Lecture 2: Adrenergic Pharmacology Flashcards
1
Q
Which class of receptors are adrenergic receptors?
A
G protein-coupled (GPCR)
2
Q
Which catecholamines do adrenergic receptors target?
A
1) Norepinephrine
2) Epinephrine
3
Q
Do adrenergic receptors stimulate the PNS or SNS?
A
SNS and activates different G-proteins
4
Q
List the tissues (4) affected by ⍺1 receptors
A
- Most vascular smooth muscle
- Heart
- Prostate
- Pupillary dilator muscle
5
Q
How does an α1 receptor affect most vascular smooth muscle?
HIGH yield
A
Vasoconstriction
6
Q
What is the G protein for an α1 receptor?
A
Gq
7
Q
How does an α1 receptor affect the heart?
LOW yield
A
Increase force
8
Q
How does an α1 receptor affect the prostate?
LOW yield
A
Contraction
9
Q
How does an α1 receptor affect the pupillary dilator muscle?
LOW yield
A
Pupil dilation
10
Q
List the systems (2) affected by the ⍺2 receptors
A
- Postsynaptic CNS
- Presynaptic ANS
⍺2=Decreases sympathetic tone
11
Q
How does an α2 receptor affect the postsynaptic CNS?
HIGH yield
A
Decreases SNS tone
12
Q
How does an α2 receptor affect the presynaptic ANS?
HIGH yield
A
Decreases NT release
13
Q
What is the G protein for an α2 receptor?
A
Gi
14
Q
List the tissues (2) affected by the β1 receptors
A
- Heart
- Juxtaglomerular cells
15
Q
What are the G proteins for a β1 receptor?
A
Gs, Gi
16
Q
How does a β1 receptor affect the heart?
HIGH yield
A
Increases force and rate
17
Q
How does a β1 receptor affect the juxtaglomerular cells?
HIGH yield
A
Increases renin release = retains fluid
18
Q
List the tissues (4) affected by β2 receptors
A
- Skeletal muscle blood vessels
- Bronchial smooth muscle
- Liver
- Uterus
19
Q
What are the G proteins for a β2 receptor?
A
Gs, Gi
20
Q
How does a β2 receptor affect skeletal muscle blood vessels?
HIGH yield
A
Relaxation
21
Q
How does a β2 receptor affect the bronchial smooth muscle?
HIGH yield
A
Relaxation
22
Q
How does a β2 receptor affect the liver?
HIGH yield
A
Glycogenolysis and gluconeogenesis = increases blood glucose
23
Q
How does β2 receptors affect the uterus?
LOW yield
A
Relaxation
24
Q
List the tissue affected by the β3 receptors
Low yield
A
Adipose tissue (fat cells)
25
What are the G protein for β3 receptors?
Gs
26
How does β3 receptor affect adipose tissue?
## Footnote
LOW yield
Increases Lipolysis
27
Which organs (4) receive adrenergic synapses?
* Cardiac muscle
* Smooth muscle
* Gland cells
* Nerve terminals
28
Adrenergic receptors have sympathetic responses. Explain what occurs to the:
* Pupils
* Heart rate and contractility
* Respiratory rate
* Digestion
* Blood flow to muscle
* Urination
* Dilates pupil
* Increase heart rate, contractility
* Increase respiratory rate (dilates bronchi)
* Inhibits digestion
* Diverts blood flow to muscles (by vasoconstriction/dilation)
* Inhibits urination
29
What are the different agonist drug classes (4) of Adrengeric receptors
1. ⍺1 agonist
2. ⍺2 agonist
3. Non-selective agonist (β1+β2)
4. β2 agonist
30
Which drug is an α1 agonist?
Phenylephrine (vasoconstriction)
31
Which drugs are α2 agonists?
* Clonidine
* Methyldopa = decrease SNS tone
32
Which drugs (2) are non-selective β agonists (β1 + β2)?
* Isoproterenol
* Dobutamine
33
Which drug is a β2 agonist?
* Albuterol (dilates bronchial smooth muscle)
34
List the antagonist drug classes of Adrenergic receptors (5)
## Footnote
Antagonist: opposite effect
1. Non-selective ⍺ antagonist
2. ⍺1 antagonist
3. Non-selective β antagonist (β blockers)
4. β1 antagonist (β blockers)
5. Mixed ⍺/β antagonists
35
Which drug is a non-selective α antagonist (blocks α1 and α2)?
