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Pharmacology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What does Spironolactone block?

A

Na+ channals (amloride, nitroprussin)

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2
Q

What does Mannitol alter?

A

It alters osmolarity of blood and urine

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3
Q

What is a direct acting vasodilator?

A

Nitroprusside (lowers BP produces NO)

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4
Q

What does Amiloride block?

A

It blocks Na+ channels

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5
Q

What does Minoxidil do?

A

Increases hair growth (ACE inhibitor and lowers BP)

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6
Q

What is a target of aliskiren?

A

Renin

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7
Q

What is a target of losartan?

A

Angiotensin 2 receptors

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8
Q

What is a potent vasoconstrictor?

A

Angiotensin 2

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9
Q

What do thiazides do?

A

Prevents resorption of sodium in distal tubule and blocks NaCl cotransportor

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10
Q

What is a target of captopril?

A

Angiotensin converting enzyme

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11
Q

Given IV, produces a transient increase in blood volume?

A

Mannitol

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12
Q

If a patient has angina:

A

It could be relieved with nitroglycerin.

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13
Q

Calcium channel blockers:

A

Can be used to halt weakly conducted circular action potentials originating in the SA or AV node.B.

Can be used to dilate vascular smooth muscle.

Can reduce the ability of the heart muscle to develop contractile force.

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14
Q

Dobutamine

A

Acts to stimulate beta 1 adrenergic receptors at the heart.

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15
Q

Mannitolcan:

A

Mobilize water from the intracellular compartment into the bloodstream

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16
Q

Digoxin

A

Inhibits the Na+/K+ ATPase in heart cells.

Can increase the Ca++ levels inside heart muscle cells.

Can produce fatal arrhythmias.

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17
Q

Reserpine

A

Reduces the ability of SNS nerve terminals to release norepinephrine.

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18
Q

Captopril

A

Is an inhibitor of angiotensin 2 production.

Can produce fetal malformations and is contraindicated

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19
Q

Quinidine

A

Blocks Na+ channels in ischemic heart cells.

Can block the K+channels that repolarize the heart cells at the end of the action potential.

Can lengthen the action potential in heart cells.

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20
Q

Captopril

A

Reduces fluid retention and lowers blood pressure.

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21
Q

Furosemide

A

Reduces central venous pressure and reduces blood pressure.

Reduces fluid levels in the body and can be used to relieve edema.

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22
Q

Thiazides

A

Can cause a loss of K+ in the blood.

Can reduce urine output in nephrogenic diabetes insipidus.

Can cause a reflex change in renin levels, producing a problem that could be addressed by administration of spironolactone.

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23
Q

A drug that blocks NaCl resorption in the distal tubule?

A

A thiazide diuretic

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24
Q

Clonidine

A

Will reduce the amount of norepinephrine released by postsynaptic SNS nerve terminals.

Will produce a reduction in heart rate and force of contraction.

Will produce peripheral vasodilation.

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25
Q

Aliskiren

A

Will block the pathway leading to formation of

angiotensin 2, thus producing a fall in blood pressure.

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26
Q

Amiloride

A

Can be used to reduce a side effects caused by thiazides

Blocks the Na+ resorption caused by aldosterone

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27
Q

Furosemide

A

Reduces water resorption in the loop of Henle, but also at the collecting tubule.

Blocks the transport of Na+, K+and Cl-in the thick ascending limb of Henle.

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28
Q

Furosemide inhibits?
decreases?
produces?

A

Inhibits resorption of Ca++and Mg++from the nephron back into the blood.

Can be used to decrease total fluid volume and central venous pressure, allowing fluid accumulated in the tissues to more easily drain back into the veins.

Can produce a loss of serum potassium.

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29
Q

Amiodarone

A

Can be used to block heart arrhythmias

Can lengthen the action potential in the heart, prolonging the refractory period

30
Q

To increase cardiac efficiency and slow the progression of heart failure one could:

A

Add captopril –this would act to reduce vasoconstriction and reduce cardiac stretching during diastole.

Reduce stretching of the heart by adding a diuretic such as furosemide.

Add propranolol to slow the heart rate.

31
Q

Sotalol and bretylium are drugs that work by the same mechanism. They:

A

Block K+channels needed to repolarize the heart after an action potential.

32
Q

Minoxidil

A

Can be used to reduce blood pressure

33
Q

Calcium channel blockers

A

Can lower blood pressure and can be used to treat ischemic heart disease

34
Q

Nitroglycerin

A

Produces nitric oxide (NO) and relaxes vascular smooth muscle.

Reduces preload on the heart by dilating the great veins.

Reduces heart afterload by dilating arterioles.

35
Q

Ivabradine

A

Blocks the Na+ channels that produce the “funny current”, reducing automaticity and slowing heart rate.

