GENERAL PHARMACOLOGY | Part II Flashcards
A patient with MELD score of >25 is in need of immediate pharmacologic intervention from what seem to be a bleeding from a post-operative TIPS procedure. You decide to administer recombinant factor VII.
The mechanism of action of factor VII includes all
EXCEPT
A. Co-factor to tissue factor
B. Inhibited by antithrombin III–heparin complex
C. Factor X activation
D. Extrinsic pathway activation
E. Factor IX activation
B. Inhibited by antithrombin III–heparin complex
Factor VII has the shortest half-life of all the factors produced by the liver and it is the first to become deficient in liver disease, vitamin K deficiency, or warfarin therapy. It is central to the classical extrinsic pathway by being bound by tissue factor (TF). It also plays a role in the intrinsic pathway as evidenced by its usefulness in patients with hemophilia A and B. It also has activity suggesting direct platelet aggregation and factor IX and X activation.
It is not affected by the heparin/ ATIII complex, unlike other vitamin K-dependent factors. Typically a prolonged PT with normal aPTT would indicate deficiency or abnormality of factor VII.
The mechanism of action of clopidogrel is:
A. Adenosine diphosphate (ADP) receptor blockade (P2Y12 )
B. Platelet glycoprotein IIB/IIIa antagonism
C. Cyclooxygenase COX-1 and COX-2 inhibition
D. Direct thrombin inhibition
A. Adenosine diphosphate (ADP) receptor blockade (P2Y12 )
Which of the following is most closely associated with minimum alveolar concentration (MAC)?
A. Blood/gas partition coefficient
B. Oil/gas partition coefficient
C. Vapor pressure
D. Brain/blood partition coefficient
B. Oil/gas partition coefficient
Which of the following is an important consideration concerning the pulmonary toxicity of bleomycin?
A. N2 O should not be used
B. Preoperative pulmonary function tests should be obtained
C. The patient should be ventilated at a slow rate and inspiratory-toexpiratory (I:E) ratio of 1:3
D. FIO2 should be less than 0.3
D. FIO2 should be less than 0.3
Atropine causes each of the following EXCEPT
A. Decreased gastric acid secretion
B. Inhibition of salivary secretion
C. Increased lower esophageal sphincter tone
D. Mydriasis
Which of the following vasopressor agents increases systemic blood pressure (BP) indirectly by stimulating the release of norepinephrine from sympathetic nerve fibers and directly by binding to adrenergic receptors?
A. Vasopressin
B. Ephedrine
C. Epinephrine
D. Phenylephrine
D. Phenylephrine
Which of the following drugs should be administered with caution to patients
receiving echothiophate for the treatment of glaucoma?
A. Atropine
B. Succinylcholine
C. Ketamine
D. Remifentanil
B. Succinylcholine
Termination of action of the neurotransmitter norepinephrine is achieved predominately by which mechanism?
A. Reuptake into postganglionic sympathetic nerve endings (uptake1)
B. Dilution by diffusion away from receptors
C. Metabolism by catechol-O -methyltransferase (COMT)
D. Metabolism by monoamine oxidase (MAO)
A. Reuptake into postganglionic sympathetic nerve endings (uptake1)
The principal advantage of Ryanodex over conventional formulations of dantrolene is
A. Cost
B. Speed of reconstitution and administration
C. Absence of large amounts of mannitol
D. Need for lower dose
B. Speed of reconstitution and administration
The primary site of action of lisinopril is:
A. Heart
B. Lungs
C. Kidney
D. Metarterioles
B. Lungs
A 43-year-old woman with ascites, hepatopulmonary syndrome, and bleeding
esophageal varices is admitted to the ICU. Which of the therapies below is LEAST likely to improve symptoms associated with hepatic encephalopathy (HE)?
A. Amino acid–rich total parenteral nutrition (TPN)
B. Neomycin
C. Lactulose
D. Flumazenil
D. Flumazenil
Which of the following drugs can prevent tachyarrhythmias in patients with Wolff-Parkinson-White (WPW) syndrome?
A. Droperidol
B. Pancuronium
C. Ketamine
D. Verapamil
A. Droperidol
The half-life of pseudocholinesterase is:
A. 1 hour
B. 12 hours
C. 1 week
D. 2 weeks
B. 12 hours
