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BCR 1 > Pharmacology - Adrenoceptor antagonists > Flashcards

Pharmacology - Adrenoceptor antagonists Flashcards

1
Q

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

A

b. b1

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2
Q

what is the primary adrenoceptor in the arterioles that when activated causes constriction?

a. a1
b. b1
c. b2
d. a2

A

a. a1

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3
Q

what is the primary adrenoceptor in the skeletal muscle that when activated causes constriction?

a. a1
b. b1
c. b2
d. a2

A

c. b2

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4
Q

what is the primary adrenoceptor in the veins that when activated causes constriction?

a. a1
b. b1
c. b2
d. a2

A

a. a1

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5
Q

what is the primary adrenoceptor in the airway smooth muscle that when activated causes di;ation?

a. a1
b. b1
c. b2
d. a2

A

c. b2

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6
Q

what do a1 generally do in smooth muscle?

a. constrict
b. relax

A

a.constrict

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7
Q

what do b2 generally do in smooth muscle ?

a. constrict
b. relax

A

b.relax

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8
Q

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

a. a1

c. b2

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9
Q

which adrenoceptor causes tremor and glycogenolysis in skeletal muscle?

a. a1
b. b1
c. b2
d. a2

A

c. b2

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10
Q

which adrenoceptor causes glycogenolysis in the liver? (2 choices)

a. a1
b. b1
c. b2
d. a2

A

a. a1

b. b2

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11
Q

which adrenoceptor causes lipolysis in the adipose tissue ?

a. a1
b. b1
c. b3
d. a2

A

c.b3

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12
Q

which adrenoceptor causes increased renin secretion in the kidney ?

a. a1
b. b1
c. b3
d. a2

A

b.b1

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13
Q

which adrenoceptor causes aggregation of the platelets?

a. a1
b. b1
c. b3
d. a2

A

d. a2

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14
Q

adrenaline binding to which adrenoceptor causes increased release from peripheral sympathetic nerves?

a. a1
b. b1
c. b2
d. a2

A

c. b2

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15
Q

adrenaline binding to which adrenoceptor causes decreased release from peripheral sympathetic nerves?

a. a1
b. b1
c. b2
d. a2

A

d.a2

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16
Q

activation of which adrenoceptors in the brainstem leads to decreased sympathetic outflow?

a. a1
b. b1
c. b2
d. a2

A

d.a2

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17
Q

what group of drugs prevent the action of epinephrine and norepinephrine?

a. ccb
b. beta blockers
c. ACE
d. ARBS
e. ARNIS

A

b.beta blockers

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18
Q

-OSIN

A

a1 blockers

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19
Q

-lol

A

beta blockers

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20
Q

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

A

c.propanolol, timolol

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21
Q

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

a.prindolol, oxeprenolol

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22
Q

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

A

b.sotalol

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23
Q

which is true of acebutol?

a. partial agonist non selective
b. non selective
c. partial agonist b1 selective
d. partial agonist b2 selective

A

c.partial agonist b1 selective

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24
Q

which is true of atenolol, metoprolol and bisoprolol?

a. partial agonist non selective
b. non selective
c. b1 selective
d. partial agonist b1 selective

A

c. b1 selective

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25
Q

which is true of carvedilol, labetolol, nebivilolol?

a. partial agonist non selective
b. arteriolar vasodilator
c. b1 selective
d. partial agonist b1 selective

A

b.arteriolar vasodilator

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26
Q

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

A

d.carvedilol, labetolol, nebivolol

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27
Q

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

A

b.sotalol, atenolol

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28
Q

which of these drugs are lipid soluble ?

a. propanolol, oxeprenolol
b. sotalol, atenolol
c. propanolol, timolol
d. carvedilol, labetolol, nebivolol
e. propanolol, oxeprenolol

A

a.propanolol, oxeprenolol

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29
Q

true or false atenolol and sotalol have a long half life

a. true
b. false

A

a.true

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30
Q

true or false propanolol and oxeprenolol have a short half life?

a. true
b. false

A

a.true

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31
Q

dose of propanolol should be reduced in..

a. renal impairment
b. hepatic impairment

A

b.hepatic impairment

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32
Q

dose of atenolol should be reduced in..

a. renal impairment
b. hepatic impairment

A

a.renal impairment

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33
Q

which drug is most likely to cause nightmares and poor quality sleep?

a. atenolol
b. sotalol
c. propanolol

A

c.propanolol

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34
Q

true or false beta blockers reduce skeletal and peripheral blood flow?

A

true

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35
Q

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

A

c.reduce ejection fraction

36
Q

how do beta blockers reduce blood pressure?

A

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

37
Q

which adrenoceptors do beta blockers antagonise in the heart?

a. B1
b. B2
c. B3
d. a1
e. a2

A

a.B1

38
Q

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

A

d.noradrenaline

39
Q

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

A

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

40
Q

blockage of which receptors in the kidney leads to reduced renin secretion?

a. a1
b. a2
c. b1
d. b2
e. b3

A

c.b1

41
Q

which drug is most likley to be given for glaucoma?

a. ACEi
b. B blocker
c. ARNI
d. ARB

A

b.B blocker

42
Q

when are B blockers used in hypertension?

a. first line
b. second line
c. other drugs unsuitability

A

c.other drugs unsuitability

43
Q

which group has generally higher renin levels?

a. caucasion older
b. caucasian younger
c. black african older
d. black african younger

A

b.caucasian younger

44
Q

in which group of patients are b blockers most beneficial?

a. caucasion older
b. caucasian younger
c. black african older
d. black african younger

A

b.caucasian younger

45
Q

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

A

d.B blockers

46
Q

what step of hypertension management are b blockers introduced?

