Cholinomimetic Drugs and Cholinesterase Inhibitors

1. During operation the anaesthesiologist has overdosed tubocurarine chloride to patient. Proserine has been prescribed. What is the base of action proserine in this case?

*A. Inhibition of cholinesterase activity.

B. Increase of cholinesterase activity.

C. Blockade of presynaptic membrane.

D. Stimulation of M-cholinoceptors.

E. Blockade of adrenoceptors.

2. A patient is delivered into hospital with complaints of dizziness, decrease of vision acuteness, nausea, hypersalivation, and abdominal cramps. The diagnosis is poisoning with organophosphorus compounds. What drugs should be included in complex therapy?

*A. Atropine sulfate and dipyroxime.

B. Thiosulfate sodium and bemegride.

C. EDTA.

D. Naloxone and bemegride.

E. Glucose and bemegride.

3. A patient with complaints of dry mouth and skin, vision disturbances, mydriasis, and tachycardia has been delivered into hospital. The doctor has put the diagnosis of poisoning with Belladonna’s alkaloids. What drug should be prescribed?

*A. Proserinum (neostigmine).

B. Aceclidine.

C. Pilocarpine.

D. Armin.

E. Dipyroxime.

4. Residual phenomena is observed in a child after poliomyelitis. What drug should be prescribed in this case?

*A. Galanthamine.

B. Pentaminum (azamethonium).

C. Dimecoline.

D. Atropine sulfate.

E. Pyrroxane.

5. A victim processed the plant by insecticides without the individual means of protection. After some time the following symptoms were developed in him: hypersalivation, sweating, diarrhoea, miosis, and pain in the abdomen. The drug, which has caused this poisoning, is included to the group of:

*A. Cholinesterase inhibitors.

B. N-cholinomimetics.

C. Cuprum salts.

D. Nitrates.

E. Organic chloride compounds.

6. After the dropping of drops of some drug into eyes the miosis and short-sightedness has developed in patient with glaucoma. The intraocular pressure has decreased. What group of drug can cause such effect?

*A. M-cholinomimetics.

B. M-cholinoblockers.

C. -adrenomimetics.

D. N-cholinomimetics.

E. Ganglioblockers.

7. Paresis of intestine has developed in patient after surgery. What drug from group of cholinesterase inhibitors should be prescribed to this patient?

*A. Proserinum.

B. Carbacholine.

C. Aceclidine.

D. Pilocarpine.

E. Acetylcholine.

8. A 5-year-old child has been delivered to emergency department with the following symptoms: marked psychomotor excitation, delirium, hallucinations, hoarse voice, dilatation of pupils, hyperaemia of the skin, tachycardia, tachypnoa. These symptoms were developed after the child has used the berries of belladonna. What group of drug should be prescribed for treatment of the child?

*A. Cholinesterase inhibitors.

B. N-cholinomimetics.

C. M-cholinomimetics.

D. N-cholinoblockers.

E. Cholinesterase regenerators.

9. The disturbances of breathing had developed in patient during the operation with the use of peripheral myorelaxants. The administration of proserinum improves the patient’s condition. What is such interaction of drugs called?

*A. Antagonism.

B. Synergism.

C. Incompatibility.

D. Tachyphylaxis.

E. Cumulation.

10. A 4-year-old boy was delivered to toxicological department with poisoning by berries of belladonna. What drug should be prescribed to boy in this condition?

*A. Galantamine

B. Aceclidine

C. Lobeline

D. Cytitonum

E. Platyphyllin

11. The peristaltic of intestine was not restored in patient after resection of stomach. What drug should be prescribed to patient for stimulation of GI-tract function?

*A. Proserinum (neostigmine).

B. Platyphyllin.

C. Cyclodolum.

D. Atropine.

E. Dithylinum.

12. A patient with complaints of weakness and disturbances of gait came to the doctor. The doctor has diagnosed myasthenia and prescribed to the patient the injection of proserinum. What is mechanism of proserinum action?

*A. Inhibition of cholinesterase.

B. Direct stimulation of cholinoceptors.

C. Stimulation of metabolic processes.

D. Inhibition of brake processes.

E. Activation of acetylcholine synthesis.

13. A 40-year-old male was delivered to toxicological department with poisoning by insecticides. What cholinesterase regenerator drug should be prescribed to patient?

*A. Dipyroxime.

