Drug MOA's

Question 1

ASA

Answer 1

in small doses blocks thromboxane a2, potent platelet aggregate and vasoconstrictor
decreased platelet aggregation

Question 2

adenosine

Answer 2

slows conduction time through AV node, can interrupt re entrant pathways through AV node
slows sinus rate
larger doses decrease bp by decreasing peripheral resistance

Question 3

albumin normal serum

Answer 3

exerts oncotic pressure, which expands volume of circulating blood and maintains cardiac output

Question 4

albuterol

Answer 4

beta agonist primarily b2, relaxes bronchial smooth muscle, resulting in bronchodilation, also relaxes vascular and uterine smooth muscle, decreases airway resistance

Question 5

amiodarone

Answer 5

multiple effect on NA K and CA channels
prolongs action potential, refractory period
ventricular automaticity K
slows membrane depolarization and impulse conduction NA
negative chronotropic activity in nodal tissue, rate reduction, and antisympathetic acticity CA and Beat blockade
dilates coronary arteries DA Alpha blockade

Question 6

atropine pharmacological

Answer 6

blocks action of ACH as competitive antagonist at muscarinic sites in smooth muscle secretory gland, and CNS
blocks parasympathetic response allows sympathetic to take over
increase in cardiac output, drying of secretions

Question 7

atropine clinical

Answer 7

CV: +chrono, +dromo, slight +ino, increased cardiac output
Resp: decreased mucus production, bronchodilation
GI: decreased secretion, motility
GU: decreased urinary bladder tone
Misc: mydriasis decreased sweat production

Question 8

bumetanide

Answer 8

inhibity electrolyte reabsorption in ascending loop of henle leading to diuresis

Question 9

calcium chloride

Answer 9

increases ECF ICF calcium levels
stimulates release of catecholamines
\+ino
may enhance ventricular automaticity
inhibits effects of adenosine on mast cells

Question 10

calcium gluconate gel

Answer 10

neutralizes hydrofluoric acid to form calcium fluoride

helps stop fluoride ion from penetrating tissue and bone

Question 11

activated charcoal

Answer 11

pharmacological: physical binding of toxins from GI tract
clinical: prevents/reduces systemic absorption of toxins

Question 12

cimetidine

Answer 12

competitively inhibits action of histamine at h2 sites of parietal cells decreasing gastric acid secretion

Question 13

dexamethasone sodium phosphate

Answer 13

improves lung function and myocardial performance

decrease in pulmonary edema, relaxation of bronchospasm

Question 14

D50

Answer 14

pharm: aerobic metabolic substrate
clinical: reverses CNS effects of hypoglycemia by rapidly increasing serum glucose levels
provides short term osmotic diuresis

Question 15

diazepam

Answer 15

works on parts of limbic system, thalmus, and hypothalamus producing calming effects
increases seizure threshold
transient analgesia
amnesic
sedative

Question 16

diltiazem

Answer 16

pharm: inhibits calcium ion influx during cardiac depolarization, decreases SA and AV conduction and dilates coronary and peripheral arteries and arterioles
clinical: slows rapid ventricular rate associated with a-fib and flutter, reduces coronary and peripheral vascular resistance

Question 17

diphenhydramine

Answer 17

blocks histamine receptors
decreased capillary permeability and decreased vasodilation, prevention of bronchospasm
some anticholinergic effects

Question 18

dopamine 1-2 mcg

Answer 18

dopaminergic receptors to stimulate cerebral renal and mesenteric vasodilation, HR BP usually unchanged

Question 19

dopamine 2-10 mcg

Answer 19

B1 receptors, increased cardiac output, modest increase in SVR

Question 20

dopamine 10-20 mcg

Answer 20

a adrenergic effects, renal mesenteric peripheral arterial and venous vasoconstriction, marked increase in SVR, pulmonary vascula resistance, further increased preload

Question 21

dopamine >20 mcg

Answer 21

effects similar to norepi, may increase HR and o2 demand to undesirable levels

Question 22

epi pharmacological

Answer 22

A&B agonist, A-increased SVR, B1- +inotropic and chronotropic increases automaticity and irritability
B2- bronchodilation, dilation of skeletal vasculature

