MCQs PHARMACOLOGY: 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: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 M1 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):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: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?a) Succinylcholine b) Rapacuronium c) Pancuronium d) Tubocurarine

048. Indicate the neuromuscular blocker, whose breakdown product readily crosses the blood-brain barrier and may cause seizures: a) Pancuronium b) Succinylcholine c) Tubocurarine d) Atracurium

049. Which competitive neuromuscular blocking agent could be used in patients with renal failure? a) Atracurium b) Succinylcholine c) Pipecuronium d) Doxacurium

050. Indicate the nondepolarizing agent, which has short duration of action: a) Succinylcholine b) Tubocurarine c) Mivacurium d) Pancuronium

051. Which depolarizing agent has the extremely brief duration of action? a) Mivacurium b) Rapacuronium c) Rocuronium d) Succinylcholine

052. Neuromuscular blockade by both succinylcholine and mivacurium may be prolonged in patients with: a) Renal failure b) An abnormal variant of plasma cholinesterase c) Hepatic disease d) Both b and c

053. Depolarizing agents include all of the following properties EXCEPT: a) Interact with nicotinic receptor to compete with acetylcholine without receptor activation b) React with the nicotinic receptor to open the channel and cause depolarisation of the end plate c) Cause desensitization, noncompetive block manifested by flaccid paralysis d) Cholinesterase inhibitors do not have the ability to reverse the blockade

054. Which of the following neuromuscular blockers causes transient muscle fasciculations? a) Mivacurium b) Pancuronium c) Succinylcholine d) Tubocurarine

055. Indicate muscles, which are more resistant to block and recover more rapidly: a) Hand b) Leg c) Neck d) Diaphragm

056. Which neuromuscular blocking agent has the potential to cause the greatest release of histamine? a) Succylcholine b) Tubocurarine c) Pancuronium d) Rocuronium

057. Which of the following muscular relaxants causes hypotension and bronchospasm? a) Vecuronium b) Succinylcholine c) Tubocurarine d) Rapacuronium

058. Indicate the neuromuscular blocker, which causes tachycardia: a) Tubocurarine b) Atracurium c) Pancuronium d) Succinylcholine

059. Which of the following neuromuscular blocking agents cause cardiac arrhythmias?a) Vecuronium b) Tubocurarine c) Rapacuronium d) Succinylcholine

060. Effects seen only with depolarizing blockade include all of the following EXCEPT: a) Hypercaliemia b) A decrease in intraocular pressure c) Emesis d) Muscle pain

061. Which neuromuscular blocking agent is contraindicated in patients with glaucoma? a) Tubocurarine b) Succinylcholine c) Pancuronium d) Gallamine

062. Indicate the following neuromuscular blocker, which would be contraindicated in patients with renal failure: a) Pipecuronium b) Succinylcholine c) Atracurium d) Rapacuronium

063. All of the following drugs increase the effects of depolarizing neuromuscular blocking agents EXCEPT: a) Aminoglycosides b) Antiarrhythmic drugs c) Nondepolarizing blockers d) Local anesthetics

064. Which of the following diseases can augment the neuromuscular blockade produced by nondepolarizing muscle relaxants? a) Myasthenia gravis b) Burns c) Asthma d) Parkinsonism

065. Indicate the agent, which effectively antagonizes the neuromuscular blockade caused by nondepolarizing drugs: a) Atropine b) Neostigmine c) Acetylcholine d) Pralidoxime