B. Platyphyllin.

C. Scopolamine.

D. Amizylum.

E. Atropine.

14. What drug, which can cause miosis, will keep the action in animal with denervation of smooth muscles of eye?

*A. Pilocarpine.

B. Galantamine.

C. Proserinum.

D. Prazosin.

E. Reserpine.

15. A female was received injections of galantamine for restoration of CNS functions after ischaemic stroke. The condition of female was significantly improved. What is the mechanism of this drug action?

*A. Blockade of cholinesterase.

B. Blockade of cholinoceptors.

C. Blockade of catechol-ortho-methyltransferase.

D. Blockade of dopaminehydroxylase.

E. Blockade of monoamine oxidase.

16. A 65-year-old male is accepted in neurological department with postinsult syndrome. What drug should be prescribed for acce-leration of this patient recovery?

*A. Galantamine hydrobromide.

B. Ipratropium bromide.

C. Dipyroxime.

D. Isonitrosine.

E. Aceclidine.

17. Drug A. was prescribed to patient with myasthenia and caused the improving of muscles activity. But several side effects had developed gradually: hypersalivation, sweating, diarrhoea, nausea. What drug was used for treatment of the patient?

*A. Proserinum (neostigmine).

B. Analginum (metamizole).

C. Strychnine.

D. Caffeine.

E. Armin.

18. A physician has prescribed eye drops with proserinum to patient for decrease of intraocular pressure. What is the mechanism of proserinum action?

*A. Blockade of cholinesterase.

B. Blockade of cyclooxygenase.

C. Blockade of lipoxygenase.

D. Blockade of phosphodiesterase.

E. Blockade of phospholypase.

19. The victim was delivered to emergency department with complaints of dryness in mouth, photophobia, and disturbances of vision. Hyperaemia, dryness of skin, and tachycardia are observed. The diagnosis is the poisoning with alkaloids of Belladonna. What drug should be prescribed?

*A. Proserinum.

B. Diazepam.

C. Pilocarpine.

D. Armin.

E. Dipyroxime.

20. The atony of intestine has developed in patient on the 3^rd day after resection of stomach. What drug should be used?

*A. Proserinum.

B. Atropine sulfate.

C. Benzohexonium (hexamethonium).

D. No-spa (drotaverine).

E. Pirilenum.

21. A 2-year-old child has had a drink of eye drops from the first-aid set. The child has significant sweating and hypersalivation, difficult breathing, and cough. The pupils are narrowed and bradycardia is observed. The peristaltic of intestine is increased. The blood pressure is low. What drug has caused poisoning?

*A. Pilocarpine hydrochloride.

B. Propranolol (anaprilinum).

C. Atropine.

D. Platyphyllin.

E. Sulfacylum-sodium.

22. A patient was delivered to emergency department with such symptoms: miosis, hypersalivation, sweating, vomiting diarrhoea, and spasm of bronchi. The diagnosis of poisoning with organophosphorus substances was ascertained. What drugs should be included in complex therapy?

*A. Atropine sulfas and dipyroxime.

B. Thiosulfate sodium and bemegride.

C. Nalorphine hydrochloride and bemegride.

D. Glucose and bemegride.

E. Panangin and unithiole.

23. Analeptical remedy of reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monooxide. What medicine was prescribed to the patient?

*A. Lobeline hydrochloride.

B. Mesaton.

C. Adrenaline hydrochloride.

D. Pentamin.

E. Atropine sulphate.

24. A 50-year-old male farm worker has been brought to the emergency room. He was found confused in the orchard and since then has remained unconscious. His heart rate is 45 and his blood pressure is 80/40 mm Hg. He is sweating and salivating profusely. Which of the following should be prescribed?

*A. Atropine.

B. Proserine.

C. Physostigmine.

D. Noradrenaline.

E. Pentamine.

25. A child has residual phenomena after poliomyelitis. What drug is to be prescribed?

*A. Galanthamini hydrobromidum.

B. Pentaminum.

C. Dimecolinum.

D. Atropini sulfas.

E. Pyroxanum.

26. An injection of galanthamine hydrobromide was made to a woman, 63-year-old, after ischaemic stroke. Condition of the patient has considerably improved. What is the mechanism of this medication effect?

*A. Inhibition of acetylcholinesterase.

