Pharmacology - Adrenoceptor antagonists Flashcards
what is the primary adrenoceptor in the heart that when activated by adrenaline causes an increase in cardiac conductivity, rate and force ?
aa. a1
b. b1
c. b2
d. a2
b. b1
what is the primary adrenoceptor in the arterioles that when activated causes constriction?
a. a1
b. b1
c. b2
d. a2
a. a1
what is the primary adrenoceptor in the skeletal muscle that when activated causes constriction?
a. a1
b. b1
c. b2
d. a2
c. b2
what is the primary adrenoceptor in the veins that when activated causes constriction?
a. a1
b. b1
c. b2
d. a2
a. a1
what is the primary adrenoceptor in the airway smooth muscle that when activated causes di;ation?
a. a1
b. b1
c. b2
d. a2
c. b2
what do a1 generally do in smooth muscle?
a. constrict
b. relax
a.constrict
what do b2 generally do in smooth muscle ?
a. constrict
b. relax
b.relax
what is the primary receptor in the GI smooth muscle that when activated causes relaxation? (2 options)
a. a1
b. b1
c. b2
d. a2
a. a1
c. b2
which adrenoceptor causes tremor and glycogenolysis in skeletal muscle?
a. a1
b. b1
c. b2
d. a2
c. b2
which adrenoceptor causes glycogenolysis in the liver? (2 choices)
a. a1
b. b1
c. b2
d. a2
a. a1
b. b2
which adrenoceptor causes lipolysis in the adipose tissue ?
a. a1
b. b1
c. b3
d. a2
c.b3
which adrenoceptor causes increased renin secretion in the kidney ?
a. a1
b. b1
c. b3
d. a2
b.b1
which adrenoceptor causes aggregation of the platelets?
a. a1
b. b1
c. b3
d. a2
d. a2
adrenaline binding to which adrenoceptor causes increased release from peripheral sympathetic nerves?
a. a1
b. b1
c. b2
d. a2
c. b2
adrenaline binding to which adrenoceptor causes decreased release from peripheral sympathetic nerves?
a. a1
b. b1
c. b2
d. a2
d.a2
activation of which adrenoceptors in the brainstem leads to decreased sympathetic outflow?
a. a1
b. b1
c. b2
d. a2
d.a2
what group of drugs prevent the action of epinephrine and norepinephrine?
a. ccb
b. beta blockers
c. ACE
d. ARBS
e. ARNIS
b.beta blockers
-OSIN
a1 blockers
-lol
beta blockers
which of these beta blockers do not have partial agonist activity and are non selective ?
a. prindolol, oxeprenolol
b. sotalol
c. propanolol, timolol
d. atenolol, sotalol
e. propanolol, oxeprenolol
c.propanolol, timolol
which of these beta blockers have partial agonist activity and are non selective ?
a. prindolol, oxeprenolol
b. sotalol
c. propanolol, timolol
d. atenolol, sotalol
e. propanolol, oxeprenolol
a.prindolol, oxeprenolol
which of these beta blockers inhibit k+ channels to act as anti arrhythmics ?
a. prindolol, oxeprenolol
b. sotalol
c. propanolol, timolol
d. atenolol, sotalol
e. propanolol, oxeprenolol
b.sotalol
which is true of acebutol?
a. partial agonist non selective
b. non selective
c. partial agonist b1 selective
d. partial agonist b2 selective
c.partial agonist b1 selective
which is true of atenolol, metoprolol and bisoprolol?
a. partial agonist non selective
b. non selective
c. b1 selective
d. partial agonist b1 selective
c. b1 selective
which is true of carvedilol, labetolol, nebivilolol?
a. partial agonist non selective
b. arteriolar vasodilator
c. b1 selective
d. partial agonist b1 selective
b.arteriolar vasodilator
which of these groups of these drugs are b blockers that also act as arteriolar vasodilators?
a. prindolol, oxeprenolol
b. sotalol
c. propanolol, timolol
d. carvedilol, labetolol, nebivolol
e. propanolol, oxeprenolol
d.carvedilol, labetolol, nebivolol
which of these groups of drugs are water soluble beta blockers?
a. prindolol, oxeprenolol
b. sotalol, atenolol
c. propanolol, timolol
d. carvedilol, labetolol, nebivolol
e. propanolol, oxeprenolol
b.sotalol, atenolol
which of these drugs are lipid soluble ?
a. propanolol, oxeprenolol
b. sotalol, atenolol
c. propanolol, timolol
d. carvedilol, labetolol, nebivolol
e. propanolol, oxeprenolol
a.propanolol, oxeprenolol
true or false atenolol and sotalol have a long half life
a. true
b. false
a.true
true or false propanolol and oxeprenolol have a short half life?
a. true
b. false
a.true
dose of propanolol should be reduced in..
a. renal impairment
b. hepatic impairment
b.hepatic impairment
dose of atenolol should be reduced in..
