PART III Cholinoreceptor blocking drugs

001. The group of nicotinic receptor-blocking drugs consists of:

a) Ganglion-blockers
b) Atropine-similar drugs
c) Neuromuscular junction blockers
d) Both a and c
002. M3 receptor subtype is located:
a) In the myocardium
b) In sympathetic postganglionic neurons
c) On effector cell membranes of glandular and smooth muscle cells
d) On the motor end plates
003. Which of the following drugs is both a muscarinic and nicotinic blocker?
a) Atropine
b) Benztropine
c) Hexamethonium
d) Succinylcholine
004. Indicate a muscarinic receptor-blocking drug:
a) Scopolamine
b) Pipecuronium
c) Trimethaphan
d) Pilocarpine
005. Which of the following agents is a ganglion-blocking drug?
a) Homatropine
b) Hexamethonium
c) Rapacuronium
d) Edrophonium
006. Indicate the skeletal muscle relaxant, which is a depolarizing agent:
a) Vencuronium
b) Scopolamine
c) Succinylcholine
d) Hexamethonium
007. Which of the following drugs is a nondepolarizing muscle relaxant?
a) Pancuronium
b) Succinylcholine
c) Hexamethonium
d) Scopolamine
008. Indicate the drug, which is rapidly and fully distributed into CNS and has a greater effect than most
other antimuscarinic
agents?
a) Atropine
b) Scopolamine
c) Homatropine
d) Ipratropium
009. The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT:
a) Eye
b) Heart
c) Smooth muscle organs
d) Glands
010. The mechanism of atropine action is:
a) Competitive ganglion blockade
b) Competitive muscarinic blockade
c) Competitive neuromuscular blockade
d) Noncompetitive neuromuscular blockade
011. The tissues most sensitive to atropine are:
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a) The salivary, bronchial and sweat glands
b) The gastric parietal cells
c) Smooth muscle and autonomic effectors
d) The heart
012. Atropine is highly selective for:
a) M1 receptor subtype
b) M2 receptor subtype
c) M3 receptor subtype
d) All of the above
013. Which of the following antimuscarinic drugs is often effective in preventing or reversing vestibular
disturbances,
especially motion sickness?
a) Atropine
b) Ipratropium
c) Scopolamine
d) Homatropine
014. Atropine causes:
a) Miosis, a reduction in intraocular pressure and cyclospasm
b) Mydriasis, a rise in intraocular pressure and cycloplegia
c) Miosis, a rise in intraocular pressure and cycloplegia
d) Mydriasis, a rise in intraocular pressure and cyclospasm
015. Patients complain of dry or “sandy” eyes when receiving large doses of:
a) Atropine
b) Hexamethonium
c) Pilocarpine
d) Carbachol
016. All of the following parts of the heart are very sensitive to muscarinic receptor blockade except:
a) Atria
b) Sinoatrial node
c) Atrioventricular node
d) Ventricle
017. Atropine causes:
a) Bradycardia, hypotension and bronchoconstriction
b) Tachycardia, little effect on blood pressure and bronchodilation
c) Decrease in contractile strength, conduction velocity through the AV node
d) Tachycardia, hypertensive crisis and bronchodilation
018. Atropine is frequently used prior to administration of inhalant anesthetics to reduce:
a) Muscle tone
b) Secretions
c) Nausea and vomiting
d) All of the above
019. Atropine is now rarely used for the treatment of peptic ulcer because of:
a) Slow gastric empting and prolongation of the exposure of the ulcer bed to acid