36
Q

Prazosin

A

Alpha adrenergic antagonist

37
Q

Funny current channels

A

Ivabradine

38
Q

Lidocaine

A

Blocks Na+ channels in the heart and can produce numbness

39
Q

Direct acting vasodilator that can lower heart contractility

A

Ca++ channel blockers

40
Q

Target of aliskiren

A

renin

41
Q

Target of losartan

A

Angiotensin 2 receptors

42
Q

Target of propranolol

A

Beta adrenergic receptors at the juxtaglomerular apparatus.

43
Q

Nitroprusside produces a reflex that would?

A

be blocked by a drug such as propranolol

also it lowers blood pressure; in turn triggering reflex increases in sympathetic nervous system activity.

Hypertensive emergency (HTN)

44
Q

What does propranolol decrease?

A

B ant: decreases HR, BP and contractility

45
Q

Aliskiren is:

Is an antagonist at alpha 2 adrenergic receptors

Ineffective orally because of first pass clearance

a direct acting vasodilator that blocks receptors in the veins

all of the above

none of the above

A

None of the above

46
Q

Prazosin:

A. can be used to lower blood pressure

B. Will block alpha 1 adrenergiv receptors

C. is especially dangerous in patients with low serum potassium levels.

D. A and B

E. A and C

A

D. A and B

47
Q

Reserpine

A. Decreases arrhythmias stemming from Ca+ 2 transients

B. Is a direct acting vasodilator acting on vascular smooth muscle cells.

C. Will reduce heart rate and vascular resistance.

D. Is an indirect agent that releases norepinephrine from nerve terminals.

E. None of the above.

A

answer is C

D. Is an indirect agent that blocks norepinephrine from nerve terminals.

48
Q

Clonidine

A. Is a drug used to lower blood pressure

B. Will reduce the activity of the sympathetic nervous system.

C. Activates a set of alpha adrenergic receptors.

D. All of the above

E. None of the above

A

D

49
Q

Quinidine:

A. Lowers blood pressure.

B. Increases peripheral resistance.

C. Is a Na+ channel blocker

D. All of the above.

E None of the above

A

C. is a Na+ channel blocker

50
Q

Lidocaine:

A. Can wipe out circus arrhythmias.

B. Can change a poorly conducted action potential into a non-conducted action potential.

C. Binds preferentially to inactive sodium channels in ischemic tissues.

D. All of the above.

E. None of the above.

A

D. All of the above

51
Q

Captopril:

A. Is an antagonist at peripheral alpha receptors, and blocks the effect of the sympathetic nervous system.

B. Lowers blood pressue by depleting nerve terminals of catecholamines.

C. Is an agonist at alpha 2 receptors in the central nervous system that decreases the activity of the sympathetic nervous system.

D. Blocks B adrenergic receptors in the periphery.

E. Prevents the production of angiotensin 2, leading to both vasodilation and a decrease in fluid load.

A

The answer is E. ACE inhibitors end in -pril

This would be clonidine-
C. Is an agonist at alpha 2 receptors in the central nervous system that decreases the activity of the sympathetic nervous system.

This would be Propranolol-
D. Blocks B adrenergic receptors in the periphery.

52
Q

Minoxidil:

A. Forms crystalline deposits that can be observed in the patients cornea

B. Relaxes vascular smooth muscle cells, reducing patient blood pressure

C. Opens K+ channels in vascular smooth muscle, hyperpolarizing the cells.

D. A and C

E. B and C

A

E. B and C

Minoxidil opens K+ hyperpolarizes

53
Q

Your professor takes on a job as a tour guide in the mohave desert. He decides to try living off the land. Unfortunately he is clueless, and quickly runs out of water. You find hime alive but dehydrated. Under this circumstance of reduced fluid volume and reduced central venous pressure you expect:

A. His cardiac output would be reduced due to lower central venous pressure.

B. His sympathetic nervous system will be activated, increasing heart rate. This increased heart rate could be reduced by clonidine or reserpine.

C. He will have elevated renin levels. The effects of elevated renin could be blocked by aliskiren.

D. A and B.

E All of the above

A

E

54
Q

Calcium channel blockers include the drugs nifedipine, nitrendipine, and verapamil. Various members of the large group of Ca++ channel blockers:

A. Increase cardiac output by increasing the force of contraction.

B. Can decrease myocardial contractility, reducing force of contraction.

C. Are used to increase GI motility in combination with a weak acting opiod.

D. A and B.

E B and C

A

B

55
Q

Calcium channel blockers and Beta adrenergic antagonist might be used together in combination because:

A. The two drugs are synergistic in stimulating cardiac output.

B. In treating angina, the decrease in blood pressure caused by the Ca++ channel blocker would trigger relex tachycardia. This counterproductive response would be blocked by propranolol.

C. The drugs are used together to dilate smooth muscle in the lungs.

D. A and C

E. B and C.

A

B

56
Q

A patientis given furosemide and digoxin. THere is something that furosemide and digoxin will both do to help with congestive heart failure.

A. Both stimulate adrenergic receptors in the blood vessels, restoring blood pressure.

B. Reduce fluid load, relieving edema, and decreasing cardiac stretching during diastole.

C. Increase cardiac contractility, producing a net increase in cardiac output and a decrease in fluid load.

D. B and C

E reverses diabetes insipidus.

