MCQs on Pharmacology - Drugs acting on Autonomic Nervous System

# The highest seat of regulating autonomic functions is located in:
A. Hypothalamus
B. Medulla
C. Spinal cord
D. Midbrain

# Catecholamines are synthesized from which amino acid?
A. Histamine
B. Phenylalanine
C. Tryptophan
D. Glycine

# The alpha receptors function is mediated mainly by:
A. ATP
B. NADH
C. IP3/DAG
D. cAMP

# The B actions are mediated by which of the following?
A. Cyclic AMP and adenyl cyclase
B. Monoamino-oxidase
C. Adenosine triphosphatase and NADH
D. None of the above

# Which of the following is not a catecholamine?
A. Adrenaline
B. Noradrenaline
C. Isoproterenol
D. Phenylephrine

# In which of the following categories are ephedrine, tyramine and amphetamine classified?
A. Anticholinesterases
B. Alpha-adrenergic blocking agents
C. Indirect acting sympathomimetics
D. Direct acting sympathomimetics

# Which of the following regarding the adrenergic actions mediated by receptors is not true?
A. Stimulation of alpha receptors causes vasoconstriction and increase in BP
B. Mydriasis effect is mediated by beta receptors
C. Cardiac stimulation is mediated by B1 receptors
D. Bronchodilation is mediated by B2 receptors

# The alpha and beta receptors have opposite action on the following tissues/organs EXCEPT:
A. Contraction of arterioles and veins
B. Contraction of uterus
C. Contraction of intestinal muscles
D. Insulin secretion

# Which of the following are therapeutic uses of adrenergic drugs?
A. Hypotensive states as seen in shock
B. Control of local bleeding and to prolong duration of action of anesthetics
C. Nasal decongestants and in relaxation of bronchial muscles
D. All of the above

# All of the following are the actions of adrenaline EXCEPT:
A. Increase in heart rate and blood pressure
B. Increase in gastric motility and increased contraction of muscles of GIT
C. Dilation of bronchial muscles
D. Increased contraction of uterus

# Epinephrine is formed from norepinephrine by:
A. Acetylation
B. Methylation
C. Decarboxylation
D. Deamination

# An excess of which of the following hormones may be associated with increased sensitivity to epinephrine?
A. Testosterone
B. Parathyroid
C. Insulin
D. Thyroid

# In which of the following conditions is complete contraindications to vasoconstrictors (adrenergic drugs)?
A. Thyrotoxicosis
B. Hypertension
C. Myocardial infarction
D. All of the above

# Which of the following is not an action of epinephrine when administered intravenously in a high dose?
A. Increases liver glycogenolysis
B. Causes bronchiolar constriction
C. Evokes extrasystoles in the heart
D. Produces restlessness and anxiety

# Vasopressor action of adrenaline is mediated by:
A. Alpha receptors
B. Beta receptors
C. Both alpha and beta receptors
D. None of the above

# When noradrenaline is given, it ultimately results in:
A. Increased heart rate and decreased blood pressure due to stimulation of B receptors only
B. Increased heart rate and increased blood pressure due to stimulation of alpha receptors only
C. Increase in blood pressure and reflex bradycardia due to vasovagal stimulation
D. None of the above

# The cardiac stimulatory actions of catecholamines are mainly mediated by:
A. B1 receptors
B. B2 receptors
C. Alpha 1 receptors
D. Alpha 2 receptors

# The drug of choice in shock is:
A. Acetylcholine
B. Atropine
C. Adrenaline
D. Isoproterenol

# In allergic patients, epinephrine reverses the action of histamine by bronchodilation and increasing blood pressure. This kind of interaction between epinephrine and histamine is called:
A. Physiological antagonism
B. Competitive antagonism
C. Physiological agonist activity
D. Partial agonist activity

# When an alpha blocking agent is given with the following drugs a 'vasomotor reversal of Dale' or fall in BP is noticed. The drug is:
A. Adrenaline
B. Acetylcholine
C. Noradrenaline
D. All of the above

# The vasopressor action of adrenaline is reversed by (OR) Dale's vasomotor reversal is exhibited by adrenaline if following drug is given before it:
A. Adrenergic drugs like amphetamine
B. Alpha blockers like phenoxybenzamine and phentolamine
C. Beta blocker like propranolol
D. Beta agonists like salbutamol

# Which of the following drugs improves renal blood flow and BP in patients of shock and severe CHF (cardiogenic shock)?
A. Dopamine
B. Amphetamine
C. Ephedrine
D. Phenylephrine

# Felypressin is a :
A. Vasodilator
B. Vasoconstrictor
C. Neuroleptic drug
D. Anticoagulant

# Which of the following drugs acts by releasing noradrenaline from the nerve terminals in CNS:
A. Dopamine
B. Amphetamine
C. Ephedrine
D. Phenylephrine

