Pharm Ii -Exam 3

Front 1

What is the treatment of choice for an actively wheezing pt?

Back 1

B agonist

Front 2

What is the treatment of choice for prevention of asthma?

Back 2

Inhaled corticosteroids

Front 3

Where does adenosine work?

Back 3

purinergic receptors

Front 4

How do BBlockers work? (3 ways)

Back 4

1. direct CNS suppression
2. direct cardiac depression: blocks beta 1 receptors
3. prevent renin release from kidneys

Front 5

Why do bblockers prevent renin release from kidneys?

Back 5

There are beta 1 receptors in kidneys

Front 6

Why does esmolol have a short DOA?

Back 6

metabolized by non specific esterases (RBC esterases) so short DOA

Front 7

Nipride: arteria ldilator, venous dilator or both?

Back 7

both

Front 8

Nitroglycerin: arterial dilator, venous dilator or both?

Back 8

venous

Front 9

What is the major difference between labelotlol and esmolol?

Back 9

esmolol has vasoconstrictive property, labetolol has vasodilator effect

Front 10

How do direct agents work?

Back 10

on smooth muscle of vascular wall

Front 11

How is nipride metabolized?

Back 11

by hgb

Front 12

What is the cause of rebound HTN after stopping nipride infusion?

Back 12

renin release

Front 13

How do CCBs work to lower BP?

Back 13

By blocking calcium entry into myocyt. Calcium is needed for cardiac muscle contraction, and CCBs block it from entering. Also has vasodilation effect.

Front 14

What is step 1 of the 4 step asthma classification?
What is tx?

Back 14

Mild intermittent
prn inhaled B agonist (albuterol)

Front 15

What is step 2 on 4 step asthma classification scale? What is tx?

Back 15

Mild persistant
inhaled steroid +/- singulair

Front 16

What is step 3 on asthma classfication scale? What is tx?

Back 16

moderate persistant
medium dose inhaled steroids +/- LABA

Front 17

What is step 4 on asthma classification scale? What is tx?

Back 17

high dose inhaled steroids, LABA, systemic steroids

Front 18

Do you need to give stress dose of IV steroids to pt with daily inhaled steroids ?

Back 18

No.

Front 19

How do Class 1 antiarrythmic agents work? What kind of arrythmias are they best for?

Back 19

Blocks Na channels
ventricular

Front 20

What drugs are in Class 2 for antiarrythmic agents?

Back 20

BBlockers

Front 21

How do BBlockers work?
Examples of drugs?

Back 21

decrease HR and contractility
metoproLOL, carvediLOL, esmoLOL, antenoLOL

Front 22

How do class 3 antiarrythmics work?

Back 22

blocks K channels

Front 23

Examples of Class 1 antiarrythmics?

Back 23

lido, Pronestyl, norpace,

Front 24

What drugs are Class 4 antarrythmics? How do they work?

Back 24

CCBs. Work by decreasing amt of Ca in cell, which decreases contractility.

Front 25

Which antiarrythmic class is best for atrial arrythmias?

Back 25

CCBs (or BBs)

Front 26

Which agents are drugs of choice for SVT?

Back 26

CCB's (or BB). Adenosine is too, but wouldnt use in anesthesia setting

Front 27

Which drugs are tx of choice for ventricular dysrythmias?

Back 27

lido or amio

Front 28

What is tx of choice for Toursades de Points VT?

Back 28

magnesium

Front 29

What is JNC6 "normal BP"?

Back 29

<120/<80

Front 30

What is considered "prehypertension"?

Back 30

120-139/80-89

Front 31

What is considered stage 1 HTN?

Back 31

140-159/90-99

Front 32

What is considered stage 2 HTN?

Back 32

>160/>100

Front 33

Hypertensive urgency is
A. lower within 24 hours or pt could have event-oral agents could be OK
B. Lower within 1 hour

Back 33

A

Front 34

Hypertensive emergency is:
A. must lower within 24 hours or pt could have event. Oral agents might be OK
B. Needs lowered within 1 hour

Back 34

B

Front 35

Which of the following are drugs of choice for HTN in pregnant women?
A. atenolol
B. labetolol
C. hydralazine
D. nipride

Back 35

B (according to Nag)
C (according to texts)

Front 36

What is the MOA for ACE inhibitors?

Back 36

prevents conversion of angiotenin 1 to angiotensin 2

Front 37

What is the MOA for ARBs?