B. Inhibition of cholinergic receptors.

C. Inhibition of catechol-orto-methyltranspherase.

D. Inhibition of dopamine-hydroxylase.

E. Inhibition of monoamine oxidase.

27. It is necessary to prescribe a medication to a patient with glaucoma diagnosis. Which anticholinesterase drug (tertiary amine) isn’t used in ophthalmologic practice due to its irritative influence on the eye conjunctiva?

*A. Galanthamini hydrobromidum.

B. Pyridostigmini bromidum.

C. Phosphacolum.

D. Proserinum.

E. Arminum.

28. A patient with myasthenia was prescribed a drug which improved muscle performance. But a number of defects have been revealed gradually: intensive salivation, transpiration, diarrhoea, nausea. What drug was used for treatment?

*A. Proserinum.

B. Analginum.

C. Strychnini nitras.

D. Coffeinum-natrii benzoas.

E. Arminum.

29. A 25-year-old man appeals to neurologist with complaints of weakness in legs and gait disorder. The doctor diagnoses myasthenia and prescribes to patient an injection of proserin. What is typical action of this drug?

*A. Prevention of acetylcholine destruction.

B. Direct cholinomimetic.

C. Stimulation of metabolic processes.

D. Ganglion blocking.

E. Activation of acetylcholine synthesis.

30. A child poisoned with mushrooms, namely fly agarics, has been taken to a toxicological department. What drug should be used for emergency first of all?

*A. Atropini sulfas.

B. Papaverini hydrochloridum.

C. Unithiolum.

D. Natrii thiosulfas.

E. Dipiroxinum.

31. A child, 2-years-old, has drunk eye drops from the domestic first-aid kit. The child’s condition is poor, accompanied by transpiration and salivation, asthmatic breathing, cough, sharply miotic pupils, muffled heart sounds, bradycardia, low arterial pressure, intensive intestinal peristalsis, diarrhea. What is the drug which has caused the poisoning?

*A. Pilocarpini hydrochloridum.

B. Propranololum.

C. Atropini sulfas.

D. Platyphyllini hydrotartras.

E. Sulfacylum-natrium.

32. A victim treated plants with an insecticidal solution without personal protection equipment. After a while, salivation, transpiration, tears secretion, pain in the stomach, and diarrhoea began. Examination revealed miosis. What group does the substance, which has caused such symptoms, belong to?

*A. Organic compounds of phosphorus.

B. N-cholinomimetics.

C. Copper salt.

D. Nitrates.

E. Organic compounds of chlorine.

33. Having used eye drops, a patient with glaucoma has developed miosis and myopia, intraocular pressure has decreased. What group of drugs causes such effect?

*A. M-cholinomimetics.

B. M-cholinergic blockers.

C. -adrenergic blockers.

D. N-cholinomimetics.

E. Ganglionic blockers.

34. An 18-year-old unconsciousness patient was delivered to urgent unit with signs of dry skin and widened pupils. It is known, that patient has poisoned with berries of belladonna which containing M-cholinoblocker atropine. What drug should be prescribed to patient?

*A. Proserinum.

B. Adrenaline.

C. Pilocarpine.

D. Anaprilinum.

E. Platyphyllin.

35. A victim with acute poisoning by fly-agaric was delivered to urgent department. What drug should be prescribed to him?

*A. Atropine sulfate.

B. Dithylinum.

C. Diazolinum.

D. Furacilinum.

E. Omeprazole.

36. The agent which decreases intraocular pressure is prescribed to patient with glaucoma. Indicate this agent.

*A. Proserinum.

B. Noradrenaline.

C. Phenazepam.

D. Analginum.

E. Penicillin.

37. Paralysis of bladder muscles has developed in patient owing to surgery. What group of drugs should be prescribed to this patient?

*A. Cholinesterase inhibitors.

B. Diuretics.

C. Antibiotics.

D. Adrenoblockers.

E. Antianginal drugs.

M-Cholinoblocking Drugs

1. Laryngospasm and hypersalivation have developed in patient after introduction of thiopental sodium for initial anaesthesia. The previous introduction of what drug can prevent the development of these side effects?

*A. Atropine sulfate.

B. Proserinum.

C. Alloxime.

D. Pyrroxane.

E. Epinephrine hydrochloride.

2. A patient was delivered to emergency department with poisoning by mushrooms, among which fly-agaric has casually appeared. The injection of atropine sulfate was prescribed to patient except the gastric lavage, active carbon, saline laxative drugs, and infusion therapy. Name a type of interaction between the atropine and muscarine.

*A. Direct functional one-way antagonism.

