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55 Cards in this Set
- Front
- Back
Class IV:
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Calcium Channel Blockers
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Class III responsible for:
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prolonged repolarization
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All are classes of antidysrthymics
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all of the above (I-IV)
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Phase II
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low membrane conductance and slow calcium inflow
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Phase IV
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deactivates K & reduces transmembrane potential
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Phenytoin used for:
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dig toxicity arrhythmia
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Pt is on amiodorone what is action to decrease pulmonary toxicity?
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Reduced FIO2
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Magnesium influenced by:
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by N, K, Ca & Na/K ATP
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CCB act at:
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L alpha type receptors
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How do CCBs affect HR and afterload?
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reduce HR and decrease afterload
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CCB do all of the following except:
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increase SA conduction
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Nifedipine SL causes all of the above
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MI, Cerebral ischemia & hypotension
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Essential HTN and tachy but does not have angina which drug?
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Diltiazem
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CCB do all of the above EXCEPT:
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have an effect on VAA
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Dantrolene causes hyperkalemia and hypotension when given with:
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verapamil or diltiazem
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All of the following are common to 1,4 Dyhyropyramidines cause reflex tachy due to sympathetic/baroreceptor except:
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Verapamil
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Greatest depression of AV node conduction?
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Verapamil
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Which is not a class of CCB?
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Beneophyrines (or something like that)
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Magnesium has diverse electrophysiologic effects on the heart by influencing NA, K, Ca channels and?
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NAK ATPase.
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Which is true regarding Vasopressin?
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It is produced by the nuclei of the hypothalamus and is released by the posterior pituitary gland
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Characterized by low membrane conductance and the activation of a slow inward Ca++ current is?
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Phase 2 (Plateau phase)
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Outward K+ current is deactivated and an inward Na+ current reduces transmembrane potential?
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Phase 4
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Which class prolongs repolarization?
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Class III
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Something about digitalis?
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Positive inotrope-drug induced inhibition of the NA-K ATPase ion transport system.
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The four main classes of antiarythmic agents are:
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Class I Na channel Blockers
Class II adrenergic receptor antagonist Class III prolong repolarization Class IV Ca channel blockers (All of the above) |
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Verapamil is a:
(not a 1,4dihydropyrimidine) |
Phenylaklyamine
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Verapamil depresses which node the most?
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A-V node
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Adenosine blocks __________ cells from depolarization
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POTASSIUM
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Choose two of the following interactions that may occur with calcium channel blockers and anesthetic drugs:
a. Increase the risk of local toxicity b. Have no effect when on depolarizing and non-depolarizing muscle relaxants c. Have no effect on platelet function d. Hyperkalemia can occur when treating hypokalemia with the use of a exogenous potassium infusion. |
a. Increase the risk of local toxicity
d. Hyperkalemia can occur when treating hypokalemia with the use of a exogenous potassium infusion. |
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12) Which of the following is a false statement regarding the pharmacologic effects of calcium channel blockers?
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a. Decrease in myocardial contractility (FALSE) – didn’t get the rest of it
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Which of the following is a true statement regarding the cardiovascular effects of amiodarone.
a. Prolong Q-T interval b. Decreases the incidence of tachydysrhythmia’s including torsades de points c. Increase the responsiveness to catecholamiens d. General anesthesia may increase amioderone’s postive inotropic effects |
a. Prolong Q-T interval
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14) All of the following are classification of calcium ch blockers except:
a. Benzothiazepines b. 1,4 dihydropyridines c. Butyrophenones d. Phenylakylamines |
c. Butyrophenones
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15) Which voltage-gated channel in the cardiovascular system is the main channel for slow and sustained Ca++ entry into vascular smooth muscle:
a. Mu channels b. L channels c. Pi channels d. T channels |
b. L channels
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In the process of excitation-contraction coupling, intracellular __________ combines with _____________ to form the complex that activates myosin and causes the formation of cross-bridges with actin, which in turn begins the process of muscle contraction.
a. Sodium cystol b. Calcium cyclooxygenase c. Sodium ATPs d. Calcium Camodulin |
d. Calcium Camodulin
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17) Calcium channel blockers decrease myocardial O2 demand by __________ and _____________
a. Decreasing afterload, decreasing HR b. Decreasing preload, decreasing HR c. Increasing afterload, increasing HR d. Increasing preload, increasing HR |
a. Decreasing afterload, decreasing HR
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18) Mrs. Valentino is a 78 year old who has essential HTN and left ventricular dysfunction.
