Anesthesia Pharmacology Practice Questions: Drugs Used to Treat Congestive Heart Failure (CHF) and Underlying Pathophysiology

Drug classes used in management of congestive heart failure:
1. bipyridines (e.g. milrinone (Primacor), amrinone (Inocor))
2. α₁ adrenergic agonists (e.g. phenylephrine (Neo-Synephrine))
3. vasodilators
4. A & C
5. A, B & C
Relationships which illustrate the fundamental abnormality heart failure include:
1. depression of the myocardial force-velocity relationship
2. abnormal length-active tension curves reflecting impairment in myocardial contractility
3. both
4. neither
Associated with congestive heart failure; particularly with advanced disease:
1. increases in the ventricular preload
2. increases in pulmonary capillary pressure
3. dyspnea
4. increased heart rate
5. all the above
Initial drug(s) for management of mild to moderate aheart failure:
1. parenteral inotropic drugs, e.g. dobutamine (Dobutrex)
2. hydralazine (Apresoline)
3. furosemide (Lasix)
4. captopril (Capoten)
5. all of the above
Used for inotropic support of the failing heart-- less arrhythmogenic
1. dobutamine (Dobutrex)
2. dopamine (Intropin)
Parenteral, positive inotropic agent that does not increase renal blood flow:
1. dobutamine (Dobutrex)
2. dopamine (Intropin)
3. both
4. neither
Dopamine (Intropin) -mediated renal vasodilation is caused by which receptor(s) system(s):
1. β₂ adrenergic receptors
2. β₁ adrenergic receptors
3. dopamine D1 and D2 postsynaptic receptors
4. muscarinic receptors
5. leukotriene receptors
Cardiac effects of digitalis glycosides:
1. increased transmission through the AV node
2. positive inotropism
3. both
4. neither
Most important cardiac effect produced by digoxin relative to management of congestive heart failure:
1. increased rate
2. decreased AV conduction
3. peripheral vasodilation
4. shifted the force-velocity curve upward
5. increased diuresis
Agent of choice among the phosphodiesterase inhibitors for short term parenteral support in severe heart failure patients:
1. amrinone (Inocor)
2. amiodarone (Cordarone)
3. milrinone (Primacor)
4. losartin (Cozaar)
5. theophylline
Associate with a reversible thrombocytopenia:
1. amrinone (Inocor)
2. milrinone (Primacor)
Factors that may increase preload:
1. lying down
2. volume depletion
3. left ventricular failure
4. A & C
5. A, B & C
Factors which reduce or eliminate the effectiveness of atrial kick:
1. increased heart rate
2. atrial arrhythmias
3. both
4. neither