# All of the following result from stimulation of beta receptors EXCEPT:
A. Bronchodilation and intestinal relaxation
B. Tachycardia and vasodilation
C. Vasoconstriction and pupillary dilation
D. Hyperglycemia

# Which of the following is not a result of B-adrenergic stimulation?
A. Contraction of radial muscle of iris and mydriasis
B. Cardiac stimulation increases rate, force and conduction velocity
C. Bronchodilation and decreased tone of intestinal musculature
D. Liver glycogenolysis leading to hyperglycemia

# All of the following are the results of B2 adrenergic stimulation EXCEPT one which results mainly by B1 adrenergic stimulation. The EXCEPTION is:
A. Increase in cardiac activity
B. Bronchial relaxation
C. Liver glycogenolysis
D. Dilation of arteries and fall in BP

# Which of the following drugs is a predominantly Beta 2 agonist?
A. Dobutamine
B. Procaterol
C. BRL37344
D. Isoproterenol

# Beta -2 agonist causes:
A. Mydriasis
B. Contraction of urinary sphincters
C. Vasoconstriction
D. Bronchial muscle relaxation

# Beta-2 adrenergic receptor stimulating drugs are used in:
A. Bronchial asthma
B. Cardiac asthma
C. Hypertension
D. Angina pectoris

# Which of the following catecholamines have potent bronchodilation property?
A. Noradrenaline and adrenaline
B. Noradrenaline and isoprenaline
C. Isoprenaline and dopamnine
D. Adrenaline and isoproterenol

# Long acting beta-2 agonist?
A. Albuterol
B. Salmeterol
C. Pirlbuterol
D. Orciprenaline

# WHich of the following adrenergic drugs has a selective B agonist property and is a potent bronchodilator?
A. Salbutamol and orciprenaline
B. Ephedrine and phenylephrine
C. Isoprenaline and pronalterol
D. Amphetamine and ephedrine

# Which of the following is not a selective B2 agonist?
A. Salbutamol
B. Terbutaline
C. Orciprenaline
D. Methoxamine

# The drug which is typically known for tachyphylaxis is:
A. Amphetamine
B. Isoproterenol
C. Ephedrine
D. Phenylephrine

# Which of the following is an endogenous catecholamine?
A. Noradrenaline
B. Ephedrine
C. Amphetamine
D. Isoproterenol

# Which of the following is not a direct acting sympathomimetic drug?
A. Norepinephrine
B. Phenylephrine
C. Salbutamol
D. Tyramine

# Which of the following selectively blocks alpha 1 receptors?
A. Prazosin
B. Metoprolol
C. Salbutamol
D. Amphetamine

# Which of the following statements about tyramine is false?
A. It is direct acting amine
B. Cheese is the richest source
C. Can precipitate hypertensive crisis
D. None of the above

# Which of the following causes rise in systolic as well as diastolic blood pressure for prolonged period?
A. Epinephrine
B. Ephedrine
C. Norepinephrine
D. Dopamine

# Which of the following group of drugs are used in the treatment of glaucoma?
A. Beta blockers such as timolol and betaxolol and alpha agonists like phenylephrine
B. Cholinergic agonists like carbachol, pilocarpine, and anticholinesterases like physostigmine
C. Diuretics like acetazolamide
D. All of the above

# In which of the following patients beta blockers are contraindicated?
A. Asthmatic patients
B. Hyperthyroid patients
C. Hypertensive patients
D. Migraine patients

# In which of the following patients beta blockers are given for therapeutic effects?
A. Treatment of hypertension and hyperthyroidism
B. Myocardial infarction and angina pectoris
C. Migraine and glaucoma
D. All of the above

# The antihypertensive effect of beta-blockers is due to:
A. Decrease in cardiac output
B. Decreased angiotensin II
C. Antitension effect
D. All of the above

# Beta blocker with additional alpha-blocking property is:
A. Propranolol
B. Timolol
C. Metoprolol
D. Labetalol

# Beta blocker without local anesthetic action is:
A. Metoprolol
B. Pindolol
C. Atenolol
D. Timolol

# Which of the following is a contraindication to adrenaline?
A. Halothane
B. B blockers
C. Both of the above
D. None of the above

# Which of the following beta blockers has selective beta 1 blocking effect (or) the beta blocker which is cardioselective is:
A. Metoprolol and atenolol
B. Propranolol and timolol
C. Pindolol and acebutol
D. All of the above

# Which of the following beta blockers are said to have intrinsic sympathomimetic activity?
A. Metoprolol and atenolol
B. Propranolol and timolol
C. Pindolol and acebutol
D. Labetalol and timolol