Question 23

epi clinical

Answer 23

cardiac arrest- increases cerebral and myocardial perfusion pressure, increases bp, increases electrical activity in myocardium
bradycardia- +chrono, increases bp,
reverses s/s of bronchospasm and anaphylaxis

Question 24

etomidate

Answer 24

produces hypnosis rapidly causing CNS depression and anesthesia, no analgesic effect

Question 25

fentanyl citrate

Answer 25

alleviates pain by acting on pain receptors in brain, elevates pain threshold depresses CNS, depresses brainstem respiratory centers increases venous pooling, vasodilates arterioles thus reducing preload and afterload

Question 26

furosemide

Answer 26

pharm: inhibits NA K chloride reabsorption in ascending loop of henle, venous pooling and decreased afterload clinical: diruesis

Question 27

glucagon pharmacological

Answer 27

acts only on liver glycogen, converting it to glucose, counteracts effects of insulin, relases gi smooth muscle causing dilation and decreased motility cardiac inotrope

Question 28

glucagon clinical

Answer 28

may reverse hypoglycemia within 4 mins

Question 29

hydroxocobalamin

Answer 29

binds to cyanide ions

Question 30

ipratropium bromide

Answer 30

anticholinergic agent, antagonizes action of ACH

Question 31

ketamine

Answer 31

produces dissociative anesthesia minimal cardiac depression bronchodilator, respiratory stimulation frequently seen

Question 32

lidocaine

Answer 32

decreases automaticity by slowing rate of spontaneous phase 4 depolarization terminate re-entry by decreasing conduction in re-entrant pathways increases v-fib threshold

Question 33

lorazepam

Answer 33

high afinity for GABA benzo receptor without displacing GABE | exerts tranquilizing action on CNS

Question 34

magnesium sulfate

Answer 34

decreases myocardial irritability and neuromuscular irritability reduces ventricular irritability inhibition of muscular excitability

Question 35

solu-medrol

Answer 35

thought to stabilize cellular and intracellular membranes

Question 36

midazolam

Answer 36

CNS effects mediated through GABA acts on limbic, thalamic, and hypothlamic levels of CNS producing anxiolytic, sedative, hypnotic, and anticonvulsant effects capable of producing all levels of CNS depression, from mild sedation to coma

Question 37

morphine

Answer 37

acts on pain receptors in brain, elevates pain threshold depresses CNS, respiratory centers venous pooling, vasodilates arterioles, reducing preload and afterload histamine release

Question 38

nitro

Answer 38

``` smooth muscle relaxant on vascular, uterine, bronchial, and intestinal smooth muscle decreases preload and afterload coronary artery vasodilation increases blood flow to myocardium decreases myocardial o2 demand ```

Question 39

norepi

Answer 39

stimulates b1 and a1 receptors causing vasoconstriction, increased bp, enhanced contractility and decreased heart rate

Question 40

ondanestron

Answer 40

selectively blocks serotonin 5-HT3 receptors located in CNS at chemoreceptor trigger zone and in peripheral nervous syste on nerve terminals of vagus nerve

Question 41

oxytocin

Answer 41

binds to oxytocin receptor sites on surface of uterine smooth muscles, increases force and frequency of uterine contractions

Question 42

propofol

Answer 42

produces effects by positive modulation of GABA through ligand-gated GABA receptors

Question 43

sodium bicarbonate

Answer 43

buffers H+ and increases PH

Question 44

succinylcholine

Answer 44

combines with cholinergic receptors of the motor end plate to produce depolarization hydrolyzed by ACHe

Question 45

vasopressin

Answer 45

causes vasoconstriction of peripheral, cerebral, pulmonary, and coronary vessels

Question 46

verapamil

Answer 46

blocks calcium ion influx results in negative inotropy coronary and peripheral vasodilation slows conduction and prolongs refractory period in AV node slows SA discharge in summary, decreases myocardial contractile force and slows AV conduction