* Phentolamine (vasodilation & increases HR)
36
Which drug is an α1 antagonist?
Prazosin
37
Which drug is a non-selective β antagonist (β blocker)?
## Footnote
β=olol
Propranolol
## Footnote
β1 antagonist= decreased HR
β2 antagonist=Bronchoconstriction
38
Which drugs (2) are β1 antagonists (β blockers)?
## Footnote
β=olol
* Atenolol
* Metroprolol
## Footnote
β1 antagonist= derease HR
39
List the drugs that are β blockers
* Propranolol (non-selective)
* Atenolol (β1)
* Metroprolol (β1)
## Footnote
all antagonist
40
Which drugs are mixed α1/β antagonists?
##Footnote##
-lol: mixed
* Carvedilol
* Labetalol
41
What is the oral usability of epinephrine?
completely ineffective
42
Is the duration of action of epinephrine long or short? And explain why?
Short, b/c the structure of epi includes a catechol which gets metabolized quickly by COMT (↑ COMT sensitivity)
## Footnote
COMT: catechol-O-methyltransferase
43
Does epinephrine have good or poor penetration of the CNS?
poor d/t the high polarity of the structure (canNOT cross barrier)
44
Why is phenylephrine better than epinephrine as a ⍺1 selective agonist?
* More stable and is not broken down as fast (↓COMT sensitivity)
* Higher ⍺ selectivity compared to epinephrine which has mixed ⍺/β selectivity
45
Explain the mechanisms of action of ⍺1 agonist.
## Footnote
Drug: Phenylephrine
* Stimulation of ⍺1
* Induce contraction of smooth muscle
* **Vasoconstriction of most vascular muscle**
* Decrease mucosal edema
46
What is the primary effect of α1 agonist?
## Footnote
Drug: Phenylephrine
vasoconstriction of most vascular smooth muscle
47
What are the clinical uses of α1 selective agonists? What are the effects?
## Footnote
Drug: Phenylephrine
● **Nasal congestion** = decreases inflammation markers
● **Hypotension** = vasoconstriction = increases BP
● **Hemorrhoids** = vasoconstriction = stops inflammation of markers to swollen/inflamed veins
● Dilates pupils
48
What are the adverse effects of phenylephrine?
## Footnote
⍺1 agonist
* **Angina**
* **Anxiety**
* **Bradycardia**
* **Tissue necrosis**
* **HTN**
49
What are the contraindications of phenylephrine?
Contraindications- Underlying diseases
## Footnote
⍺1 agonist
● **Vfib**
● **Tachycardia**
● **HTN**
50
What are the interactions of phenylephrine?
| Interactions-Substances that affect the drug
## Footnote
⍺1 agonist
* **MAO inhibitors**
* MOA breaks down NE, if pt is taking a MOAI w/ the drug phyenyleprine it will increase the level of NE in the body and ↑↑↑ vasoconstriction
## Footnote
MAO-monoamine oxidase
51
# Drug
**Pheylephrine:**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): ⍺1 agonist
* Effect: Vasoconstriction
* Treatment: Nasal cong., hypotension, hemorrhoids
* Side Effects: Angia, Bradycardia, HTN, Necrosis
* Contraindication: Vfib, Tachy, HTN
* Interactions:MAOI
52
List the drugs that are ⍺2 selective agonists
* Clonidine
* Methyldopa
53
Stimulation of the α2 receptors in the medulla has what type of effects?
**Sympatholytic**
* No reflex tachycardia
* Decrease overall NE release through stimulation of pre-synaptic receptors
54
What are the net effects of α2 agonists?
● Decreased BP
● Decreased HR
● Decreased cardiac output
## Footnote
Activate Gi (inhibitory)
55
What clinical condition are ⍺2 agonists used for?
## Footnote
Clonidine&Methyldopa
Hypertension
56
Which ⍺2 agonist is the first line of therapy for hypertension (HTN) during pregnancy?
## Footnote
HIGH yield
Methyldopa
57
Why is clonidine used more often than methyldopa?
## Footnote
⍺2 agonist
More potent
58
Why is clonidine not used for pregnancy?
## Footnote
⍺2 agonist
Catagory C for pregnancy = risk cannot be ruled out
59
Why is methyldopa the first line therapy for HTN during pregnancy?
