Quiz Questions and Answers Flashcards
Which sympathomimetic is not recommended to be given as a continuous infusion?
Ephedrine
Phrase for Catecholamines and Sympathomimetics
ALL sympathomimetics are catecholamines but not all catecholamines are sympathomimetics
While receiving norepinephrine, a patient accidentally pulls at his IV, causing the skin around the IV site to become red and dark purple. After shutting off the IV infusion, which medication may be administered to prevent further damage due to extravasation?
Phentolamine
At low doses, epinephrine causes which effects most predominantly?
Beta 2
Which of the following vasoconstrictors may work best if the patient is acidotic due to sepsis?
Norepinephrine
A patient with hypotension and tachycardia would benefit most from using which vasopressor?
Phenylephrine
Bronchospasms may occur more frequently with which beta blocker?
Non-Selective Beta Blockers: Propanolol, Nadolol, Timolol
Combined alpha and non-selective: Labetalol and Carvedilol
Chronic use of which class of antihypertensives may potentiate the activity of neuromuscular blockers?
Alpha-2 Agonists
Hydralazine primarily reduces blood pressure by which mechanism of action?
pure arteriole vasodilator
decrease DBP > SBP
has its own receptor site
Angiotensinogen is released from which organ?
LIVER
If a patient is using a Phosphodiesterase 5 inhibitor for pulmonary hypertension (ex: Sildenafil (Revatio)), which vasodilator is unsafe to use to control blood pressure?
Nitroglycerin
Sodium nitroprusside induced cyanide toxicity may present with which of the following symptoms?
Profound hypotension, blurred vision, pink skin, absent reflexes, faint heart sounds
Which antihypertensive may lead to prolonged sedation if using Midazolam for sedation?
Clonidine,
also reduces propofol and thiopental requirements
Which of the following medications may cause accelerated hypertension due to withdrawal if discontinued abruptly, and not restarted soon after a procedure?
Clonidine
Which vasodilator has the fastest onset of action?
Nitro
Which combination of antihypertensives increases the risk of hyperkalemia for patients with chronic kidney disease?
ACE Inhibitors ( w/ NSAIDS, aspirin)
Beta Blockers
High doses of catecholamines primarily produce which effects?
Increase HR, BP,
True of False: Inoconstrictors have lower rates of myocardial oxygen consumption than inodilators.
False, they have higher (Epi, Norepi, Dopamine)
Which electrolyte abnormality greatly increases the risk of developing digoxin toxicity?
Hypercalemia (or hypokalemia, hypomagnesemia if only options)
Glucagon is useful for beta blocker overdose by:
Acts on receptor other than Beta to increase cAMP (Glucagon receptor)
True or False: Milrinone is less potent than Inamrinone and has a lower risk of side effects.
False: milrinone is 15-20x more powerful than Inamrinone and DOES NOT have Thrombocytopenia risk
Which lab value should be monitored closely after administration of Milrinone?
Calcium or Creatinine?
Which inotropes have the highest risk of arrhythmia development?
Dobutamine (lowest risk)<DA<Epi<Isoproterenol (highest risk)
Which type of arrhythmia is the most frequent cause of death from digoxin toxicity?
V-fib
Giapreza ® is a medication used for low blood pressure readings in shock. To which endogenous hormone is this synthetic medication similar?
Angiotensin II
Adenosine may be used for treatment of which of the following arrythmias?
Treatment for PSVT (no effect on arrhythmia distal to AV node)
Torsades de Pointes (TdP) may be exacerbated by which electrolyte abnormality?
Mainly a K+ driven arrhythmia (Class IA and class III drugs block potassium channels and prolong QTc interval)
True or False: Class Ia antiarrhythmics are considered to be the most pro-arrhythmic.
False: the most pro-arrhythmic are class Ic
Which classes of antiarrhythmic are most highly associated with Torsades de Pointes?
Class IA and class III drugs block potassium channels and prolong QTc interval)
Which of the following medications may precipitate Torsades de Pointes?
Ia - Quinidine, Procainamide, Disopyramide, Moricizine
III- Amiodarone, Dronedarone, Sotalol, Ibutilide, Dofetilide, Bretylium
Adenosine produces an arrhythmia to stop an arrhythmia. What is seen on EKG after a dose of adenosine?
3rd degree AV block
Sotalol is primarily classified as which type of antiarrhythmic?
Class III (K+ blocking)
Which of the following antiarrhythmics has the highest risk of drug-drug interactions?
Amiodarone has a lot
Alpha-1 antagonists do what?
Reduce afterload by causing vasodilation
Alpha-2 Agonists….
Reduce sympathetic outflow
Cardio-selective Beta-1 antagonists….
Reduce inotropy, chronotropy, dromotropy and renin release
Hydralazine reduces…
Afterload
Nitroglycerin reduces…
Preload
SNP reduces….
Both preload and afterload