She suddenly has a HR of 165 and B/P 191/88 She does not have SOB or Angina Which calcium channel blocker would be most appropriate for her at this time? a. Verpamil b. Nifedipine c. Nimodipine d. Dilatizem |
d. Dilatizem
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19) During surgery for a subdural hematoma, a cerebral vasospasm develops. Which of the following calcium channel blockers is most appropriate management for this problem?
a. Verapamil b. Nimodipine c. Dilatizem d. Nifedipine |
b. Nimodipine
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20) Clinical indications for Verapamil include:
a. Ventricular tachycardias b. Cerebral vasomotor spasm c. Angina pectoris d. Fetal distress |
c. Angina pectoris
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21) Emergency sublingual administration of nifedipine for HTN emergencies comes at an increase risk for
a. Cerbrovascular ischemia b. Myocardial ischemia c. Sever hypotention d. All of the above |
d. All of the above
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Calcium channel blocking drugs _________ the effects of non-depolarizing and ___________ the effects of depolarizing neuromuscular blocking agents.
Filling in the blanks above, which combination of words below will make this statement true? a. potentiate pontentiate b. potentiate diminish c. diminish potentiate d. diminish diminish |
a. potentiate pontentiate
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Which of the following statements is false with respect to CCBs:
a. CCBs may interfere with Ca++ mediated platelet functions b. CCBs may increase the plasma concentration of digoxin c. CCBs have no adverse interaction with volatile anesthetic agents d. CCBs may slow intracellular movement of potassium |
c. CCBs have no adverse interaction with volatile anesthetic agents
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24) Which of the following calcium channel blockers has a greater coronary and peripheral vasodilating properties resulting in activation of baroreceptors increasing heart rate?
a. Verapamil b. Nimodipine c. Nifedipine d. Diltiazem |
c. Nifedipine
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Administration of Dantrolene to a patient receiving Verapamil or Diltiazem may result in _______________ and _____________
a. hyperkalemia hypotention b. hyperkalemia hypertention c. hypokalemia hypotention d. hypokalemia hypertention |
a. hyperkalemia hypotention
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Which of the following predominantly blocks the Calcium channels AV node?
a. Nimodipine b. Nicardipine c. Nifedipine d. Diltiazem |
d. Diltiazem
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Which calcium channel blocker produces the greatest degree of coronary dilation?
a. Nicardipine b. Nifedipine c. Diltiazem d. Verapamil |
a. Nicardipine
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Which calcium channel blocker produces the depression node conduction?
a. Verapamil b. Nifedipine c. Diltiazem d. Nimodipine |
a. Verapamil
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More common to the 1, 4 dihydropyridines, reflex tachycardia attributed to sympathetic nervous system activation or baroreceptor reflexes may be observed with acute administration of all of the following EXCEPT:
a. Nifedipine b. Nicardipine c. Verapamil d. Amlodipine |
Verapamil
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Factors underlying cardiac dysrrhytnmias that are to be considered with all preop interviews include
a. Arterial hypoxia b. Electrolyte and acid base abnormalities c. Administration of certain drugs d. All of the above |
d. All of the above
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Phenytoin
a. is the drug of choice for complete heart block b. is metabolized chiefly by cholinesterease c. can be useful in the treatment of digitalis associated arrhythmias d. is given in D5W |
c. can be useful in the treatment of digitalis associated arrhythmias
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Lidocaine
a. is a class IB cardiac drug used principally for suppression of ventricular dysrrhythmias b. Can be safely administered in high doses c. causes severe hematuria if used for a long period of time d. Can cause bronchospasm |
a. is a class IB cardiac drug used principally for suppression of ventricular dysrrhythmias
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Amioderone
a. should be stopped 2 hr before surgery b. has a half life of 4 hrs c. it is used to treast SVT and ventricular dysrrhythmias d. Can cause intraoperative arrythmias and requires pre treatment with lidocaine |
c. it is used to treat SVT and ventricular dysrrhythmias
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The most serious side effect of amioderone is pulmonary toxicity, as an anesthesia provider possible way to reduce the chances of this is to:
a. Administer 100% oxygen for the entire procedure b. Restrict fio2 while maintaining adequate PAO2 c. Increase administration of IV fluids d. Restrict administration of IV fluids |
b. Restrict fio2 while maintaining adequate PAO2
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Digoxin
a. Inhibits Na/K ATPase ion transport system b. Decreases contractile force of the heart c. Increases extracellular Ca ions d. Increases HR |
a. Inhibits Na/K ATPase ion transport system
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45) Which calcium ch in the cardiac muscle is most affected by CCB?
a. L-Type voltage gated b. Receptor operated c. Stretch sensitive d. Passive leak |
a. L-Type voltage gated
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Choose two of the following interactions that may occur with calcium channel blockers and anesthetic drugs
a. Increase the risk of local toxicity b. Have no effect when on depolarizing and non-depolarizing muscle relaxants c. Have no effect on platelet function d. Hyperkalemia can occur when treating hypokalemia with the use of a exogenous potassium infusion. |
a. Increase the risk of local toxicity
d. Hyperkalemia can occur when treating hypokalemia with the use of a exogenous potassium infusion. |