# Propranolol is contraindicated in:
A. CHF, heart blocks, and vascular diseases
B. Bradycardia, chronic obstructive lung diseases
C. Hypoglycemia due to insulin therapy
D. All of the above

# Beta blockers are used in all EXCEPT:
A. Pheochromocytoma
B. Migraine
C. Thyrotoxicosis
D. Secondary shock

# Beta blockers are not indicated in:
A. Mild hypertension, pheochromocytoma and hypertension
B. Tachycardia and arrhythmias
C. Angina pectoris and myocardial infarction
D. Bronchial asthma

# WHich of the following sites acetylcholine exhibits its action through muscarinic receptors?
A. All parasympathetic and sympathetic ganglia
B. Adrenal medulla
C. All postganglionic or neuroeffector junction of parasympathetic nervous system
D. Neuromuscular junction of skeletal muscle

# The direct cholinergic agonists or cholinomimetic drugs exhibit their action by:
A. Mimic the effects of acetylcholine by directly bonding to choline receptors
B. Binding to acetylcholinesterase and thereby reversibly inhibiting the hydrolysis of acetylcholine
C. By stimulating the release of acetylcholine from nerve endings
D. None of the above

# Which of the following is not a direct acting cholinergic drug?
A. Pilocarpine
B. Edrophonium
C. Methanechol
D. Bethanechol

# Which of the following is an irreversible anticholinesterase?
A. Pralidoxime
B. Neostigmine
C. Edrophonium
D. Organophosphates like parathion and malathion

# Which of the following anticholinesterases has more prominent effect on motor endplate of skeletal muscle?
A. Neostigmine
B. Physostigmine
C. Pyridostigmine
D. Edrophonium

# The muscarinic receptors can be selectively blocked by:
A. Atropine
B. Scopolamine
C. Curare
D. Hexamethonium

# Mechanism of action of ipratropium bromide:
A. Dilating peripheral bronchioles
B. Beta 2 agonist
C. Muscarinic antagonist
D. All of the above

# Which of the following statements is true?
A. Cholinergic receptors are closely related in structure to acetylcholinesterase
B. Acetylcholine is a major neurohormonal transmitter at autonomic as well as somatic sites
C. Acetylation of choline is facilitated by the enzyme choline acetylase
D. All of the above

# Which of the following actions of acetylcholine is mediated largely by nicotinic receptors?
A. Bradycardia
B. Smooth muscle contraction
C. Increased secretions
D. Twitching and fasciculations

# Which of the following is not a function of acetylcholine given in therapeutic doses?
A. Increased secretions like increased sweating, salivation, lacrimation and increased gastric secretions
B. Constriction of smooth muscles and precipitation of asthma due to bronchoconstriction
C. Peripheral vasoconstriction and increase in blood pressure
D. Decreased heart rate and decreased force of contraction

# Organophosphate blocks the action of which of the following enzymes?
A. Acetylcholinesterase
B. Mono amino-oxidase
C. Adenyl cyclase
D. All of the above

# Which of the following reactivates cholinesterase?
A. Pralidoxime
B. Neostigmine
C. Physostigmine
D. Isoflurophate

# All of the following result in cholinergic crises EXCEPT (OR) Which of the following do not potentiate the action of acetylcholine:
A. Physostigmine and neostigmine
B. Carbachol and bethanechol
C. Scopolamine and pralidoxime
D. Pilocarpine and edrophonium

# Scopolamine helps in: (TWO ANSWERS CORRECT)
A. Motion sickness
B. Hypertension
C. Decreasing secretions
D. Myasthenia gravis

# Which of the following are specific antidotes for anticholinesterase poisoning?
A. Atropine
B. Pralidoxime
C. Both of the above
D. None of the above

# WHich of the following anticholinesterases is mainly used in the treatment of Myasthenia gravis?
A. Physostigmine
B. Neostigmine
C. Pyridostigmine
D. Edrophonium

# The beneficial effect of drug neostigmine in the treatment of myasthenia gravis is due to the action:
A. It produces more acetylcholine
B. It inhibits the action of cholinesterase
C. It produces more acetylcholine receptors
D. It increases the action of cholinesterase

# Which of the following causes miosis of the eye?
A. Morphine
B. Pilocarpine
C. Prazosin
D. All of the above

# All of the following may result in mydriasis EXCEPT:
A. Atropine and Scopolamine
B. Ephedrine and phenylephrine
C. Phenoxybenzamine and dibenamine
D. Ephedrine and amphetamine

# Which of the following produces mydriasis without cycloplegia?
A. Ephedrine
B. Atropine
C. Pilocarpine
D. Isoproterenol