B. Indirect functional antagonism.

C. Intermediary antagonism.

D. Chemical antagonism.

E. Physicochemical antagonism.

3. Nausea, vomiting, diarrhoea, and twitching of skeletal muscles developed in patient with myasthenia after administration of proserinum. What drug can eliminate these symptoms?

*A. Atropine.

B. Physostigmine.

C. Pyridostigmine bromide.

D. Isadrinum (isoprenaline).

E. Mesatonum (phenylephrine).

4. As a rule, the attacks of bronchial asthma develop in patient at night, and are accompanied by bradycardia, spastic pain of intestine, and diarrhoea. What group of drug can eliminate these symptoms?

*A. M-cholinoblockers.

B. N-cholinoblockers and blockers of H₂-histamine receptors.

C. -adrenoblockers.

D. -adrenoblockers.

E. Sympatholytics.

5. It is necessary to expand the pupils for examination of the eye fundus. Call the drug, which is used for this purpose in clinic.

*A. Atropine.

B. Pilocarpine.

C. Ezerinum.

D. Adrenaline.

E. Acetylcholine.

6. The drugs of this group are used for decrease of salivary glands secretion, prevention of laryngospasm, nausea, and bradycardia. Call this group.

*A. M-cholinoblockers.

B. Myorelaxants.

C. M-cholinomimetics.

D. Inhibitors of cholinesterase.

E. Cholinesterase regenerators.

7. Bronchospasm has developed in worker as a result of careless using of organophosphorus substances. What broncholytic should be used in this situation?

*A. Atropine.

B. Berotec (fenoterol).

C. Euphyllinum (aminophylline).

D. Adrenaline.

E. Ephedrine.

8. Atropine is used as antidote in case of poisoning with fly-agaric mushrooms. What is the mechanism of atropine action, which causes the elimination of toxic effects of muscarine?

*A. Competition for same receptors

B. Physico-chemical

C. Anti-enzymatic

D. Metabolic

E. Enzymatic

9. A 48-year-old male was delivered to urologic department with symptoms of renal colic. Choose a drug, which is most rational in this case.

*A. Atropine.

B. Morphine.

C. Analginum (metamizole).

D. Promedolum (trimeperidine).

E. Fenthanyl.

10. The decrease of salivation and expansion of pupils are developed in experimental animal after introduction of drug A. After following intravenous administration of acetylcholine the heart rate has not changed. Call the drug A.

*A. Atropine.

B. Adrenaline.

C. Anaprilinum (propranolol).

D. Proserinum.

E. Salbutamol.

11. A female with glaucoma asked the pharmacist with the request to give out to her eye drops with atropine sulfate. But pharmacist has explained her that this drug is contraindicated for her. Why atropine is contraindicated in glaucoma?

*A. It causes increase of intraocular pressure.

B. It causes paralysis of accommodation.

C. It causes expansion of pupils.

D. It reduces acuteness of vision.

E. It oppresses eye reflexes.

12. A patient was delivered to the hospital with the following symptoms: dizziness, thirst, impairment of swallowing, bad vision of near subjects. Patient has tachypnoe, expanded pupils, and excitement. The blood pressure is 110/70 mm Hg, heart rate is 110 per 1 minute. These symptoms testify overdose of:

*A. Atropine.

B. Morphine.

C. Ephedrine.

D. Aminazinum (chlorpromazine).

E. Caffeine.

13. Mydriasis and paralysis of accommodation have developed in patient after dropping into eyes the solution of drug A. Call the group, to which the drug A. concerns.

*A. M-cholinoblockers.

B. M-cholinomimetics.

C. Cholinesterase inhibitors.

D. -adrenomimetics.

E. -adrenomimetics.

14. A patient, who receives the treatment concerning bronchial asthma, also suffers from glaucoma. The drugs of which group are not recommended to this patient for treatment of asthma?

*A. M-cholinoblockers.

B. Adrenomimetics.

C. Miotropic spasmolytics.

D. Glucocorticoids.

E. Adrenoblockers.

15. Atropine sulfate was prescribed to patient for interruption of intestine colic. What disease is contraindication for administration of atropine?

*A. Glaucoma.

B. Bronchial asthma.

C. Node tachycardia.

D. Hypotension.

E. Dizziness.

16. A 6-year-old child was delivered to hospital with markedly expressed symptoms of psychomotor excitement, impairment swallowing, and hoarse voice. The skin is dry and hot. The pupils are expended. Tachycardia is observed. The doctor has established, that child had taken some berries of dark-violet colour. What substance is the cause of poisoning?