## Footnote
⍺2 agonist
Pro drug = only effective in the brain = safer
60
What does clonidine treat?
## Footnote
⍺2 agonist
* Hypertension
* Several CNS disorders including ADHD
* Mitigate drug withdrawal
* Severe pain
61
Clonidine is effective in both the _____ and the ____.
## Footnote
⍺2 agonist
periphery, brain
62
Where is ⍺-methyldopa ONLY effective and why?
## Footnote
⍺2 agonist
* **In the brain**
* It easily enters the brain where it is metabolized to the active compund ⍺-methyl-norepinephrine (⍺2 agonist)
63
What are the adverse effects of clonidine?
## Footnote
⍺2 agonist
* Dry mouth
* Sedation
* Depression
* Orthostatic hypotension
64
What drug class is Clonidine and Methyldopa?
α2 agonist
65
What is the effect of Clonidine?
## Footnote
⍺2 agonist
Decreases SNS tone
66
What are the contraindications for Clonidine?
## Footnote
⍺2 agonist
* Depression
* Caution: Sudden withdrawal causes hypertensive crisis
67
What are the adverse effects of Methyldopa?
## Footnote
⍺2 agonist
* Sedation
* Depression
* Tolerance
68
What are the contraindications for Methyldopa?
## Footnote
⍺2 agonist
* Depression
* MAO inhibitory therapy = increases NE
69
# Drug
**Clonidine**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): ⍺2 selective agonist
* Effect: ↓SNS tone, ↓ NT release ( decreases BP, HR, CO)
* Treatment: Hypertension, CNS disorders (e.g. ADHD)
* Side Effects: Dry mouth, sedation, depression, orthostatic hypotension
* Contraindication: Depression
* Interactions: MOAI
70
# Drug:
**Methyldopa**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): ⍺2 selective agonist
* Effect: ↓SNS tone, ↓ NT release ( decreases BP, HR, CO)
* Treatment: **Hypertension (Used doing pregnancy)**
* Side Effects: Sedation, depression, tolerance
* Contraindication: Depression
* Interactions: MOAI
71
List the drugs that are non-selective β agonist
* Isoproternol
* Dobutamine (racemic mixture)
72
What drug class is Isoproterenol?
Non-selective β agonist = agonist at both β1and β2 receptors
73
Explain the mechanism of action (MOA) of Isoproterenol
## Footnote
Non-selective β agonist
* Potent agonist at both β1 and β2 receptors
* Potent vasodilator and bronchodilator
* Positive inotropic (contraction) and chronotropic (heart rate) agent
74
What does Isoproterenol treat?
## Footnote
Non-selective β agonist
* Cardiac arrest
* AV block
* Bradycardia
* Torsade de pointes
75
What are the adverse effects of Isoproterenol?
## Footnote
Non-selective β agonist
Arrythmias (common)
76
Explain why Isoproterenol causes an increase in pulse rate (HR), and decreased resistance.
## Footnote
Non-selective β agonist
* Increased HR is d/t activation of β1 agonist (which increases force and rate)
* Dramatic decreased Resistance is d/t activation of β2 agonist (relaxation) and no ⍺ activation
77
Explain the MOA of Dobutamine
## Footnote
Non-selective β agonist
* Stimulates β1 receptors on the heart but produces greater inotropic (contraction) than chronotropic (heart rate) effects
* There is some β2 and ⍺1 stimulation as well as ⍺1 inhibition resulting in NO net charge in total peripheral resistance
* Inotrope
## Footnote
Formerly considered β1 selective
78
# Drug
**Isoproterenol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): Non-selective β agonist
* Effect: Potent vasodilator, bronchodilator, positive iontropic and chronotropic agent
* Treatment: Cardiac arrest, AV block, bradycardia, torsade de pointes
* Side Effects: Arrhythmias
* Contraindication: N/A
* Interactions: N/A
79
List the drugs that are β2 selective agonists
* **Albuterol- short action acute bronchospasm**
* Salameterol- longer acting maintenance
* Metaproterenol-short action acute bronchospasm
* Terbutaline-short action
80
What are the MOA and Pharmacology of β2 selective agonist
| Albuterol
* Relaxation of bronchial smooth muscle
* Relaxation of vascular smooth muscle (particularly in skeletal muscle vasculature)
* Stimulation of glycogenolysis (may lead to hyperglycema)
* Relaxation of uterine smooth muscle
81
What are the clinical uses of β2 selective agonist?
