Chapter 27 Drug Therapy to Enhance the Adrenergic Response


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Chapter 27  Drug Therapy to Enhance the Adrenergic Response



Complete chapter Questions And Answers

Sample Questions



1. A patient is experiencing anaphylaxis. Which of the following medications will most likely be administered?

  1. A)  Epinephrine
  2. B)  Norepinephrine
  3. C)  Acetylcysteine (Mucomyst)
  4. D)  Dantrolene sodium (Dantrium)

Ans: A
Epinephrine is the adrenergic drug of choice for relief of anaphylactic shock, the most serious allergic reaction, as well as in treatment of cardiac arrest. Norepinephrine is not administered. Acetylcysteine (Mucomyst) is used for acetaminophen overdose. Dantrolene sodium is used to treat malignant hyperthermia.

2. A patient is suffering from hypovolemic shock. Which agents are administered if fluid volume replacement does not restore sufficient blood pressure?

  1. A)  First-line agents
  2. B)  Second-line agents
  3. C)  Beta-blockers
  4. D)  Antianginal drugs

Ans: B
In hemorrhagic or hypovolemic shock, the drugs are second-line agents that may be used if adequate fluid volume replacement does not restore sufficient blood pressure and circulation to maintain organ perfusion. First-line agents are not used; the first-line therapy is fluid replacement. Beta-blockers decrease heart rate and are not administered with hypovolemic shock. Antianginals are not administered in hypovolemia.

3. A patient has been diagnosed with narrow-angle glaucoma. What ocular effect will be produced if the patient is prescribed an adrenergic agent?

  1. A)  Hypothyroidism
  2. B)  Decreased heart rate
  3. C)  Mydriasis
  4. D)  Hypertension

Ans: C
Narrow-angle glaucoma is a contraindication to adrenergic agents because the drugs result in mydriasis, closure of the filtration angle of the eye, and increased intraocular pressure. Hypothyroidism will not occur with the administration of adrenergic agents. Decreased heart rate will not occur with the administration of adrenergic agents and is not an ocular effect. Hypertension is not an ocular effect.

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4. A patient is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?

  1. A)  Decreased cerebral circulation
  2. B)  Decreased coronary circulation
  3. C)  Increased vasoconstrictive effects
  4. D)  Increased bronchoconstriction

Ans: C Feedback:

Epinephrine is added to local anesthetics for vasoconstrictive effects, which include prolonging the action of the local anesthetic drug, preventing systemic absorption, and minimizing bleeding. Epinephrine will not decrease cerebral circulation or coronary circulation. Epinephrine will not increase bronchoconstriction.

  1. An emergency department nurse enters a patient’s room with an order to administer epinephrine subcutaneously to treat his asthma attack. The patient’s wife asks the nurse why it could not be given by mouth. Which of the following is the best response by the nurse?
    1. A)  “The medication he is to receive is only given by an injection in the arm.”
    2. B)  “The medication is administered this way because it works faster than by mouth.”
    3. C)  “The medication is given many ways, but this is the way it was ordered.”
    4. D)  “The medication will not absorb in the GI tract if given by mouth.”

    Ans: D
    Epinephrine is not given orally because enzymes in the GI tract and liver destroy it. The medication can be given through inhalation, intravenously, and subcutaneously. The medication will work more quickly in a parenteral form but is not given orally. Stating to the patient that this method is the way the physician ordered it to be given will belittle the patient and not provide adequate patient teaching.

  2. A patient suffers from bronchial asthma. Which of the following medications is a mixed-acting adrenergic drug that may be administered?
    1. A)  Epinephrine
    2. B)  Ephedrine
    3. C)  Pseudoephedrine
    4. D)  Isoproterenol

Ans: B Feedback:

Ephedrine is a mixed-acting adrenergic drug that acts by stimulating alpha1 and beta receptors and causing release of norepinephrine from presynaptic terminals. It is used in the treatment of bronchial asthma. Epinephrine is not a mixed-acting adrenergic drug. Pseudoephedrine is a related drug, stimulating alpha1 and beta receptors. It is used as a nasal decongestant. Isoproterenol is a synthetic catecholamine that acts on beta1- and beta2-adrenergic receptors.

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