b) Low efficiency and necessity of large doses
c) Adverse effects
d) All of the above
020. Which of the following antimuscarinic drugs is a selective M 1 blocker?
a) Atropine
b) Scopolamine
c) Pirenzepine
d) Homatropine
021. Atropine causes:
a) Spasmolitic activity
b) Intestinal hypermotility
c) Stimulation of contraction in the gut
d) Stimulation of secretory activity
022. Which of the following drugs is useful in the treatment of uterine spasms?
a) Carbachol
b) Vecuronium
c) Atropine
d) Edrophonium
023. Atropine may cause a rise in body temperature (atropine fever):
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a) In adults
b) In pregnant women
c) In infants and children
d) All of the above
024. The pharmacologic actions of scopolamine most closely resemble those of:
a) Hexamethonium
b) Atropine
c) Succinylcholine
d) Pilocarpine
025. Compared with atropine, scopolamine has all of the following properties EXCEPT:
a) More marked central effect
b) Less potent in decreasing bronchial, salivary and sweat gland secretion
c) More potent in producing mydriasis and cycloplegia
d) Lower effects on the heart, bronchial muscle and intestines
026. Which of the following drugs is useful in the treatment of Parkinson′s disease?
a) Benztropine
b) Edrophonium
c) Succinylcholine
d) Hexamethonium
027. Indicate the antimuscarinic drug, which is used as a mydriatic:
a) Pilocarpine
b) Neostigmine
c) Homatropine
d) Ipratropium
028. Which of the following agents is used as an inhalation drug in asthma?
a) Atropine
b) Ipratropium
c) Lobeline
d) Homatropine
029. Which of the following agents is most effective in regenerating cholinesterase associated with
skeletal muscle
neuromuscular junctions?
a) Suscinilcholine
b) Pralidoxime
c) Pirenzepine
d) Propiverine
030. Indicate an antimuscarinic drug, which is effective in the treatment of mushroom poising:
a) Pralidoxime
b) Pilocarpine
c) Homatropine
d) Atropine
031. Antimuscarinics are used in the treatment of the following disorders EXCEPT:
a) Motion sickness
b) Glaucoma
c) Hyperhidrosis
d) Asthma
032. The atropine poisoning includes all of the following symptoms EXCEPT:
a) Mydriasis, cycloplegia
b) Hyperthermia, dry mouth, hot and flushed skin
c) Agitation and delirium
d) Bradicardia, orthostatic hypotension
033. The treatment of the antimuscarinic effects can be carried out with:
a) Neostigmine
b) Hexametonium
c) Homatropine
d) Acetylcholine
034. Contraindications to the use of antimuscarinic drugs are all of the following except:
a) Glaucoma
b) Myasthenia
c) Bronchial asthma
d) Paralytic ileus and atony of the urinary bladder
035. Hexamethonium blocks the action of acethylcholine and similar agonists at:
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a) Muscarinic receptor site
b) Neuromuscular junction
c) Autonomic ganglia
d) Axonal transmission
036. The applications of the ganglion blockers have disappeared because of all of the following reasons
EXCEPT:
a) Orthostatic hypotension
b) Lack of selectivity
c) Homeostatic reflexes block
d) Respiratory depression
037. Which of the following agents is a short-acting ganglion blocker?
a) Homatropine
b) Trimethaphane
c) Hexamethonium
d) Pancuronium
038. Indicate the ganglion-blocking drug, which can be taken orally for the treatment of hypertension?
a) Mecamylamine
b) Scopolamine
c) Trimethaphane
d) Vecocuronium
039. The systemic effects of hexamethonium include all of the following EXCEPT:
a) Reduction of both peripheral vascular resistance and venous return
b) Partial mydriasis and loss of accommodation
c) Constipation and urinary retention
d) Stimulation of thermoregulatory sweating
040. Ganglion blocking drugs are used for the following emergencies EXCEPT:
a) Hypertensive crises
b) Controlled hypotension
c) Cardiovascular collapse
d) Pulmonary edema
041. Agents that produce neuromuscular blockade act by inhibiting:
a) Interaction of acetylcholine with cholinergic receptors
b) Release of acetylcholine from prejunctional membrane
c) Packaging of acetylcholine into synaptic vesicles
d) Reuptake of acetylcholine into the nerve ending
042. Skeletal muscle relaxation and paralysis can occur from interruption of functions at several sites,
including all of the
following EXCEPT:
a) Nicotinic acethylcholine receptors
b) Muscarinic acethylcholine receptors
c) The motor end plate
d) Contractile apparatus
043. Nondepolarisation neuromuscular blocking agents:
a) Block acetylcholine reuptake
b) Prevent access of the transmitter to its receptor and depolarization
c) Block transmission by an excess of a depolarizing agonist
d) All of the above
044. Which of the following drugs has “double-acetylcholine” structure?
a) Rocuronium
b) Carbachol
c) Atracurium
d) Succylcholine
045. Indicate the long-acting neuromuscular blocking agent:
a) Rapacuronium
b) Mivacurium
c) Tubocurarine
d) Rocuronium
046. Which of the following neuromuscular blocking drugs is an intermediate-duration muscle relaxant?
a) Vecuronium
b) Tubocurarine
c) Pancuronium
d) Rapacuronium
047. Indicate the nondepolarizing agent, which has the fastest onset of effect?
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a) Succinylcholine
b) Rapacuronium
c) Pancuronium
d) Tubocurarine