a. renal impairment
b. hepatic impairment
a.renal impairment
which drug is most likely to cause nightmares and poor quality sleep?
a. atenolol
b. sotalol
c. propanolol
c.propanolol
true or false beta blockers reduce skeletal and peripheral blood flow?
true
which of these is not an action of beta blockers?
a. reduce heart rate
b. reduce force of contraction
c. reduce work and oxygen demand
d. reduce blood pressure
c. reduce ejection fraction
c.reduce ejection fraction
how do beta blockers reduce blood pressure?
antagonise B1 adrenoceptors in the heart
quickly compensated by a rise in peripheral vascular resistance via noradrenaline on vasc a1 adrenoceptors (small bp fall)
blockage of kidney b1 receptors decreases renin and blockage of presynaptic b2 on symp nerve
so delayed indirect fall in vasc resistance with continued reduced cardiac output so BP down
which adrenoceptors do beta blockers antagonise in the heart?
a. B1
b. B2
c. B3
d. a1
e. a2
a.B1
what acts on the vascular a1 receptors following b1 antagonism in the heart to increase peripheral vascular resistance ?
a. adrenaline
b. epinephrine
c. choline
d. noradrenaline
d.noradrenaline
why is there a delayed indirect fall in TPR when taking beta blockers?
a. noradrenaline acting on vascular a1 adrenoceptors
b. blockage of b1 receptors in kidney reducing renin secretion
c. decreased parasympathetic outflow and blockade of facilitator pre synaptic B2 receptors
b. blockage of b1 receptors in kidney reducing renin secretion
(+ decreasedcentral sympathetic outflow and blockade of facilitator pre-
synaptic β2 receptors on sympathetic nerve terminals
blockage of which receptors in the kidney leads to reduced renin secretion?
a. a1
b. a2
c. b1
d. b2
e. b3
c.b1
which drug is most likley to be given for glaucoma?
a. ACEi
b. B blocker
c. ARNI
d. ARB
b.B blocker
when are B blockers used in hypertension?
a. first line
b. second line
c. other drugs unsuitability
c.other drugs unsuitability
which group has generally higher renin levels?
a. caucasion older
b. caucasian younger
c. black african older
d. black african younger
b.caucasian younger
in which group of patients are b blockers most beneficial?
a. caucasion older
b. caucasian younger
c. black african older
d. black african younger
b.caucasian younger
which of these drugs gives patients an increased risk of impaired glucose regulation vs other drugs?
a. ccb
b. ARB
c. ARNI
d. B blockers
d.B blockers
what step of hypertension management are b blockers introduced?
a/1
b. 2
c. 3
d. 4
d.4
with atrial fibrillation (fast irregularly irregular rhythm) there is an increased risk of?
a. stroke
b. hypertension
c. MI
d. atherosclerosis
a.stroke
what drug is used in the management of supraventricular tachycardia?
a. beta blocker
b. NSAID
c. CCB
d. ARB
a.beta blocker
How are B blockers used in prophylaxis of angina?
a. blunt parsaympathetic response to excercise
b. blunt sympathetic pain response
c. blunt sympathetic response to exercise
d. blunt parasympathetic response to pain
c. blunt sympathetic response to exercise
beta blockers reducing peripheral vascular resitance reduces oxygen demand , BP and?
a. pre load
b. after load
c. heart rate
b.after load
what is true of beta blockers?
a. reduce heart rate and contractility so O2 demand
b. reduce heart rate and increase cardiac contractility to reduce o2 demand
c. increase blood pressure by reducing after load
a.reduce heart rate and contractility so O2 demand
what does the prolonged diastole caused by b blockers improve?
a. pulse rhytm
b. heart rate
c. subendocardial myocardium perfusion
d. supepicardial myocardium perfusion
c.subendocardial myocardium perfusion
b blockers are particularly beneficial for secondary MI prevntion in which group?
a. young caucasian
b. left ventricular dysfunction/ cardiac ischaemia
d. atrial fibrillation
b.left ventricular dysfunction/ cardiac ischaemia
which of these are B blockers contraindicated in?
a. left ventricular dysfunction/ cardiac ischaemia
b. atrial fibrillation
c. supraventricular tachycardia
d. acute/ unstable heart failure
d.acute/ unstable heart failure
compromise CO and promote pulmonary odoema
carvedilol, bisoprolol and metoprolol are useful in which condition?
a. left ventricular dysfunction/ cardiac ischaemia
b. atrial fibrillation
c. supraventricular tachycardia
d. acute/ unstable heart failure
e. chronic stable systolic failure
e.chronic stable systolic failure
what is the most significant way that b blockers benefit patients with stable chronic heart failure?
a. reduce heart rate
b. decrease RAAS activation
c. attenuate adverse remodelling
d. anti arrhythmic effects
d. anti arrhythmic effects
in heart failure with reduced ejection fraction what should be offered first line alongside a ACEi?
