table 18-1. plus a few random things from reading

Question 1

describe propranolol class

Answer 1

PURE antagonist (no sympathomimetic activity) nonselective beta blockers

Question 2

propanolol IV dose

Answer 2

1-10mg

Question 3

what is the standard drug all beta antagonist are compared

Answer 3

propanolol

Question 4

cardiac effects of propranolol

Answer 4

decrease HR
decrease contractility
decrease CO

Question 5

when are propranolol effects most noted

Answer 5

during exercise or increase sympathetic nervous system activity

Question 6

what does propranolol do to fentanyl

Answer 6

first pass up take of fentanyl is decreased. 2-4x as much fentanyl enters the systemic circulation.

Question 7

what does dibucaine reflect

Answer 7

the quality of the cholinesterase enzyme

Question 8

if dibucaine is 70 or greater

Answer 8

then your cholinesterase is normal

Question 9

if dibucaine is less than 20

Answer 9

then you have homozygous atypical cholinesterase

Question 10

if dibucaine is 40-60

Answer 10

then you have atypical heterozygous variant.

Question 11

verapamil what is it

Answer 11

papaverine derivative

supplied as a racemic mixture

Question 12

verapamil side effects

Answer 12

depresses AV node

vasodilation coronary and systemic artieries

Question 13

who should NOT get verapamil

Answer 13

HF
bradycardia
sinus node dysfunction
av nodal block
WPW- precipitate dysrhythmias 
not for acute MI

Question 14

clinical uses of verapamil

Answer 14

SVT
ANGINA pectoris
symptomatic hypertrophic cardiomyopathy with out without left ventricular outflow

Question 15

which drugs increase the pharmacological active unbound portion of the drug verapamil

Answer 15

lidocaine
diazepam
propranolol

Question 16

diltiazem what does it block

Answer 16

blocks calcium channels of the av node

Question 17

what do we use diltiazem for

Answer 17

svt

htn

Question 18

what are diltiazem metabolites half life.

Answer 18

20 hours

Question 19

patients with preexisting cardiac conduction abnormalities receiving verapamil or diltiazem plus beta blocker or digoxin will experience

Answer 19

greater degrees of AV heart blocks

Question 20

how do we reverse toxicity of ccb

Answer 20

calcium or dopamine

Question 21

dantrolene plus ccb

Answer 21

hyperkalemia and cardiovascular collapse

Question 22

verapamil plus dantrolene equal

Answer 22

high potassium

Question 23

calcium channel blockers and dig

Answer 23

increase plasma concenration

Question 24

verapamil and dig

Answer 24

increase dig

Question 25

what do beta agonist do to the slow calcium channels

Answer 25

beta agonist increase the number of functioning slow calcium channels in myocardial cell membranes through camp and readily counter the effects of calcium channel blockers

Question 26

patients treated with beta blocker and nifedipine have what fentanyl effects

Answer 26

tolerate high dose fentanyl

Question 27

amiodarone increases the plasma concentrations of ...

Answer 27

quindine procainamide phenytoin

Question 28

amiodarone depress what

Answer 28

vitamin K clotting factors

Question 29

propafenone increases plasma concentration of what drug

Answer 29

warfarin

Question 30

``` EPI receptors mechanism of action co hr dysrhythmas renal blood flow airway resistance cns stimulant mean arterial pressure peripheral vascular resistance ```

Answer 30

``` a b1 b2 direct moderate increase cardiac output moderate increase HR-reflex down marked increase dysrhythmias marked decrease renal blood low moderate decrease airway resistance cns stimulant mean arterial pressure minimal increase peripheral vascular resistance +- ```

Question 31

``` NE receptors mechanism of action co hr dysrhythmias renal blood flow airway resistance cns stimulant mean arterial pressure peripheral vascular resistance ```

Answer 31

``` a b1 b2 direct minimal decrease hr minimal decrease co minimal increase dysrhythmias no change airway resistance no cns stimulant marked increase MAP marked increase peripheral vascular resistance decrease renal blood flow ```

Question 32

dopamine

Answer 32

``` alpha beta beta direct marked increase cardiac output minimal increase hr minimal increase dysrhythmias marked increase renal blood flow minimal increase peripheral vascular resistance minimal increase mean arterial pressure ```

Question 33

isoproterenol

Answer 33

``` beta beta direct marked increase cardiac output marked increase heart rate marked increase dysrhythmias moderate decrease peripheral vascular resistance minimal increase renal blood flow +-map marked decrease airway resistance ```

Question 34

dobutamine

Answer 34

``` beta1>beta2 direct marked increase cardiac output minimal increase heart rate +-dysrhythmias nc to peripheral vascular resistance moderate increase renal blood flow minimal increase map ```

Question 35

``` ephedrine CO HR dysrhythmias PVR rbf map airway cns ```

Answer 35

``` direct alpha indirect beta moderate increase co moderate increase hr moderate increase dysrhythmias minimal increase peripheral vascular resistance moderate decrease renal blood flow moderate increase map moderate decrease airway resistance cns stimulant ```

Question 36

``` phenylephrine co hr dysrhythmias pvr rbf map airway ```

Answer 36

``` direct but indirect on beta minimal decrease co minimal decrease hr nc dysrhythmias marked increase in peripheral vascular disease marked decrease in renal blood flow marked increase in mean arterial pressure nc in airway resistance ```