*A. Atropine.

B. Pirenzepine.

C. Pilocarpine.

D. Platyphyllin.

E. Metacinum.

17. It is necessary to prescribe M-cholinoblocker for patient who suffers from ulcer disease of stomach (with hyperacidic syndrome) and glaucoma. What drug may be prescribed to this patient?

*A. Metacinium.

B. Spasmolytinum (adiphenine).

C. Atropine.

D. Scopolamine.

E. Homatropine.

18. The increase of heart rate, mydriasis, and significant dryness of mucous membranes has developed in patient after introduction of atropine. What drug should be prescribed to patient for reduction of these symptoms?

*A. Proserinum.

B. Metacinium.

C. Salbutamol.

D. Ephedrine hydrochloride.

E. Strophanthine.

19. A 40-year-old male was delivered to the hospital with acute attack of hepatic colic, which is accompanied by sharp pain. What drug should be introduced first of all?

*A. Atropine.

B. Codeine.

C. Analginum (metamizole).

D. Pentazocine.

E. Morphine.

20. A patient with complaints of dryness in the mouth, photophobia, and vision violation was admitted to the reception-room. Skin is hyperemic, dry, pupils are dilated, tachycardia. Poisoning with belladonna alkaloids was diagnosed on further examination. What drug should be prescribed?

*A. Proserine.

B. Pilocarpine.

C. Armine.

D. Diazepam.

E. Dipyroxim.

21. A 50-year-old male farm worker has been brought to the emergency room. He was found confused in the orchard and since then has remained unconscious. His heart rate is 45 and his blood pressure is 80/40 mm Hg. He is sweating and salivating profusely. Which of the following should be prescribed?

*A. Atropine.

B. Proserine.

C. Physostigmine.

D. Noradrenaline.

E. Pentamine.

22. Pirenzepine was prescribed to a woman for stomach ulcer treatment. What pharmacological group can this medication be referred to?

*A. Selective M₁-cholinergic antagonists.

B. Acetylcholinesterase reactivators.

C. -adrenergic blockers.

D. Selective ₁-adrenergic blockers.

E. Local anaesthetics.

23. A patient with glaucoma appealed to a pharmacist with the request to give her atropine sulfate eye drops, but she was explained, that atropine sulfate is contraindicated in case of glaucoma. Why?

*A. It increases intraocular pressure.

B. It leads to a paralysis of accommodation.

C. It dilates pupils.

D. It reduces distance of vision.

E. It narrows the field of vision.

24. A doctor has been appealed to by a man who has preliminary been examined by an ophthalmologist. Patient complains of thirst and bad vision of close subjects. Objectively he demonstrates tachypnoea, mydriatic pupils, general excitation, garrulity, though the speech is obscure. Arterial pressure is 110/70, pulse is 110 per minute. The overdose of which drug can cause these symptoms?

*A. Atropini sulfas.

B. Morphini hydrochloridum.

C. Ephedrini hydrochloridum.

D. Aminazinum.

E. Coffeinum-natrii benzoas.

25. Sharp pain in the eye area of patient has developed after the use of atropine in eye drops during examination of the eye fundus. From anamnesis it became clear that patient suffers from mild form of glaucoma. Why atropine is contraindicative at glaucoma?

*A. Atropine increases intraoccular pressure.

B. Atropine causes paralysis of accommodation.

C. Atropine narrows pupils.

D. Atropine affects vision.

E. Atropine oppresses eye reflexes.

26. The victim with acute poisoning by fly-agaric was delivered to urgent department. What drug should be prescribed to him?

*A. Atropine sulfate.

B. Dithylinum.

C. Diazolinum.

D. Furacilinum.

E. Omeprazole.

27. A patient suffering from myasthenia has been administered proserin. After its administration the patient has got nausea, diarrhoea, twitch of tongue and skeletal muscles. What drug would help to eliminate the intoxication?

*A. Atropine sulfate.

B. Mesatonum.

C. Pyridostigmine bromide.

D. Isadrine.

E. Physostigmine.

28. A patient with drug intoxication presented with the dryness of oral mucous membrane and mydriatic pupils. Such action of this drug is associated with the following effect:

*A. Muscarinic cholinoceptor block.

