Anesthesia Pharmacology Chapter
6: Autonomic (ANS) Pharmacology
Practice Questions
Click on the correct answer.
Cardiovascular characteristics of patients who might benefit from IV dopamine (Intropin) administration:
- low systemic blood pressure
- decreased atrial filling pressures
- high urinary output
Simultaneous increases in myocardial contractility, glomerular filtration rate, sodium excretion, urine output, and renal blood flow are associated most likely with:
- epinephrine
- isoproterenol (Isuprel)
- phenylephrine (Neo-Synephrine)
- dopamine (Intropin)
- norepinephrine (Levophed)
IV dopamine (Intropin) properties:
- promotes renal tubule or solid reabsorption
- reduces sodium excretion
- causes reduced ventilatory response to arterial hypoxemia
- decreases myocardial contractility
- increases atrial filling pressures
Therapeutic uses for isoproterenol (Isuprel):
- management of heart block
- management of severe bradycardia
- management Torsades de pointes (a ventricular arrhythmia)
- all of the above
- none of the above; no therapeutic uses for isoproterenol (Isuprel)
Properties of dobutamine (Dobutrex):
- positive inotropic agent; causes significant increase in heart rate
- promotes catecholamine release
- mainly acts through dopamine receptors
- positive inotropic effect is mediated through beta-adrenergic receptor activation
- appropriate for long-term management of myocardial pump-failure following surgery
Examples of beta-2 selective adrenergic agonists
- metaproterenol (Alupent)
- terbutaline (Brethine)
- albuterol (Ventolin,Proventil)
- A & B
- A, B & C
Adverse effects associated with beta2 adrenergic receptor agonists:
- excessive cardiovascular stimulation
- skeletal muscle tremor
- over usage of these drugs may predisposed to morbidity immortality in asthmatics
- A & C
- A, B & C
Alpha-1-selective adrenergic agonists: properties of
- phenylephrine (Neo-Synephrine) is an example of the indirect-acting vasoconstrictor
- metaraminol (Aramine) acts by direct and indirect mechanisms
- methoxamine (Vasoxyl) is an indirect acting vasoconstrictor
- alpha1-receptor activation decreases calcium influx
- all of the above
Clinical use(s) of alpha-1-receptor agonists:
- management hypotensive states
- termination of paroxysmal atrial tachycardia
- nasal decongestant
- A & B
- A,B & C
Primary use for alpha-2-selective adrenergic agonists:
- to manage hypotensive states
- to increase myocardial contractility
- to reduce blood pressure
- A & B
- A,B & C