| Albuterol
* Asthma
* Acute bronchospasm
* Brochospasm prophylaxis
* Premature Labor-Ritodrine (Yutopar®)
82
What are the adverse effects, contraindications and interactions of β2 selective agonist?
| Albuterol
* Tremors
* Stimulation (CNS)
* Palpitations
* Tachycardia (direct and reflex)
83
# Drug
**Albuterol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): β2 selective agonist
* Effect: Relaxation, Glycogenolysis, Gluconeogenesis
* Treatment: Asthma, acute bronchospasm, bronchospasm prophylaxis, premature labor
* Side Effects, Contraindication, Interactions: Tremors, stimulation (CNS), palpitations, tachycardia
84
List the **antagonist effects** of the adrenergic receptor.
* ⍺1
* ⍺2
* β1
* β2
* β3
* ⍺1-Dilation
* ⍺2-Increase SNS tone, Increase NT release
* β1-Decrease HR, Decrease fluid retention
* β2-Contraction of skeletal muscle blood vessels, bronchial constriction, decrease blood glucose
* β3-Decrease lipolysis
85
List the drugs that are ⍺-adrenoceptor antagonists
* Phentolamine
* Prazosin
86
List the drug that are Non-selective ⍺ antagonist
Phentolamine
87
What are the MOA and pharmacology of non-selective ⍺ antagonists?
| Phentolamine
* Block ⍺1 or both ⍺1 & ⍺2 receptors
* Decrease peripheral vascular resistance
* Vasodilation triggers increased heart rate
88
Which target of ⍺ antagonist cause pronouced increase in HR? and why?
**Mixed ⍺1/⍺2 antagonist** because ⍺2 antagonist increases SNS→release of NE binds to β receptors (which ↑HR)
89
What are the clinical uses of Phentolamine?
| Non-selective ⍺ antagonist
* **Anesthesia reversal**
* Extravasation of ⍺ agonist
* Pheochromocytoma (tumor at adrenal gland, high BP)
90
What are the clinical uses of Prazosin?
| ⍺1 antagonist
* Hypertension⋆
* **Benign prostatic hyperplasia (BPH)**
## Footnote
⋆Not first line. Increased risk of heart failure (2x) compared to diuretics
91
What are the adverse effects of Phentolamine and Prazosin?
* **Tolerance**
* Na/H2O retention when used alone for HTN
* Dizziness
* Hypotension
* Postural hypotension
* **Reflex tachycardia**
* Miosis
* Nasal stuffiness
* Inhibition of ejaculation
92
What are the precautions/contraindications of Phentolamine and Prazosin?
* Angina (ischemia chest pain)
* MI (myocardia infraction)
93
What are the interactions that affect Phentolamine and Prazosin?
Beta blocker withdrawal
94
# Drug:
**Phentolamine**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
## Footnote
HIGH yield
* Type (class): Non-selective ⍺-antagonist
* Effect: Dilation, ↑SNS, ↑NT
* Treatment: Anesthesia reversal
* Side Effects: Tolerance, Reflex tachycardia
* Contraindication: Angina, MI
* Interactions: Beta blocker withdrawal
95
# Drug:
**Prazosin**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
## Footnote
HIGH yield
* Type (class): ⍺1 selective antagonist
* Effect: Dilation
* Treatment: HTN (not first choice) and BPH
* Side Effects: Tolerance, reflex tachycardia
* Contraindication: Angina, MI
* Interactions: Beta-blocker withdrawal
96
List the drugs that are β-adrenoceptor antagonist (β blockers)
* Propranolol
* Atenolol
* Metoprolol
* Carvedilol
* Labetalol
97
List the drug that is a Non-selective β antagonist (1st gen)
## Footnote
-olol=β
Propran**olol**
98
What are the MOA and pharmacology of non-selective β antagonist?
Block β1 or both β1 and β2 receptors
99
What are the effects of non-selective β antagonist on the cardiovascular system?
* **Negative inotropic, dromotropic (conduction speed) and chronotropic effects**
* **Decrease renin release**
* Block of β2 may increase peripheral resistance (mild)
100
What are the effects of non-selective β antagonists on the CNS?