B. Nicotinic cholinoceptor stimulation.

C. Adrenoceptor stimulation.

D. Muscarinic cholinoceptor stimulation.

E. Adrenoceptor block.

N-Cholinoblocking Drugs

1. The breathing does not restore more than 30 minutes after introduction of dithylinum (suxamethonium) to patient for performing of short operation. What is the aid for this patient?

*A. Blood transfusion.

B. Haemodialysis.

C. Haemosorption.

D. Peritoneal dialysis.

E. Forced diuresis.

2. A patient with fracture of the bottom jaw was delivered to the hospital. The myorelaxant was introduced to him for performing of operation. The short-term twitching of face muscles was observed after drug introduction. What drug was introduced to patient?

*A. Dithylinum (suxamethonium).

B. Tubocurarine chloride.

C. Pipecuronium.

D. Diazepam.

E. Mellictinum.

3. The symptoms of overdose of dithylinum have appeared in a patient during operation. What measure can decrease these symptoms?

*A. Blood transfusion.

B. Introduction of cholinesterase inhibitors.

C. Ganglion blockers.

D. M-cholinoblockers.

E. N-cholinoblockers.

4. The stopping of breathing had developed in a 42-year-old woman after operation on kidney with the use of dithylinum. Choose the drug which can restore the muscles tone.

*A. Blood plasma.

B. Proserinum.

C. Strychnine nitrate.

D. Caffeine.

E. Galantamine.

5. The curare-like drugs (myorelaxants) are used in clinic for decrease or stopping of impulse transmission from motor nerve endings to muscular cells. What is the mechanism of action of these drugs?

*A. Blockade of N-cholinoceptors of postsynaptic membrane.

B. Blockade of Ca²⁺ moving through channels of postsynaptic membrane.

C. Inhibition of Na⁺,K⁺-ATPase activity.

D. Inhibition of acetylcholinesterase.

E. Decrease of mediator releasing in synaptic cleft.

6. The breathing of patient is not restored after ending of operation with reposition of fractured bone of hip. What drug should be introduced to patient for elimination of relaxation?

*A. Proserinum.

B. Platyphyllin.

C. Cyclodolum.

D. Atropine.

E. Aceclidine.

7. A patient with dislocation of a humeral joint was delivered to hospital. For relaxation of skeletal muscles the doctor has introduced to him dithylinum. In norm this drug acts during 5–7 minutes. But in this patient the drug action lasted for 8 hours. What is probable cause of this phenomenon?

*A. Hereditary insufficiency of blood cholinesterase.

B. Decrease of microsomal enzymes activity.

C. Decrease of drug excretion.

D. Material cumulation.

E. Potentiation of effect by other drug.

8. It is necessary to prescribe the myorelaxation short-acting drug to patient for reposition of fractured bone of hip. Choose the drug.

*A. Dithylinum (suxamethonium).

B. Arduan.

C. Tubocurarine.

D. Decametonium.

E. Melictinum.

9. The operation with the use of tubocurarine was performed to patient with abdominal wound. In the end of operation after restoration of breathing, the doctor has administered gentamycine to patient. But unexpectedly the breathing stopped and skeletal muscles had relaxed. What effect is the base of this phenomenon?

*A. Potentiation.

B. Cumulation.

C. Tolerance.

D. Antagonism.

E. Sensibilization.

10. The relaxation of skeletal muscles and inhibition of breathing has lasted more than 2 hours in patient in the result of introduction of dithylinum. Indicate the enzyme, insufficiency of which in plasma is the cause of this phenomenon.

*A. Butyrilcholinesterase.

B. Catalase.

C. Acetylcholinesterase.

D. Glucose-6-phosphate dehydrogenase.

E. Glutathione peroxidase.

11. The introduction of dithylinum to patient with dislocation of a humeral joint has caused the apnoea. The doctor introduced proserinum to patient, but breathing is not restored. What substance should be introduced to this patient?

*A. Blood.

B. Galantamine.

C. Dipyroxime.

D. Isonitrosine.

E. Atropine.

12. Myorelaxant was introduced to patient for relaxation of skeletal muscles before reposition of bone fracture. This introduction has caused respiratory arrest. After introduction of fresh blood the breathing has restored. Call the myorelaxant, which was introduced to patient.

*A. Dithylinum.

B. Diplacinum.

C. Tubocurarine chloride.

D. Pipecuronium.

E. Pancuronium.

13. The signs of tubocurarine overdose have arisen in patient after operation. What drug group should be introduced to patient for elimination of overdose?

