Antihypertensives/Beta Blockers

Question 1

labetalol nonselective β-1 effects

Answer 1

decreases HR and contractiliity

Question 2

labetalol nonselective β-2 effects

Answer 2

vasodilation

Question 3

where is labetalol selective

Answer 3

α-1 adrenergic agoist

Question 4

what does labetalol cause at α-1 receptors

Answer 4

arterial vasodilation

Question 5

labetalol blockade ratio

Answer 5

1 α to 7 β

Question 6

labetalol uses

Answer 6

acute and chronic HTN in pregnant pts, treat increases in BP and HR from stimulation (intubation)

Question 7

how does labetalol cause ↓ BP

Answer 7

decreased CO and PVR, can depress cardiac contractility, minimally affects CBP or ICP

Question 8

when is labetalol contraindicated

Answer 8

bronchospastic disease → impaired cardiac conduction or underlying resting bradycardia

Question 9

labetalol dose

Answer 9

5-20 mg boluses IV

Question 10

labetalol onset

Answer 10

1-2 min

Question 11

labetalol duration

Answer 11

up to 6 hrs

Question 12

esmolol mechanism of action

Answer 12

Rapid-onset and short-acting selective Beta-1 antagonist

Question 13

esmolol uses

Answer 13

treat perioperative tachycardia, pre-treatment during intubation/extubation

Question 14

esmolol ♡ effects

Answer 14

Decrease in HR, myocardial contractility, CO , and some decrease in BP, with no rebound effects

Question 15

when is esmolol contraindicated

Answer 15

bradycardia
heart block
cardiogenic shock
heart failure

Question 16

esmolol dose

Answer 16

10mg boluses IV
infusions of 50 mcq/kg/min after a .5mg/kg bolus

Question 17

esmolol onset and duration

Answer 17

rapid onset; 10-15 min duration

Question 18

how is esmolol metabolized

Answer 18

by plasma esterases

Question 19

propranolol class

Answer 19

non selective β-1 and β-2 antagonist

Question 20

propranolol uses

Answer 20

HTN, angina, acute MI, pheochromocytoma, treat anxiety and panic attacks

Question 21

how does propranolol work

Answer 21

Decreases BP due to decrease in myocardial contractility, HR, CO therefore decrease in myocardial oxygen demand

Question 22

propranolol cautions in

Answer 22

bronchospastic disease, AV block, and bradycardia

Question 23

propranolol dose

Answer 23

1-3 mg IV (no more than 1 mg/min), titrated to effect

Question 24

propranolol onset

Answer 24

2-3 min

Question 25

propranolol duration

Answer 25

4-6 hours

Question 26

metoprolol class

Answer 26

selective β-1 adrenergic receptor antagonist

Question 27

metoprolol mechanism of action

Answer 27

prevents inotropic and chronotropic responses to β- stimulation

Question 28

metoprolol uses

Answer 28

rapid HR and contractility control, CO and therefore decrease BP, treatment for MI

Question 29

metoprolol dose

Answer 29

1-5 mg IV up to 15 mg

Question 30

metoprolol half life

Answer 30

3-4 hours

Question 31

vasopressin is also known as

Answer 31

antidiuretic hormone

Question 32

where is vasopressin released in the body

Answer 32

the posterior pituitary

Question 33

vasopressin receptors and effects

Answer 33

V1- CV effects V2- renal V3- pituitary receptors

Question 34

vasopressin uses

Answer 34

cardiac arrest (removed from ACLS algorithm), sepsis, shock and hypotension secondary to ACE inhibitors refractory to catecholamines or sympathomimetics

Question 35

vasopressin dose

Answer 35

mix I0/20 units/ml in a 10/20 ml syringe to get 1 unit/mL concentration

Question 36

vasopressin dose

Answer 36

1-2 unit bolus

Question 37

vasopressin is a ____________

Answer 37

potent vasoconstrictor (arterial and mesenteric)

Question 38

hydralazine mechanism of action

Answer 38

direct systemic arterial vasodilator

Question 39

how does hydralazine work

Answer 39

causes relaxation of arterial smooth muscle; blocks calcium release from sarcoplasmic reticulum; decreases BP with **increase** in HR, SV, and cardiac output

Question 40

hydralazine uses

Answer 40

HTN, heart failure, eclampsia

Question 41

hydralazine can cause

Answer 41

increased ICP

Question 42

when is hydralazine contraindicated

Answer 42

in coronary artery disease

Question 43

hydralazine dose

Answer 43

2.5-5 mg IV titrated q 20-30 min

Question 44

hydralazine onset

Answer 44

15-30 min

Question 45

hydralazine duration

Answer 45

4-6 hrs

Question 46

which drug is contraindicated in bronchospastic disease?

Answer 46

labetalol

Question 47

which drug is used to treat pheochromocytoma?

Answer 47

propanolol

Question 48

which drug should be used carefully in bronchospastic disease?

Answer 48

propanolol

Question 49

which drug can be used for hypotension secondary to ACE inhibitors refractory to catecholamines or sympathomimetics?

Answer 49

vasopressin

Question 50

which drug decreases blood pressure with an increase in HR

Answer 50

hydralazine

Question 51

which drug is contraindicated in CAD

Answer 51

hydralazine