AUTONOMICS- SGD 1.

A 65 year old complains of some degree of difficulty in starting urination, dribbling and decreased force of the urinary stream. Physical examination revealed an enlarged prostate. Review of systems also revealed that the patient has colds for which the patient was prescribed a nasal decongestant. a. What autonomic receptor is affected by the nasal decongestant? b. Give the mechanism of action of the nasal decongestant and its pharmacologic effects. c. What is the relationship of this drug to the patients chief complaint? d. What other systemic symptoms might the patient experience? 2. A 70 year old female patient underwent open cholecystectomy. She developed postoperative nausea and vomiting for which metoclopramide was prescribed three times a day. On the second day postoperatively, the patient developed uncontrolled motor movements. a. What autonomic receptor is affected by metoclopramide? b. Give the mechanism of action of metoclopramide and its pharmacologic effects. c. What is the relationship of this drug to the patients chief complaint? d. What other systemic symptoms might the patient experience? e. Aside from stopping the metoclopramide, what medication(s) may be given to alleviate the patients symptoms? 3. A 25 year old female patient is diagnosed to have myasthenia gravis. She was scheduled to undergo dilatation and curettage and was prescribed an increased dose of neostigmine. One day postoperatively, she developed difficulty of breathing with increased bronchial gland secretions. a. What autonomic receptor is affected by neostigmine? Nicotinic Receptor b. Give the mechanism of action of neostigmine and its pharmacologic effects. c. What is the relationship of this drug with the patients chief complaint? d. What other systemic symptoms might the patient experience? e. Aside from lowering the dose of neostigmine, what medication(s) may be given to alleviate the patients symptoms?

4. A 58 year old patient was scheduled to undergo opthalmoscopic examination under slit lamp and was given scopolamine eye drops. After the eye exam, the patient complained of difficulty in going down the stairs and blurring of vision. a. What autonomic receptor is affected by scopolamine eye drops? b. Give the mechanism of action of scopolamine eye drops and its pharmacologic effects. c. What is the relationship of this drug to the patients chief complaint? d. What other systemic symptoms might the patient experience?