Anesthesia Pharmacology Chapter 6: Autonomic (ANS) Pharmacology
Practice Questions
Click on the correct answer.
Clinical applications of beta-adrenergic antagonists:
management of coronary vascular disease
treatment of arrhythmias
treatment of hypertension
all the above
A non-selective beta-adrenergic receptor blocker:
metoprolol (Lopressor)
atenolol (Tenormin)
timolol (Blocadren)
esmolol (Brevibloc)
Beta-adrenergic receptor blockers: effects on the heart --
increase heart rate
increased AV nodal refractory period
increased contractility
increased myocardial oxygen demand
increased phase 4 depolarization
Beta-adrenergic receptor blockers are usually effective in reducing blood pressure in both " high-renin" and "low-renin" patients:
true
false
Most likely to cause dangerous bronchiolar constriction in asthmatic patients or patients with COPD
metoprolol (Lopressor)
propranolol (Inderal)l
esmolol (Brevibloc)
atenolol (Tenormin)
Mechanism(s) for propranolol-decreased amide local anesthetic clearance:
decreased hepatic blood flow
inhibition of hepatic metabolism of local anesthetic
both
neither
Effect of propranolol (chronic administration) on pulmonary first-pass fentanyl (Sublimaze) uptake
significant reduction
significant enhancement
The major exception to the rule that additive myocardial depression between anesthetics and beta-adrenergic antagonists is not excessive:
metoprolol (Lopressor)
propranolol (Inderal)
esmolol (Brevibloc)
timolol (Blocadren)
nadolol (Corgard)
Bradycardia hypotension, refractory to atropine, may occur during anesthesia in pediatric and adult patients receiving this beta adrenergic receptor antagonist:
nadolol (Corgard)
propranolol (Inderal)
esmolol (Brevibloc)
timolol (Blocadren)
Greatest additive cardiovascular effects with inhaled anesthetics in the presence of beta-adrenergic receptor blockade:
enflurane (Ethrane)
halothane (Fluothane)
isoflurane (Forane)
Preferred beta-blocking agent to prevent systolic blood pressure increases associated with direct laryngoscopy in tracheal intubation:
IV propranolol (Inderal)
IV labetalol (Trandate, Normodyne)
IV esmolol (Brevibloc)
IV timolol (Blocadren)
IV nadolol (Corgard)
Beta-blocker having special benefits for patients undergoing noncardiac surgery but having significant underlying coronary artery disease-- given IV perioperatively and orally during remainder of hospital stay.