Pharm quiz 3

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Pharm quiz 3
2011-08-11 19:06:44
Pharm quiz3

43-46, 75-76, 27-28 question/answers
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  1. The most prominent actions of angiotensin II are
    vasoconstriction and

    stimulation of aldosterone release
  2. What effect does aldosterone have on the kidneys?
    Retention of sodium and excretion of potassium and hydrogen
  3. The vasculature of which organ is especially rich in angiotensin-converting enzyme (ACE)?
    The Lungs
  4. The most prominent adverse effects of ACE inhibitors include
    first-dose hypertension, cough, hyperkalemia .
  5. Which ACE inhibitor is given intravenously?
  6. The principal protective mechanism of the ACE inhibitors for diabetic and nondiabetic nephropathy is
    reduction of glomerular filtration pressure
  7. Angiotensin II receptor blockers exert their therapeutic effect by
    blocking angiotensin II actions
  8. Eplerenone (Inspra) is the
    first representative of a new class of drugs, selective aldosterone receptor blockers.
  9. Calcium channel blockers are widely used to treat
    hypertension, angina pectoris, cardiac dysrhythmias.
  10. At therapeutic doses, calcium channel blockers act selectively on the
    peripheral arterioles, arteries and arterioles of the heart

    No effect on the Veins
  11. A positive inotropic effect produces
    an increased force of cardiac contraction
  12. Calcium channel blockers and _______ have identical effects on the heart
    Beta Blockers
  13. The overall cardiovascular effect of verapamil is
    simply vasodilation accompanied by reduced arterial pressure and increased coronary perfusion
  14. The most common cause of complaints from patients taking verapamil is
  15. The overall hemodynamic response to nifedipine is
    increased heart rate, lowered blood pressure, increased contractile force of the heart.
  16. Concurrent use of a beta blocker with verapamil or diltiazem can cause
  17. Vasodilators are used for
    hypertension, angina pectoris, heart failure.
  18. Hydralazine produce
    selective dilation of arterioles
  19. nitroglycerin produce
    selective dilation of veins
  20. prazosin
    dilate arterioles and veins
  21. Blood volume is increased by two mechanisms. They include
    Secretion of Aldosterone which acts on the kidney to promote retention of sodium and water, thereby increasing blood volume, and by involvement of the kidney.

    • By reducing arterial pressure, vasodilators decrease
    • renal blood flow and glomerular filtration, causing the kidney to reabsorb an increased fraction of filtered sodium and water, which causes blood volume to expand.
  22. Patients often receive concurrent therapy with a ______ to prevent the kidney from neutralizing the beneficial effects of vasodilation.
  23. Hydralazine is inactivated by a metabolic process known as
  24. Because it is both very effective and very dangerous_____ is reserved for patients with severe hypertension that has been refractory to safer drugs.
  25. Excessive growth of hair is known as
  26. hypertrichosis and is associated with use of which vasodilator?
    Minoxidil _
  27. Sympathomimetic drugs promote vasodilation by
    preventing the sympathetic nervous system from causing vasoconstriction
  28. Prolonged infusion of nitroprusside can result in toxic accumulations of
    cyanide, thiocyanate
  29. Reserpine is an example of a(n)
    adrenergic neuron-blocking agen
  30. Reflex tachycardia is undesirable for two reasons. They are that
    tachycardia can put an unacceptable burden on the heart;