A

The answer is B.

E reverses diabetes insipidus.- A thiazide diuretic, such as chlorthalidone or hydrochlorothiazide, can be used to create mild hypovolemia which encourages salt and water uptake in proximal tubule and thus improve nephrogenic diabetes insipidus

57
Q

Nitroglycerin:

A. Is used to reduce fluid load, blocking type 3 pumps int he nephron.

B. Is used to treat heart failure by blocking the Na+/K+ ATPase.

C. Is a calcium channel blocker that dilates vascular smooth muscle.

D. Is used to treat supra ventricular arrhythmias by blocking Na+ channels.

E. Is used to treat angina because it produces general vasodilation, reducing preload and after load. This reduces myocardial oxygen demand.

A

The answer is E.

This would be Digoxin-
B. Is used to treat heart failure by blocking the Na+/K+ ATPase.

58
Q

Albuterol is a beta adrenergic agonist that is largely specific for beta 2 adrenergic receptors. THis is used in inhaler therapy for asthma. A possible advantage of a beta-2 specific agonist in theis setting might be:

A. The albuterol would be more specific for the target beta-2 adrenergic receptors in the bronchioles and would tend to leave other beta receptors such as those in the heart unaffected.

B. Beta 2 agonists have longer half-lives, making dosing easier.

C. Beta 2 agonist are new generation drugs, and are safer.

D. All of the above.

E. None of the above.

A

A

59
Q

Amiodarone:

A. Forms crystalline deposits that can lead to side effects including pulmonary fibrosis.

B. Relaxes vascular smooth muscle cells, reducing patient blood pressure.

C. Opens K+ channels in vascular smooth muscle, hyperpolarizing the cells.

D. A and C.

E. B and C.

A

A.

60
Q

Sodium Nitroprusside:

A. Is a centrally acting alpha adrenergic agonist.

B. Produces a relex decrease in heart rate and cardiac output

C. Blocks alpha adrenergic receptors at the periphery.

D. Produces nitric oxide, which causes blood vessels to dilate.

E Blocks the sympathetic nervous system.

A

D

61
Q

Rebound hypertension:

A. Is a type of arrhythmia characterized by bounding increases in blood pressure. It is best treated with an adrenergic antagonist.

B. Is a situation in which withdrawal of an antihypertensive medication produces an increase in blood pressure to a level that exceeds the original hypertensive state.

C. Is a form of oscillation in blood pressure characterized by lower pressure at night. and rebounds during the day.

D. Is common with spironolactone.

E. None of the above.

A

B.

Spironolactone would commonly used with propranolol or clonidine.

62
Q

ACE inhibitors, vasodilators, and diuretics can be given together in different combinations:

A. This will reduce preload, and thus reduces stretching of the heart. This is useful in treating heart failure.

B. The use agents that block the renin-angiotensin system would be a concern during pregnancy because captopril causes brain defects in developing fetus.

C. This combination of drugs directly increases myocardial contractility and increases exercise tolerance in heart failure.

D. This combination of drugs alters Na+ and Ca++ homeostasis, leading to an inhibition of the Na+?Ca++ transporter in the heart cell. This increases cardiac muscle contractility by increasing intracellular Ca++

E. A and B

A

E.

63
Q

Causes hyperglycemia that may aggravate diabetes mellitus

A. allopurinol

B. Sulfinpyrazone.

C.Mannitol

D. colchicine

E. none of the above.

A

E

64
Q

Used to treat nephrogenic diabetes insipidus:

A. Hydrochlorothiazide

B. ethacrynic acid

C. Aspirin

D. desmopressin

A

A

65
Q

Reduces uric acid concentration in the blood:

A. Aspirin

B. Allopurinol

C. bumetanide

D. captopril

A

Allopurinol or thiazides

66
Q

Ototoxicity (toxic to the ear) is an adverse effect:

Spironolactone

Methylclothiazide

Furosemide

Triamterene

A

Furosemide

67
Q

Causes hyperkalemia and metabolic acidosis:

A. polythiazide

B. Furosemide

C. Spironolactone

D. Mannitol

E. Probenecid

A

Spironolactone

Diuretics that increase K+ are Ameloride, Mannitol and spirnolactone

Diuretics that decrease K+ are furosemide and thiazides

68
Q

Most common clinical indication for thiazide diuretics:

A. essential hypertension

B. neurogenic diabetes insipidus

C. gout

D. diabetes mellitus

E. hyperaldosteronism

A

A

can also be used for diabetes but htn is most common

69
Q

Inhibits reabsorption of uric acid from the nephron:

A. Cyclothiazide

B Triamterene

C. Mannitol

D. ethacrynic acid

E. Probenecid

A

E

70
Q

T or F

Dobutamine acts as an agonist at beta adrenergic receptors in the heart.

A

True

Heart failure drug

alpha 1 antagonist and Beta agonist

71
Q

Teratogen

A

contraindicated in pregnancy

angiotensin 2

Pharmacology (5 decks)

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