a/1

b. 2
c. 3
d. 4

A

d.4

47
Q

with atrial fibrillation (fast irregularly irregular rhythm) there is an increased risk of?

a. stroke
b. hypertension
c. MI
d. atherosclerosis

A

a.stroke

48
Q

what drug is used in the management of supraventricular tachycardia?

a. beta blocker
b. NSAID
c. CCB
d. ARB

A

a.beta blocker

49
Q

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

A

c. blunt sympathetic response to exercise

50
Q

beta blockers reducing peripheral vascular resitance reduces oxygen demand , BP and?

a. pre load
b. after load
c. heart rate

A

b.after load

51
Q

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

a.reduce heart rate and contractility so O2 demand

52
Q

what does the prolonged diastole caused by b blockers improve?

a. pulse rhytm
b. heart rate
c. subendocardial myocardium perfusion
d. supepicardial myocardium perfusion

A

c.subendocardial myocardium perfusion

53
Q

b blockers are particularly beneficial for secondary MI prevntion in which group?

a. young caucasian
b. left ventricular dysfunction/ cardiac ischaemia
d. atrial fibrillation

A

b.left ventricular dysfunction/ cardiac ischaemia

54
Q

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

A

d.acute/ unstable heart failure

compromise CO and promote pulmonary odoema

55
Q

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

A

e.chronic stable systolic failure

56
Q

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

A

d. anti arrhythmic effects

57
Q

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

A

d.BB

58
Q

BB are used for prophylaxis of stable angina and which other condition?

a. heart failure
b. left ventricular dysfunction
c. migraine
d. depression

A

c. migraine

59
Q

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

a.reduce aqueous humour production by cilliary body so reduce intraocular pressure

60
Q

true or false beta blockers reduce the feeling of anxiety

a. true
b. false

A

b.false

they reduce physical symptoms mediated by b adrenoceptors only (trembling, palpatations, anxiety)

61
Q

what is the major adverse effect of BB?

a. heart block
b. fatigue
c. intermittent claudication
d. bradycardia

A

d.bradycardia

62
Q

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

A

b.bradycardia

63
Q

bradycardia is less marked with…

a. water soluble BB
b. lipid soluble BB
c. partial agonists
d. non partial agonists

A

c. partial agonists

64
Q

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

a.PR intervals do not change

65
Q

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

A

d.fatigue

66
Q

which of these metabolic effects is not a side effect of BB?

a. prolonged hypoglycaemia
b. dyslipidaemia
c. high iron

A

c. high iron

67
Q

Which of these is not a contraindication for BB ?

a. elderly
b. asthma
c. type 1 diabetes
d. bradycardia and heart block

A

a.elderly

68
Q

true or false BB should be withdrawn suddenly

A

false
could cause hypertension, sngina pectoris and acute MI

rebound sympathetic stimulation

69
Q

which of these should B blockers not be used in conjunction with?

a. verapamil
b. losartan
c. atenolol

A

a.verapamil

CCB

70
Q

-osin

A

a1 adrenoceptor antagonist

71
Q

which of these drugs is a non selective competitive reversible a adrenoceptor antagonist?

a.prazosin
b/tamulosin
c.phentolamine
d.phenoxybenzamine

A

c.phentolamine

72
Q

which of these drugs is a non selective competitive irreversible a adrenoceptor antagonist?

a.prazosin
b/tamulosin
c.phentolamine
d.phenoxybenzamine

A

d.phenoxybenzamine

73
Q

which of these drugs is an a1 selective a adrenoceptor antagonist?

a.prazosin
b/tamulosin
c.phentolamine
d.phenoxybenzamine

A

a.prazosin

b/tamulosin

74
Q

what do a adrenoceptor antagonists do?

a. reduce heart rate
b. reduce peripheral vascular resistance
c. increase peripheral vascular resistance
d. reduce cardiac work

A

b. reduce peripheral vascular resistance

75
Q

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

A

c.small arteries and arterioles

76
Q

true or false a adrenoceptor antagonists cause a rebound increase in heart rate, cardiac work and oxygen demand?

a. true
b. false

A

a.true

sympathetic activation, B adrenoceptor stimulation

77
Q

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

a.-ve feedback a2 adrenoceptor not blocked

78
Q

what drug is used for management of hypertension secondary to phaeochromocytoma?

a. BB
c. ARB
d. ACEi
e. aAA

A

e. aAA

79
Q

what drug is used to relieve urinary retention in prostate hyperplasia?

a. BB
c. ARB
d. ACEi
e. aAA

A

e. aAA

block a1a adrenoceptor mediated contraction of bladder sphincter

80
Q

when should the first dose of aAA be given in order to avoid postural hypotension?

a. morning
b. evening

A

b.evening

81
Q

loss of reflex activation of venoconstriction mediated by which adrenoceptor leads to postural hypotension?

a. B1
b. B2
c. B3
d. a1
e. a2

A

d.a1

82
Q

dilation of meningeal vessels leads to which side effect of aAA?

a,nasal congestion

b. stress incontinence
c. headache
d. postural hypotension

A

c.headache

83
Q

dilation of mucosal arteries leads to which side effect of aAA?

a,nasal congestion

b. stress incontinence
c. headache
d. postural hypotension

A

a,nasal congestion

84
Q

blockade of the a1a adrenoceptor leads to which side effect of aAA?

a,nasal congestion

b. stress incontinence
c. headache
d. postural hypotension

A

b.stress incontinence

85
Q

in which patient demographic is aAA associated stress incontinence most common?

a. overweight females
b. overweight males
c. underweight females
d. underweight males

A

a.overweight females

BCR 1 (60 decks)

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