*A. Cholinesterase inhibitors.

B. Ganglion blockers.

C. Adrenomimetics.

D. M-cholinoblockers.

E. N-cholinoblockers.

14. Dithylinum (lysthenon) was introduced for tracheal intubation. After finish of operation the breathing did not restore. What enzyme insufficiency is the cause of this phenomenon?

*A. Butyrilcholinesterase.

B. Succinate dehydrogenase.

C. Carboangidrase.

D. N-acetyltransferase.

E. K, Na-ANPase.

15. Tubocurarine was introduced to patient for operation of resection of stomach. What drug should be introduced for restoration of breathing?

*A. Proserinum.

B. Dithylinum.

C. Cytitonum.

D. Aethimizolum.

E. Benzohexonium.

16. A patient with fracture of an average part of the femur with displacement was delivered to traumatologic department. For reposition of bone 10 ml of 2% dithylinum solution was introduced intravenously to patient. As a result of this the long apnoea and myorelaxation have developed. What enzyme insufficiency is the cause of this phenomenon?

*A. Butyrilcholinesterase.

B. Transferase.

C. Glucose-6-phosphate dehydrogenase.

D. Methemoglobin reductase.

E. N-acetyltransferase.

17. After a short-term operative intervention with the use of dithyline, for over 30 minutes a patient was noticed to have respiratory depression, previous muscle tone hasn’t restored. What assistance is it necessary to render to the patient?

*A. Blood or plasma transfusion.

B. Haemodialysis.

C. Haemosorption.

D. Forced diuresis.

E. Peritoneal dialysis.

18. Before an operative intervention a dithyline solution was injected to a patient and intubation was performed. After the operative intervention self-breathing hasn’t restored. What enzyme insufficiency in the organism of the patient predetermines such prolonged effect of the muscle relaxant?

*A. Pseudocholinesterase.

B. Succinate dehydrogenase.

C. Carbonicanhydrase.

D. N-acetyltranspherase.

E. Na⁺, K⁺-ATP-ase.

19. Tubocurarine chloride was applied to a patient under combined narcosis as a muscle relaxant while performing the resection of the stomach. What antagonist should be injected to the patient to restore spontaneous breathing?

*A. Proserinum.

B. Dithylinum.

C. Cytitonum.

D. Aethimizolum.

E. Benzohexonium.

20. To a patient with femoral bone fracture with the purpose of reduction of the tone of cross-striated muscles with reposition of bone fragments it is necessary to prescribe muscle relaxant of short-term action. What drug is expedient for prescribing to the patient?

*A. Dithylinum.

B. Arduan.

C. Tubocurarini chloridum.

D. Pirilenum.

E. Mellictinum.

21. During an operative intervention with additional use of hygronium the patient’s arterial pressure has sharply decreased. What groups of drugs can normalize arterial pressure in the given situation?

*A. -adrenomimetics.

B. -adrenergic blockers.

C. Ganglionic blockers.

D. M-cholinoblockers.

E. N-cholinomimetics.

22. Symptoms of dithyline overdose appeared during an operative intervention. What actions will be expedient to reduce the phenomena of overdose?

*A. Transfusion of blood or plasma.

B. Introduction of anticholinesterase drugs.

C. Introduction of ganglionic blockers.

D. Introduction of M-cholinergic antagonist.

E. Introduction of N-cholinergic antagonist.

23. For the abatement or termination of excitation transmission from the nervous ending to the muscular fiber curare-like substances – muscle relaxants – are clinically used. What is the mechanism of action of this therapeutic agents group?

*A. Blockade of postsynaptic membrane N-cholinergic receptors of the myoneural junction.

B. Blockade of calcium ions passing through the channels of the presynaptic membrane.

C. Inhibition of Na⁺, K⁺-pumps activity.

D. Depression of acetylcholinesterase.

E. Reduction of mediator elimination into the synaptic cleft.

24. A 45-year-old female is delivered to urgent unit. It is necessary to perform trachea intubation. What drug should be used in this case?

*A. Dithylinum.

B. Nitroglycerin.

C. Metronidazole.

D. Atropine sulfate.

E. Gentamycin.

25. A patient with a limb fracture must be administered depola-rizing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it?

*A. Dithylinum.

B. Pentaminum.

C. Tubocurarine chloride.

D. Atropine sulfate.

E. Cytitonum.