of thyroxine to triiodothyronine

c)

propranolol is most commonly used

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