    if the vasodilator is given to reduce blood pressure, tachycardia would raise pressure and thereby counteract beneficial effects.
  31. Left untreated, chronically elevated blood pressure can lead to
    • left ventricular hypertrophy,
    • myocardial infarction,
    • angina pectoris,
    • kidney disease,
    • blindness,
    • stroke.
  32. Lifestyle modifications that are components of the management of essential hypertension include
    • weight loss,
    • sodium restriction,
    • alcohol restriction,
    • exercise,
    • smoking cessation,
    • maintenance of potassium and calcium intake
  33. Cardiac output is influenced by
    heart rate, myocardial contractility, blood volume, venous return of blood to the heart
  34. How do antihypertensive drugs act in the brainstem
    They suppress sympathetic outflow to the heart and blood vessels, resulting in a decreased heart rate, decreased myocardial contractility, and vasodilation.
  35. Angiotensin-converting enzyme (ACE) inhibitors act to
    to suppress the formation of angiotensin II
  36. Angiotensin-converting enzyme (ACE) inhibitors act to suppress the formation of angiotensin II; resulting in
    peripheral vasodilation, renal vasodilation, and suppression of aldosterone-mediated volume expansion
  37. In patients with uncomplicated hypertension and no comorbid conditions, initial therapy with a
    diuretic or beta blocker is recommended
  38. Which antihypertensive works best in the treatment of hypertension in patients who have nephrosclerosis?
    angiotensin-converting enzyme (ACE) inhibitors
  39. Sodium nitroprusside
    the drug of choice for hypertensive crisis
  40. Fenoldopam
    an intravenous (IV) drug indicated for short-term management of hypertensive emergencies
  41. Fenoldopam benefits are
    as great as those of nitroprusside
  42. Fenoldopam differs from other antihypertensives in that it
    helps to maintain (or improve) renal function.
  43. When drug therapy is initiated during pregnancy
    methyldopa is the traditional agent of choice.
  44. The principal drugs used to treat allergic rhinitis include
    • oral antihistamines,
    • intranasal glucocorticoids,
    • intranasal cromolyn,
    • sympathomimetics
  45. What is the role of antihistamines in the treatment of the common cold?
    Antihistamines are of no value against the common cold because they do not reduce nasal congestion
  46. What is the role of antihistamines in the treatment of allergic rhinitis?
    They can relieve sneezing, rhinorrhea, and nasal itching.
  47. Antihistamines are more effective when taken
  48. Antihistamines are less helpful when taken
    after symptoms have appeared
  49. Antihistamines should be administered
    on a regular basis throughout the allergy season, even when symptoms are absent.
  50. What is the only antihistamine available for intranasal use?
  51. How does cromolyn work?
    Cromolyn reduces symptoms by suppressing the release of histamine and other inflammatory mediators from mast cells
  52. What drug is a monoclonal antibody that is directed against immunoglobulin E (IgE)?
  53. The two most frequently drugs used for cough suppression are
    • codeine,
    • hydrocodone
  54. Dextromethorphan
    is the most effective nonopioid cough suppressant available.
  55. The underlying cause of the symptoms and signs of asthma is
    immune-mediated airway inflammation
  56. The two major pharmacologic classes of drugs used to treat asthma are
    • anti-inflammatory drugs,
    • bronchodilators
  57. Beta2 agonists function by promoting
  58. Glucocorticoids are indicated for the treatment of which type of asthma?
  59. Potential adverse effects of oral glucocorticoids include
    • adrenal suppression,
    • osteoporosis,
    • hyperglycemia,
    • peptic ulcer disease,
    • growth suppression in young patients
  60. Cromolyn works by
    • stabilizing the cytoplasmic membrane of mast cells, thereby preventing release of histamine and other
    • mediators
  61. The newest class of drugs for the treatment of asthma is the
    leukotriene modifiers
  62. The drug of choice for the treatment of exercise-induced bronchospasm is
    cromolyn sodium
  63. Opioid
    a general term defined asany drug, natural or synthetic, that has actions similar to those of morphine
  64. Narcotic
    • has been used to mean an analgesic, central nervous
    • system depressant and any drug capable of causing physical dependence.
  65. Responses to the activation of mu receptors
    include analgesia, respiratory depression, euphoria, sedation, and the development of physical dependence.
  66. Morphine
    is the prototype of the strong opioid analgesic and remains the standard by which newer opioids are measured.
  67. The most serious adverse effect of the opioids is
    Respiratory Depression
  68. however, when administered at usual therapeutic doses, they _____ significant respiratory depression.
    Rarely Cause
  69. The adverse effect on the gastrointestinal system related to opioid use is
  70. How does the use of morphine elevate intracranial pressure
    By suppressing respiration, morphine increases the carbon dioxide (CO2) content of the blood, which dilates the cerebral vasculature, causing intracranial pressure (ICP) to rise
  71. Opioid overdose causes
    coma, respiratory depression, pinpoint pupils
  72. Use of meperidine is on the decline because
    the drug has a short half-life, it interacts adversely with a number of drugs, there is a risk of harm owing to accumulation of a toxic metabolite
  73. The most effective dosing schedule for morphine is
    A Fixed Schedule
  74. To minimize physical dependence and abuse, opioid analgesics should be administered in
    the lowest effective dosages for the shortest time needed
  75. Analgesia refers specifically to
    refers specifically to loss of sensibility to pain, and
  76. Anesthesia refers to the
    refers to the loss not only of pain, but also of all other sensations
  77. The agents used most commonly to obtain a state of balanced anesthesia are
    • short-acting barbiturates for the induction of
    • anesthesia, neuromuscular blocking agents for muscle relaxation, opioids and nitrous oxide for analgesia
  78. In which stage of anesthesia are respirations typically irregular and vomiting and urinary or
    fecal incontinence and reflex muscle activity most likely to occur?
    Stage II
  79. The most recent data suggest that inhalation anesthetics work primarily by
    • activating receptors for gamma-aminobutyric acid
    • (GABA), the principal inhibitory transmitter in the CNS
  80. The risk of malignant hyperthermia is greatest when an inhalation anesthetic is used in combination
  81. Preanesthetic medications are administered to
    • reduce anxiety,
    • produce perioperative amnesia,
    • relieve preoperative and postoperative pain
  82. Anticholinergic drugs are given with general anesthesia to
    decrease the risk of bradycardia during surgery
  83. Isoflurane
    is the most widely used inhalation anesthetic.
  84. Midazolam
    may be used for the induction of anesthesia and to produce conscious sedation.
  85. Why does propofol carry a high risk of bacterial infection?
    Because the drug is supplied in a mixture of soybean oil, glycerol, and egg lecithin, all of which are excellent media for the growth of bacteria.
  86. The great advantage of local anesthesia, compared with inhalation anesthesia, is that
    • pain can be suppressed without causing generalized
    • depression of the entire nervous system
  87. How do local anesthetics work?
    Local anesthetics stop axonal conduction by blocking sodium channels in the axonal membrane, thereby bringing conduction to a halt.
  88. What is the order in which sensation is lost when local anesthesia is used?
    • Perception of pain is lost first, followed in order
    • by perception of cold, warmth, touch, and deep pressure.
  89. Local anesthetics are frequently administered in combination with a vasoconstrictor, usually
  90. The benefits of the vasoconstrictor (epinephrine) include
    prolonged anesthesia, reduced risk of toxicity
  91. If necessary, excessive excitation during the excitation phase of local anesthetic administration can be treated with
    intravenous (IV) benzodiazepine,

    IV thiopental
  92. Epidural
    anesthesia is achieved by injecting a local anesthetic within the spinal column, but outside the dura mater
  93. Lidocaine and bupivacaine
    are popular drugs used for this type of anesthesia.

    by injecting a local anesthetic within the spinal column, but outside the dura mater
  94. The most significant adverse effect of spinal anesthesia is
  95. How can spinal headaches be relieved?
    By having the patient assume a supine position