Direct-Acting Alpha Agonists/Selective Beta-2 agonist (N-13)

Question 1

why does a reflex bradycardia occur with administration of Neo

Answer 1

baroreceptor stimulation

Question 2

what is the onset and duration of neo

Answer 2

onset- immediate

duration 5-20 min

Question 3

other than blood pressure stimulation what is neo used for

Answer 3

prevent nosebleeds during nasal intubation
reduce bleeding during ear, nose, and throat surgery

mydriatic in ophthalmology

Question 4

where is vasopressin produced and stored?

Answer 4

hypothalamus posterior pituitary

Question 5

what does vasopressin control

Answer 5

osmoregulation

Question 6

vasopressin is a potent vasoconstrictor BUT it selectively dilates these threee things

Answer 6

renal afferents

pulmonary and cerebral arterioles

Question 7

MOA of milrinone

Answer 7

PDE 3 inhibitiros- preventing the breakdown of cAMP,

Question 8

how does milrinone improve left ventricular function

Answer 8

acceleration of calcium uptake by the sarcoplasmic reticulum.

Question 9

how is milrinone used during high risk patients from cardiopulmonary bypass

Answer 9

improves weaning from bypass

Question 10

if milrinone is given to a patient that is beta blocked or has beta receptor down regulation- does milrinone still work

Answer 10

YES- these drugs retain their inotropic effect even in the presence of beta-blocking agents or during B receptor down regulation. -as seen with HF patients-

Question 11

PDE3 inhibitors may be used to augment the effect of direct acting b agonist such as

Answer 11

dobutamine or dopamine.

Question 12

PD5 inhibitors include

Answer 12

viagra, revatio

Question 13

when do we cautiously administer milrinone

Answer 13

renal failure patients- potential for life threatening arrhythmias as the drug is eliminated by the kidenys

Question 14

ephedrine stimulates alpha and beta receptors how

Answer 14

indirectly and directly

Question 15

ephedrine onset and duration

Answer 15

onset immediate

duration 15-1.5hr

Question 16

administration forms of ephedrine

Answer 16

oral, intramuscular, subcutaneous

Question 17

according to nagelhout- newer data is questioning the use of ephedrine in OB- why?

Answer 17

ephedrine produces increases in fetal metabolic rate, leading to fetal acidosis due to B stimulation and phenylephrine does not

Question 18

subsequent dosing of ephedrine can produce

Answer 18

tachyphylaxis

Question 19

selective beta 2 agonist have increased duration of action due to

Answer 19

their non catecholamine structure - they are resistant to COMT metabolism.

Question 20

two puffs of salmeterol prevent what

Answer 20

exercise induced asthma

Question 21

chronic use of selective beta 2 agonist can result in “this” from down regulation

Answer 21

tachyphylaxis

Question 22

clonidine is used as part of catecholamine suppression test in the diagnosis of

Answer 22

pheochromocytoma

Question 23

which receptors does clonidine work on

Answer 23

peripheral presynaptic alpha2

central alpha 2 receptors