Anesthesia Pharmacology Chapter 8: Antihypertensive Drug Practice
Questions
Click on the correct answer.
Heart block in which the P wave appears before each QRS in a regular manner; P-R interval > 0.2 seconds; QRS interval < 0.12 seconds
first-degree heart block
second-degree heart block, Mobitz Type I
secondary heart block, Mobitz Type II
third-degree heart block
Alpha-adrenergic receptor blocker(s)-- blockade of alpha1 adrenergic receptors:
prazosin (Minipress)
terazosin (Hytrin)
doxazosin (Cardura)
all the above
Associated with initial prazosin (Minipress) administration:
increased venous capacitance
decreased plasma renin activity
aincreased heart rate
increased arteriolar resistance
all of the above
Vasodilators used for chronic treatment:
minoxidil (Loniten)
nitroprusside sodium (Nipride)
hydralazine (Apresoline)
A & C
A, B & C
Agent which would attenuate reflex-mediated cardiac stimulation following minoxidil (Loniten) administration:
hydralazine (Apresoline)
isoproterenol (Isuprel)
metoprolol (Lopressor)
pindolol (Visken)
nitroprusside sodium (Nipride)
Hydralazine (Apresoline)--vascular effects:
more arteriolar dilation compared to venular dilation
more venular dilation compared to arteriolar dilation
arteriolar and venular dilation similar with hydralazine (Apresoline)
Vascular beds in which hydralazine promotes significant dilation:
splanchnic
cerebral
renal
A & C
A, B & C
Cardiovascular effects of hydralazine (Apresoline):
greater effect on systolic blood pressure (compared to diastolic)
renin activity decreased
pronounced orthostatic hypotension
increased stroke volume
all of the above
Direct relaxation of arteriolar smooth muscle; when combined with the diuretic and sympatholytic, can be very effective for management of severe hypertension associated with renovascular disease, transplant rejection, renal failure:
propranolol (Inderal)
prazosin (Minipress)
minoxidil (Loniten)
phenylephrine (Neo-Synephrine)
isoproterenol (Isuprel)
Antihypertensive-Minimal orthostatic hypotension, increased plasma renin, norepinephrine (also water and sodium retention); increase heart rate, cardiac output (reflex-mediated)
amiloride (Midamor)
minoxidil (Loniten)
hydralazine (Apresoline)
B & C
A & C
Antihypertensive: direct acting, nonselective peripheral vasodilator -- acts on arteriole and venous vascular smooth muscle: 44% cyanide by weight --
labetalol (Trandate, Normodyne)
hydralazine (Apresoline)
minoxidil (Loniten)
nitroprusside sodium (Nipride)
Features of nitroprusside sodium (Nipride) mechanism of action:
reacts with oxyhemoglobin
forms methemoglobin
forms nitric oxide
nitric oxide activates guanylyl cyclase
all the above
Requires thio- containing agents to generate nitric oxide (NO):