* **Anxiolytic** (reduces anxiety)
* CNS effects may contribute to decreasing HTN
101
What are the effects of non-selective β antagonist on the eye?
* **Decreased aqueous humor production**
* Decrease intraocular pressure
102
What are the effects of non-selective β antagonist on the lungs?
* Bronchoconstriction- "spasm"
* More prominent in β1/β2 than β1-selective
103
What are the effects of non-selective β antagonists on metabolism?
* Lipolysis and glycogenolysis are inhibited
* Inhibit recovery from hypoglycemia
* More prominent in β1/β2 than β1-selective
104
List the clinical uses for Propranolol
| Non-selective β antagonist
* angina
* cardiac arrythmias
* **Hypertension**
* migraine prophylaxis
* myocardial infraction prophylaxis
* pheochromocytoma
* **Post-myocardial Infraction**
* thyrotoxicosis
* essential tremor
105
True or False. β blockers are NOT indicated as first line of therapy for HTN for age 60 and above
## Footnote
HTN: Hypertension
TRUE
106
Which type of drugs are the first line treatment for people UNDER the age of 50 with hypertension?
* ACEI (Angiotensin converting enzyme inhibitor)
* ARB (Angiotensin receptor blocker)
107
Which type of drug is the first line of treatment for people OVER the age of 50 with hypertension?
* CCB (Calcium channel blocker)
* Thiazide/thiazide-like
108
When are β-blockers used as the first-line therapy for hypertension?
* Ischemic Heart Disease
* Recent STEMI or non-STEMI (ST-Elevation Myocardial Infraction)
* Left Ventricular Systolic Dysfunction
109
What are the adverse effects of Propranolol?
| Non-selective β antagonist
* **Dizziness**
* **Fatigue**
* Lethargy
* Sinus bradycardia
* **Hypotension**
* Exacerbation of asthma
* Dyspnea
* Bronchospasm
* Diabetes mellitus
* Hypertriglyceridemia
* Decrease plasma HDL
110
What are the precautions/contraindications of Propranolol?
| Non-selective β antagonist
* Diabetes mellitus
* Hyperthyroidism
* Pregnancy category C
* **Asthma**
* **AV block**
* **Bradycardia**
* Cardiogenic shock
* Sick sinus syndrome
111
What are interactions that affect Propranolol?
| Non-selective β antagonist
* Drugs that depress AV conduction or have negative iontropic actions
* Clonidine withdrawal
112
What happens with sudden withdrawal of Propranolol?
| Non-selective β antagonist
Withdrawal syndrome: rebound hypertension, MI, cardiac arrhythmias and panic attacks
113
# Drug
**Propranolol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): Non-selective β antagonist
* Effect: ↓HR, ↓Fluid retention, Constriction (Skel BV, Bronchi SM), ↓Blood glucose
* Treatment: HTN, post-myocardial infraction
* Side Effects: Dizziness, fatigue, hypotension
* Contraindication: Asthma, AV block, bradycardia, DM
* Interactions: Drugs that depress AV conduction
114
List the drugs that are β1 antagonist
* Atenolol
* Metoprolol
115
What is the MOA and pharmacology of β1 antagonist?
| Atenolol & Metoprolol
* Negative inotropic, dromotropic (conduction speed), and chronotropic effects (↓HR)
* Decrease renin release
116
Why are β1 antagonist preferred against non-selective β antagonist in patients with bronchospasm, diabetes and peripheral vascular disease?
NO β2 activity
117
What are the clinical uses of Atenolol?
| β1 antagonist
* Acute MI
* Angina
* Hypertension
118
What are the clinical uses of Metoprolol?