# Given below is a pair of drugs which have opposite action on smooth muscles of GIT but EXCEPT one pair which has similar actions. Exception is:
A. Atropine and Carbachol
B. Epinephrine and Morphine
C. Amphetamine and Ephedrine
D. Amphetamine and Papaverine

# Which of the following increases muscle tone and contractibility of the muscles of GIT?
A. Carbachol
B. Atropine
C. Scopolamine
D. Papaverine

# Which of the following cholinergic agonists are correctly matched with its pharmacological actions?
A. Bethanechol used to stimulate atonic bladder particularly in postpartum urinary retention
B. Carbachol releases epinephrine from the adrenal medulla by its nicotinic action
C. Pilocarpine useful in lowering of intraocular pressure in narrow angle and wide angle glaucoma
D. All of the above

# Atropine, the prototype of anticholinergic, exhibits its action by:
A. Competitive antagonism with acetylcholine for receptor sites, in particular with muscarinic receptors
B. Inhibiting the release of cholinesterase and preventing the degradation og acetylcholine
C. By interfering with the uptake of choline by axonal membrane during synthesis of acetylcholine
D. None of the above

# Atropine results in tachycardia due to:
A. Vagolytic activity
B. Stimulation of B receptors
C. Stimulation of alpha receptors
D. Stimulation of cholinergic receptors

# Bradycardia is most commonly treated with which of the following drugs?
A. Epinephrine
B. Atropine
C. A diuretic
D. A potent vasodilator

# The intramuscular administration of 0.6 mg of atropine sulpahte to a 50 kg adult may produce all of the following effects EXCEPT:
A. Bradycardia
B. Decreased salivation
C. Decreased sweating
D. Mydriasis

# The side effects resulting from scopolamine overdosage such as confusion, hallucinations and other CNS actions are best treated by:
A. Physostigmine
B. Neostigmine
C. Levodopa
D. Methacholine

# In which of the following patients atropine is strongly contraindicated?
A. Acute narrow angle glaucoma
B. Peptic ulcers
C. Bronchial asthma
D. Drug induced diarrhoea

# Which of the following drugs is preferred in motion sickness?
A. Hyoscine
B. Atropine
C. Propantheline
D. Pirenzepine

# Which of the following is not a side effect of ganglion blocking drugs?
A. Braadycardia and hypotension
B. Mydriasis, cycloplegia (blurring of vision)
C. Increased salivation, sweating and urination
D. Constipation and impotency

# Which of the following are ganglion blocking agents in therapeutic doses?
A. Hexamethonium and mecamylamine
B. Atropine and scopolamine
C. Carbachol and methanechol
D. Neostigmine and physostigmine

# The most common side effect of ganglionic blocking drugs are:
A. Orthostatic hypotension
B. Precipitation of peptic ulcer
C. Bradycardia
D. Increased salivation

# The drugs which have potent anti-secretory action and given to dry secretions of mouth are:
A. Pilocarpine and muscarine
B. Propantheline and methentheline
C. Phenylephrine and ephedrine
D. Carbachol and bethanechol

# All of the following drugs result in bronchodilation EXCEPT:
A. Anticholinergics
B. Beta 2 sympathomimetics
C. Anticholinesterases
D. None of the above

# The anticholinergic drug most commonly used in the treatment of motion sickness is:
A. Atropine
B. Scopolamine
C. Pirenzepine
D. Propantheline

# Which of the following drugs are contraindicated in patients with glaucoma:
A. Anticholinergic
B. Adrenergic
C. Cholinergic
D. Opiates

# Which of the following are given in the treatment of glaucoma?
A. Anticholinesterases
B. Cholinomimetics
C. Beta adrenergic blockers and alpha adrenergic agonists
D. All of the above

# All of the following result in dry mouth EXCEPT:
A. Anticholinergics
B. Ganglion blocking agents
C. Adrenergic agonists
D. Antihistamines

# Which of the following effectively induces salivation and may be used for treatment of Xerostomia:
A. Adrenergic agonists like ephedrine
B. Cholinergic drugs like pilocarpine and neostigmine
C. Ganglion blocking drugs like hexamethonium
D. Adrenergic blocking drugs like prazosin and mecamylamine

# Pilocarpine:
A. Lowers the intraocular pressure in glaucoma
B. Cleaved by acetylcholinesterase
C. Inhibits sweat and lacrimation
D. Causes tachycardia

# All of the following have CNS stimulation EXCEPT one. The exception is:
A. Atropine
B. Scopolamine or hyoscine
C. Ephedrine
D. Amphetamine

# Which of the following effectively reduces gastric acid secretion?
A. H1 histamine receptor antagonists
B. H2 histamine receptor antagonists
C. Anticholinergics
D. NSAIDs drugs