Pharmacology of Shock and ADHF

Question 1

Inotropy

Answer 1

Altered contractility

Question 2

Lusitropy

Answer 2

Altered relaxation

Question 3

Chrontropy

Answer 3

Altered contraction rate

Question 4

Dromotropy

Answer 4

Altered AV conduction

Question 5

Alpha 1

Answer 5

Smooth muscle

Question 6

Beta 1

Answer 6

Heart, kidneys

Question 7

Which adrenergic receptor subtypes are the
most important in the treatment of ADHF and
shock?

Answer 7

Alpha 1 and Beta 1

Question 8

More intracellular Ca =

Answer 8

Stronger smooth muscle contraction

Question 9

Alpha 1 adrenergic receptor agonism =

Answer 9

Increases Ca in smooth muscle and is a Gq coupled receptor

Question 10

Activation of the a 1-adrenergic system
increases calcium within smooth muscle cells
and promotes ______

Answer 10

Actin-myosin cross bridging and smooth muscle contraction and therefore increase in blood pressure

Question 11

Epinepherine binds to?

Answer 11

Alpha 1 and Beta 1. Leads to vasosconstriction, clearing of airways, and increases HR

Question 12

Norepinepherine binds to?

Answer 12

Alpha 1 and Beta 1

Question 13

Dopamine at high concentrations?

Answer 13

Binds to Beta 1 to treat shock and extremely high for alpha 1

Question 14

Pheylepherine binds to?

Answer 14

Just alpha 1

Question 15

Wh ich adrenergic receptor subtype is responsible for the reversal of anaphylactic shock with epinephrine?

Answer 15

Alpha 1

Question 16

Which adrenergic receptor subtype is responsible for the reversal of cardiac arrest/asystole with epinephrine?

Answer 16

Beta 1

Question 17

Which adrenergic receptor subtype is responsible for the reversal of bronchospasm with epinephrine?

Answer 17

Beta 2

Question 18

Increasing activity of the L-type Calcium channel would result in:

Answer 18

Increased intracellular calcium, leading to increased contractility (inotropy)

Question 19

Phosphorylation of the β
1
-adrenergic system
increases _____

Answer 19

calcium within cardiomyocytes

Question 20

In chronic heart failure, characterized by low cardiac output, a cornerstone of treatment includes activation of the b
1
-adrenergic system.
True or false?

Answer 20

False. You don’t want to help it work harder. Increasing work load makes it decompensate faster

Question 21

Inhibition of the β1-adrenergic system

decreases calcium within cardiomyocytes and promotes ________

Answer 21

Reduce actin-myosin cross bridgingreduce ardiomyocyte contraction, and negative inotropy

Question 22

Activation of the β 1-adrenergic system
increases calcium within cardiomyocytes and
promotes ______

Answer 22

Actin myosin cross bridging, cardiomyocyte contraction, and positive inotropy

Question 23

True or False: a and b adrenergic receptors use the same GPCR mechanisms when activated.

Answer 23

False. Alpha 1 uses Gq. Beta 1 uses Gs coupled receptors.

Question 24

Dobutamine acts on?

Answer 24

Beta 1 and is used for cardiogenic shock. Positive inotropy

Question 25

Isoproterenol acts on?

Answer 25

Beta 1 and 2. Treats bradychardia, heart block, and cardiac arrest

Question 26

Phosphodiesterase inhibitors, such as milrinone, act as positive inotropes by____________.

Answer 26

Preventing breakdown of cAMP

Question 27

Milrinone MOA

Answer 27

Antagonist of PDE3 and has a similar effect of dobutamine and epinephrine by acting positively in inotropy

Question 28

In the binding site of a receptor, which atoms within functional groups can participate in hydrogen bonding interactions?

Answer 28

Hydrogen, Nitrogen, and Oxygen but Fluorine can as well

Question 29

V1RS located in vascular smooth muscles and activation causes?

Answer 29

Activation of vasoconstriction and positive inotropy (high doses)

Question 30

V2RS are located in the kidney and activation causes?

Answer 30

cAMP activation and causes antidiuresis (water retention)