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Advanced Pharmacology ANE 8433 (Spring 2023) > Exam 4 Adjuncts > Flashcards

Exam 4 Adjuncts Flashcards

(60 cards)

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1
Q

Beta receptors activate ____ to produce ___?

A

Adenylyl cyclase & cAMP

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2
Q

Chronic use of beta antagonists leads to?

A

Upregulation of receptors

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3
Q

Besides decreasing CO, beta antagonists also ____?

A

Inhibit renin release

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4
Q

Which phase of the cardiac cycle do beta blockers affect?

A

Phase 4, decrease the in slope

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5
Q

What medication would be given for thyrotoxicosis?

A

Beta antagonist

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6
Q

Under the SCIP, who receives a beta blocker & when would they not?

A
  • Pt’s at risk for MI & already on beta blocker.
  • Do not give if HR <60
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7
Q

75% of beta receptors are ___ & located in ___?

A

B1 & myocardium

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8
Q

Which beta blocker is not cardiac selective?

A

Propranolol

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9
Q

Which B1 antagonist is cleared via plasma hydrolysis?

A

Esmolol

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10
Q

Metoprolol is cleared via___ & atenolol is cleared via___?

A
  • Hepatic
  • renal
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11
Q

Which beta blocker has the longest E1/2 & what is it?

A

Atenolol & 6-7hrs

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12
Q

Which beta blocker has the smallest volume of distribution?

A

-Propranolol.
- It has high protein binding.

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13
Q

What are the IVP doses for Metoprolol, Atenolol & Esmolol?

A
  • Metoprolol: 1 mg q5min for 5mg total (repeat PRN)
  • Atenolol: 5-10 mg q 10min
  • Esmolol: 10-80 mg
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14
Q

How does Inderal affect opioids & LA’s?

A

It decreases their clearances

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15
Q

What lasts longer with Inderal, negative inotropy or negative chronotropy?

A

Negative chronotropy

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16
Q

What is the most selective B1 blocker?

A

Atenolol

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17
Q

What is the onset & offset of Esmolol?

A

5mins & 30mins

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18
Q

What meds can lead to negative side effects with Esmolol, or other beta blockers & what are they?

A

Cocaine & epinephrine. Can lead to pulmonary edema & CV collapse

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19
Q

What secondary messenger is synthesized with alpha-1 agonists?

A

IP3

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20
Q

Alpha-1 agonists determine what 3 things?

A
  • Arteriolar resistance
  • venous capacity
  • BP
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21
Q

Alpha-2 agonists do what with norepinephrine?

A

Decrease presynaptic NE release in the brain stem

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22
Q

Where does phenylephrine have its affects?

A
  • Venous constriction
  • Indirectly releasees NE
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23
Q

Increased amounts of Neo could lead to?

A

Reflex bradycardia

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24
Q

Labetalol has what kind of ratio?

A

7:1 beta to alpha blocking

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25
What receptors are affected by Labetalol?
- Selective alpha-1 - Beta-1 & 2
26
What is the IVP dose for Labetalol?
2.5 - 5 mg
27
What can possibly increase the time for a Pt to come off bypass?
Prolonged beta-1 blockage
28
What receptors & how (+/-) does dobutamine affect?
- Alpha-1 & 2 (+) - beta-1 (++++) - beta-2 (++)
29
Sympathomimetics lacking Beta-1 specificity may lead to?
Reflex-mediated bradycardia
30
What are the direct acting sympathomimetics?
Epi, NE, phenylephrine, dopamine
31
What are the indirect-acting sympathomimetics?
Ephedrine & Neo just a bit
32
Which sympathomimetic has the highest alpha selectivity?
Phenylephrine
33
Which sympathomimetic results in the highest CO?
Epinephrine
34
Which sympathomimetic results in the highest PVR increase?
Neo
35
What affects does vasopressin have on CO, HR & PVR?
- Increases CO & PVR. - No effect on HR
36
What is a downside to ephedrine?
Increased tachyphylaxis
37
What is the preferred sympathomimetic in pregnancy & why?
- Ephedrine - Does not affect uterine blood flow
38
How does vasopressin assert its affects?
Causes arterial vasoconstriction
39
What two hypotension examples is vasopressin ideal for?
- Catecholamine-resistant hypotension - ACEi resistant hypotension
40
What are the side effects of vasopressin?
- Coronary artery constriction - Abd pain, N/V - decreased Plt count
41
What secondary messenger is released from nitric oxide?
cGMP inhibits calcium entry into smooth muscle
42
How do nitro-vasodilators assert their effects?
Decreasing SVR & venous return
43
What kind of vasodilator would be beneficial in someone with pulmonary congestion?
Nitroglycerin or nitroprusside
44
What is the infusion dose for nitroprusside?
- 0.3 mcg/kg/min - up to 2 mcg/kg/min
45
Where does nitroprusside work?
Mostly arterial smooth muscle but also venous smooth muscle
46
What are some signs of cyanide toxicity?
- Increased SvO2 - metabolic acidosis - CNS dysfunction/LOC changes
47
Where does nitroglycerin act on?
Venous capacitance vessels & large coronary arteries
48
What are 4 indications for nitroglycerin use?
- Acute MI - controlled HTN - sphincter of Oddi spasm - retained placenta
49
What is the onset, ½ life & initial IV dose for hydralazine?
- Onset 1hr - ½ life: 3-7hrs - dose 2.5 mg IV
50
Which CCB type is selective for arteriolar beds?
Dihydropyrimidines
51
What are the effects of CCB’s?
- Decrease SVR & systemic BP - increase coronary blood flow - decrease dromotropy thru AV node
52
Which 2 CCB’s could potentially increase the HR?
Nifedipine & Nicadipine
53
Which CCB causes the least myocardial depression?
Nicardipine
54
What CCB causes the most SA node depression?
Verapamil
55
Which CCB has marked AV node depression?
Verapamil
56
Which CCB causes the highest degree of coronary artery dilation?
Nicardipine
57
Which 2 CCB cause marked peripheral artery dilation?
Nifedipine & Nicardipine
58
Which vasodilator can worsen someone’s PaO2?
Nitroprusside
59
Which type of beta blocker is best suited for COPD patients?
Beta-1 selective to prevent bronchospams & ventilatory depression
60
Which type of beta blocker is preferred in diabetics?
Beta-1, this way it does not interfere with glycogenolysis

Advanced Pharmacology ANE 8433 (Spring 2023) (16 decks)

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