| β1 antagonist
* Acute MI
* Angina
* Hypertension
* Heart failure (1 of 3 recommended) (long acting form: succinate for SUCCESS)
119
Explain β1 antagonist adverse effects, contraindications, and interactions
| Antenolol & Metoprolol
* Similar to non-selective β antagonist
* Less effect on glucose levels
* Asthma and bronchospasms are no longer absolute contraindication, but used with great caution
* Atenolol- Pregnancy category D (intrauterine growth restriction)
120
# Drug
**Atenolol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): β1 antagonist
* Effect: ↓HR, ↓Fluid rentention
* Treatment: Acute MI, Angina, HTN
* Side Effects: Dizziness, fatigue, hypotension
* Contraindication: **Pregnancy (Cat. D)**, asthma, bronchospasm
* Interactions: Drugs that depress AV conduction
121
# Drug
**Metoprolol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): β1 antagonist
* Effect: ↓HR, ↓Fluid rentention
* Treatment: Acute MI, Angina, HTN, heart failure
* Side Effects: Dizziness, fatigue, hypotension
* Contraindication: asthma, bronchospasm
* Interactions: Drugs that depress AV conduction
122
List the drugs that are mixed ⍺1/β-adrenoceptor antagonist
## Footnote
lol=both
* Carvedilol
* Labetalol
123
What are the antagonist effects of mixed ⍺1/β
* ⍺1: Vasodilation
* β1: Decreases HR
* β2: Bronchoconstriction
124
What is the MOA and pharmacology of mixed ⍺1/β antagonist
| Carvedilol & Labetalol
* Block ⍺1 and both β1 and β2 receptors
* Cardiovascular: mixture of ⍺1 and β-blockers
125
What are the clinical uses of Carvedilol?
| mixed ⍺1/β antagonist
* Angina
* Cardiomyopathy
* **Heart failure (1 of 3 recommended)**
* Hypertension
* Myocardial infarction (acute and post-MI)
126
What are the clinical uses of Labetalol?
| mixed ⍺1/β antagonist
* Hypertension
* Hypertensive emergency (IV)
* **HTN emergency in pregnancy**
127
Explain mixed ⍺1/β antagonist adverse effects, contraindications, and interactions
| Carvedilol & Labetalol
* Similar to non-selective β-blockers (i.e. bronchospasms) and ⍺1antagonist (i.e. postural hypotension)
* **Less tachycardia than ⍺1 antagonist, less peripheral vasoconstriction than β-blockers**
128
# Drug
**Carvedilol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): mixed ⍺1/β antagonist
* Effect: Vasodilation (⍺1), ↓ HR (β1), Bronchoconstriction (β2)
* Treatment: Heart failure (1 of 3 recommended), HTN
* Side Effects: Brochospasm, postural Hypotension
* Contraindication: N/A
* Interactions: N/A
129
**Labetalol**
* Type (class)
* Effect
* Treatment
* Side Effects
* Contraindication
* Interactions
* Type (class): mixed ⍺1/β antagonist
* Effect: Vasodilation (⍺1), ↓ HR (β1), Bronchoconstriction (β2)
* Treatment: HTN, HTN emergency in pregnancy
* Side Effects: Brochospasm, postural Hypotension
* Contraindication: N/A
* Interactions: N/A
130
In a patient with which of the following conditions would propranolol be contraindicated?
a. Asthma
b. Constipation
c. Hypertension
d. Migranes
e. Tachycardia
a. Asthma
131
1. A patient goes to his primary care doctor complaining of hemorrhoids. His doctor wants to prescribe him an adrenergic agonist to help alleviate his symptoms. Which of the following would be a contraindication for this medication?
a. Hypotension
b. Asthma
c. MAO inhibitor
d. Diabetes
c. MOA inhibitor
132
In the Emergency room, the nurse hands you an ECG that leads you to a diagnosis of torsades de pointes. Which of the following would be true regarding the treatment of this?
a. A1 agonist that will increase blood pressure.
b. B blocker to decrease blood pressure
c. B agonist with positive inotropic effects
d. Calcium channel blocker
c. B agonist with positive inotropic effects
133
3. Which of the following drugs can be used for anesthesia reversal?
a. Phentolamine
b. Prazosin
c. Labetalol
d. Isoproterenol
a. Phentolamine
134
4. A pregnant patient walks into the clinical and was diagnosed with hypertension, what would be the first line treatment?
a. Clonidine
b. Metoprolol
c. Methyldopa
d. Phenylephrine
c. Methyldopa
135
5. Which of the following is NOT a treatment for HTN if there is no cardiac medical history?
a. Thiazide
b. Ace inhibitors
c. Verapamil
d. Atenolol
d. Atenolol
136
6. Which beta blocker would be safest for patients with a history of asthma or diabetes?
a. Propranolol
b. Atenolol
c. Metoprolol
d. 2 of the above
e. None of the above
d. 2 of the above (b&c)