a. ccb
b. ARNI
c. NEP enzyme inhibitor
d. BB
d.BB
BB are used for prophylaxis of stable angina and which other condition?
a. heart failure
b. left ventricular dysfunction
c. migraine
d. depression
c. migraine
how do b blockers benefit glaucoma?
a. reduce aqueous humour production by cilliary body so reduce intraocular pressure
b. reduce aqueous humour production by cilliary body so reduce interocular pressure
reduce aqueous humour production by sclera so reduce interocular pressure
a.reduce aqueous humour production by cilliary body so reduce intraocular pressure
true or false beta blockers reduce the feeling of anxiety
a. true
b. false
b.false
they reduce physical symptoms mediated by b adrenoceptors only (trembling, palpatations, anxiety)
what is the major adverse effect of BB?
a. heart block
b. fatigue
c. intermittent claudication
d. bradycardia
d.bradycardia
what does lowered heart rate leading to reduced cardiac output resulting in hypotension, fainting and weakness refer to?
a. AV block
b. bradycardia
c. bronchospasm
c. heart failure
b.bradycardia
bradycardia is less marked with…
a. water soluble BB
b. lipid soluble BB
c. partial agonists
d. non partial agonists
c. partial agonists
which is true in heart block?
a. PR intervals do not change
b. PR intervals change
c. All P waves conduct to ventricles
d. no P waves conduct to ventricles
a.PR intervals do not change
which of these side effects is not caused by B2 adrenoceptor antagonism
a. raynauds exacerbation
b. cold hands and feet
c. bronchospasm in asthmatics/copd
d. fatigue
d.fatigue
which of these metabolic effects is not a side effect of BB?
a. prolonged hypoglycaemia
b. dyslipidaemia
c. high iron
c. high iron
Which of these is not a contraindication for BB ?
a. elderly
b. asthma
c. type 1 diabetes
d. bradycardia and heart block
a.elderly
true or false BB should be withdrawn suddenly
false
could cause hypertension, sngina pectoris and acute MI
rebound sympathetic stimulation
which of these should B blockers not be used in conjunction with?
a. verapamil
b. losartan
c. atenolol
a.verapamil
CCB
-osin
a1 adrenoceptor antagonist
which of these drugs is a non selective competitive reversible a adrenoceptor antagonist?
a.prazosin
b/tamulosin
c.phentolamine
d.phenoxybenzamine
c.phentolamine
which of these drugs is a non selective competitive irreversible a adrenoceptor antagonist?
a.prazosin
b/tamulosin
c.phentolamine
d.phenoxybenzamine
d.phenoxybenzamine
which of these drugs is an a1 selective a adrenoceptor antagonist?
a.prazosin
b/tamulosin
c.phentolamine
d.phenoxybenzamine
a.prazosin
b/tamulosin
what do a adrenoceptor antagonists do?
a. reduce heart rate
b. reduce peripheral vascular resistance
c. increase peripheral vascular resistance
d. reduce cardiac work
b. reduce peripheral vascular resistance
where do a adrenoceptor antagonists most significantly antagonise postsynaptic a1?
a. large veins
b. small veins and capillaries
c. small arteries and arterioles
d. large veins and arteries
c.small arteries and arterioles
true or false a adrenoceptor antagonists cause a rebound increase in heart rate, cardiac work and oxygen demand?
a. true
b. false
a.true
sympathetic activation, B adrenoceptor stimulation
why is sympathetic activation less marked in selective a1 antagonists?
a. -ve feedback a2 adrenoceptor not blocked
b. +ve feedback a2 adrenoceptor not blocked
c. -ve feedback b1 adrenoceptor not blocked
d. +ve feedback b1 adrenoceptor not blocked
a.-ve feedback a2 adrenoceptor not blocked
what drug is used for management of hypertension secondary to phaeochromocytoma?
a. BB
c. ARB
d. ACEi
e. aAA
e. aAA
what drug is used to relieve urinary retention in prostate hyperplasia?
a. BB
c. ARB
d. ACEi
e. aAA
e. aAA
block a1a adrenoceptor mediated contraction of bladder sphincter
when should the first dose of aAA be given in order to avoid postural hypotension?
a. morning
b. evening
b.evening
loss of reflex activation of venoconstriction mediated by which adrenoceptor leads to postural hypotension?
a. B1
b. B2
c. B3
d. a1
e. a2
d.a1
dilation of meningeal vessels leads to which side effect of aAA?
a,nasal congestion
b. stress incontinence
c. headache
d. postural hypotension
c.headache
dilation of mucosal arteries leads to which side effect of aAA?
a,nasal congestion
b. stress incontinence
c. headache
d. postural hypotension
a,nasal congestion
blockade of the a1a adrenoceptor leads to which side effect of aAA?
a,nasal congestion
b. stress incontinence
c. headache
d. postural hypotension
b.stress incontinence
in which patient demographic is aAA associated stress incontinence most common?
a. overweight females
b. overweight males
c. underweight females
d. underweight males
a.overweight females
