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Flashcards in Lecture 01_Spring Deck (43)
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1
Q

Name 2 non selective Alpha receptor antagonists.

A

Phentolamine and Phenoxybenzamine

2
Q

T or F A2 receptor blockade leads to tachycardia

A

True. It eliminates negative feedback which leads to more NE release.

3
Q

Phentolamine and Phenoxybenzamine are almost exclusively for the mgmt of what?

A

pheochromocytomas

4
Q

What are the cholinomimetic side effects associated with alpha agonists?

A

hyperperistalsis, abdominal pain, and diarrhea

5
Q

What can be used to treat the cholinomimetic side effects associated with alpha agonists?

A

atropine/ glycopyrrolate

6
Q

What are the main side effects associated with the non specific B antagonist Propranolol (Inderal)?

A

Side effects = bronchospasm, CHF

7
Q

What type of beta blocker should be used in pts w/ reactive airway disease?

A

B1 selective antagonist

8
Q

Which anti-hypertensive is a mixed adrenergic antagonist (A1 B1 and B2)?

A

Labetalol

9
Q

____ is an ultra short acting B1 selective antagonist.

A

Esmolol (BreviBloc)

10
Q

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Atenolol

A

B1 selective antagonist

11
Q

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Carvedilol.

A

B1 selective antagonist

12
Q

Is the following a mixed, non-selective Beta, B1 selective adrenergic antagonist?

Metoprolol

A

B1 selective antagonist

13
Q

____ is the common drug of choice for intraop HTN because decreases PVR and renin, and causes some decrease in HR.

A

Labetalol

14
Q

This adrenergic antagonist’s short duration of action is due to its rapid redistribution (2 min) and ester hydrolysis (9 min).

A

Esmolol (BreviBloc)

15
Q

T or F. Labetalol causes reflex tachycardia.

A

False. It is a mixed antagonist with alpha and beta receptor antagonism.

16
Q

___ is a good choice for preventing tachycardia and hypertension during intubation and emergence.

A

Esmolol

17
Q

What are 3 side effects associated with alpha-1 receptor blockade?

A

Side effects: hypotension, orthostatic hypotension, tachycardia

18
Q

How does an alpha-2 receptor blockade work and what does it cause?

A

A2-receptor blockade -> eliminates negative feedback -> more NE release -> tachycardia

19
Q

Unopposed stimulation of beta receptors may lead to _____.

A

HYPOTENSION

20
Q

What is Clonidine?

A

Clonidine: centrally-acting 2-agonist that decreases CNS sympathetic output at pre-synaptic 2 receptors

21
Q

Which antihypertensive agent directly causes vascular smooth muscle relaxation?

A

Hydralazine

22
Q

Which class of antihypertensive drugs is the first-line therapy for systemic hypertension and CHF?

A

ACE Inhibitors

23
Q

Which class of antihypertensive drugs cause hyperkalemia

A

ACE Inhibitors and ARBs

24
Q

Which antihypertensive agent causes direct venous and arterial vasodilation, Reflex tachycardia, and breaks down in light?

A

Sodium Nitroprusside (SNP)

25
Q

Which Nitrate is a commonly used oral nitrate for prevention of angina pectoris

A. SNP
B. NTG
C. Inhaled NO
D. Isosorbide Mononitrate (Imdur) or Dinitrate

A

D. Isosorbide Mononitrate (Imdur) or Dinitrate

26
Q

T or F. ACEIs are associated with depression, insomnia, sexual dysfunction, and electrolyte imbalances

A

False. They are free from many common side effects seen with other antihypertensive
agents (depression, insomnia, sexual
dysfunction, electrolyte imbalances)

27
Q

Which of the following is true regarding side effects of Sodium Nitroprusside?

A. Increased cerebral blood flow
B. Potential for coronary steal syndrome
C. Attenuates hypoxic pulmonary vasoconstriction (HPV)
D. All of the above

A

D. All of the above

28
Q

Which class of anitHTN drugs is associated with an allergic reaction causing the rapid swelling of the dermis, subcutaneous tissue,mucosa and submucosal tissues?

A

ACEIs - Allergy: angioedema

29
Q

How is SNP metabolized?

A

Sequestration of CN: CN + met-Hb -> cyanmet-Hb

30
Q

What is Losartan (Cozaar)?

A

an ARB (Angiotensin II Receptor Blocker)

31
Q

Which Nitrate is a selective pulmonary vasodilator, causes bronchodilation, and improves V/Q matching
A. SNP
B. NTG
C. Inhaled NO
D. Isosorbide Mononitrate (Imdur) or Dinitrate

A

C. Inhaled NO

32
Q

Which antihypertensive agent is associated with Cyanide toxicity?

A

SNP

33
Q

T or F. ACEIs should be held at least 24hrs preoperatively, but ARBs do not need to be held?

A

False. They should both be held at least 24hrs before surgery. These pts may be unresponsive to fluid bolus or sympathomimetic treatment of intraop hypotension.

34
Q

A patient on Lisinopril may require what drug to support BP intraoperatively?

A

Vasopressin

35
Q

What is the treatment for cyanide toxicity?

A
  1. STOP nitroprusside
  2. Cyanide buffers:
    a. Sodium nitrate IV (OR Amyl nitrate inhaled)
    b. THEN give sodium thiosulfate IV
  3. Vit B12a (Hydroxocobalamin)
36
Q

CN is converted to ____by ____. This process requires a sulfur donor, which is usually _____. The remaining CN is what causes cyanide toxicity.

A

thiocyanate , rhodanese enzyme, thiosulfate

37
Q

Which Nitrate causes mainly venous dilation

A. SNP
B. NTG
C. Inhaled NO
D. Isosorbide Mononitrate (Imdur) or Dinitrate

A

B. Nitroglycerin

38
Q

How do nitrates decrease BP?

A

They deliver NO (nitric oxide) to vascular smooth muscle which causes vasodilation. NO release is part of normal endothelial function -> autoregulation

39
Q

T or F. Nitrates inhibit platelet activation, aggregation, and adhesion.

A

True

40
Q

Which Nitrate can be used for uterine relaxation

A. SNP
B. NTG
C. Inhaled NO
D. Isosorbide Mononitrate (Imdur) or Dinitrate

A

B. NTG (Nitroglycerin)

41
Q

Which Nitrate is associated with risk of causing met-Hgb-emia?

A. SNP
B. NTG
C. Inhaled NO
D. Isosorbide Mononitrate (Imdur) or Dinitrate

A

B. NTG

42
Q

What is the treatment for met-Hgb-emia?

A

Methylene blue

43
Q

____ increases coronary perfusion to ischemic subendocardium, while _____ can potentially cause coronary steal syndrome.

A

NTG, SNP