Back 37

angiotensin 2 is made, but the receptor is blocked so cant bind

Front 38

What is the MOA for DRIs?

Back 38

angiotensinogen can'tbe made into angiotensin 1

Front 39

What are the 3 MOA for beta blockers?

Back 39

1. direct CNS depression'
2. direct cardiac depression by blocking beta 1 receptor
3. prevents renin release

Front 40

Which of the following agents are vasodilators?
A. esmolol
B. labetolol

Back 40

B

Front 41

What is the only BBlocker with vasodilating properties?

Back 41

labetolol

Front 42

Which of the following are vasoconstricting?
A. labetolol
B. esmolol

Back 42

B

Front 43

How is esmolol metabolized?

Back 43

hydrolyzed by RBC esterases-very short duration of action

Front 44

Why does nipride cause hypoxia?

Back 44

inhibits cytochrome oxidase inside the cell

Front 45

How is nipride metabolized?

Back 45

by hemoglobin

Front 46

What is the Tx for nipride toxicity/cyanide poisoning?

Back 46

1. Na nitrite
2. Na thiosulfate
3. Methylene blue

Front 47

What is the cause of rebound HTN after d/c nipride?

Back 47

renin release

Front 48

What is the MOA of diuretics?

Back 48

decreases preload and an additional unknown action

Front 49

What does a BB with ISA activity mean?

Back 49

intrinsic sympathomimetic activity.
Less efficacy, "weaker" bblockers

Front 50

What special consideration is given to clonidine?

Back 50

lots of rebound HTN.

Front 51

Treatment of choice for acute angina?

Back 51

nitrates

Front 52

What is the MOA for nitrates?

Back 52

decreases O2 demand by preload reduction

Front 53

What class of agents is best for variant or Prinzmetals angina?

Back 53

CCB

Front 54

What is the MOA for ASA?

Back 54

inhibits plt aggregation and endothelial COX.

Front 55

What is the MOA for CCBs?

Back 55

reduced preload, reduced afterload and vasodilation ( increase coronary flow)

Front 56

What is the MOA for statins?

Back 56

reduce thrombogenicity and antiplaque
AKA HMG-Co-A reductase inhibitors

Front 57

What is the single biggest determinant of myocardial oxygen balance?

Back 57

heart rate

Front 58

Class 1 angina:

Back 58

occurs with strenous activity but not normal activity

Front 59

Class 2 angina:

Back 59

slight limitation of ordinary activity

Front 60

Class 3 angina:

Back 60

marked limitation of ordinary activity

Front 61

Class 4 angina:

Back 61

pain present at rest or can't do any activity without angina

Front 62

Which of the following agents is more of an arterial vasodilator?
A. nitroglycerin
B.. Nipride
C. hydralazine
D. labetolol

Back 62

C

Front 63

Which of the following agents is more of a venous vasodilator?
A. NTG
B. NIP
C. hydralazine
D. labetolol

Back 63

A

Front 64

Tx of choice for stable chronic angina?

Back 64

BBlockers

Front 65

Elective surgeries should be postponed how long for a pt with bare metal stents?

Back 65

4-6 weeks

Front 66

Elective surgeries should be postponed how long for pts with drug eluting stents?

Back 66

12 months

Front 67

Which of the following conditions represent the greatest anesthetic risk?
A. angina
B. CAD
C. CHF
D. HTN

Back 67

C

Front 68

Class 1 CHF:

Back 68

can do normal physicl exercise without sx

Front 69

Class 2 CHF:

Back 69

slight limitation. sx with ordinary activity

Front 70

Class 3 CHF:

Back 70

marked limitation. sx with less than ordinary activity

Front 71

Class 4 CHF:

Back 71

symptoms at rest, cant carry out any activity

Front 72

Why do PDE inhibitors ( milrinone) work?

Back 72

blocks breakdown of cAMP

Front 73

How does dig work?

Back 73

blocks Na-K-ATPase pump. Since K and NA cant get back where they belong, Ca-Na pump takes over, which increase Ca inside cell. More ca=stronger contraction.

Front 74

Is there a clear therapeutic range for dig?

Back 74

No.

Front 75

What does K level is inverse proportion to digitalis mean?

Back 75

How well dig binds to Na-K-ATPase pump depends on serum K level. If K high, binds less, If K low, binds more.