Anesthesia Pharmcology Practice Questions: Antihypertensive Drugs

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
1. first-degree heart block
2. second-degree heart block, Mobitz Type I
3. secondary heart block, Mobitz Type II
4. third-degree heart block
Alpha-adrenergic receptor blocker(s)-- blockade of alpha1 adrenergic receptors:
1. prazosin (Minipress)
2. terazosin (Hytrin)
3. doxazosin (Cardura)
4. all the above
Associated with initial prazosin (Minipress) administration:
1. increased venous capacitance
2. decreased plasma renin activity
3. aincreased heart rate
4. increased arteriolar resistance
5. all of the above
Vasodilators used for chronic treatment:
1. minoxidil (Loniten)
2. nitroprusside sodium (Nipride)
3. hydralazine (Apresoline)
4. A & C
5. A, B & C
Agent which would attenuate reflex-mediated cardiac stimulation following minoxidil (Loniten) administration:
1. hydralazine (Apresoline)
2. isoproterenol (Isuprel)
3. metoprolol (Lopressor)
4. pindolol (Visken)
5. nitroprusside sodium (Nipride)
Hydralazine (Apresoline)--vascular effects:
1. more arteriolar dilation compared to venular dilation
2. more venular dilation compared to arteriolar dilation
3. arteriolar and venular dilation similar with hydralazine (Apresoline)
Vascular beds in which hydralazine promotes significant dilation:
1. splanchnic
2. cerebral
3. renal
4. A & C
5. A, B & C
Cardiovascular effects of hydralazine (Apresoline):
1. greater effect on systolic blood pressure (compared to diastolic)
2. renin activity decreased
3. pronounced orthostatic hypotension
4. increased stroke volume
5. 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:
1. propranolol (Inderal)
2. prazosin (Minipress)
3. minoxidil (Loniten)
4. phenylephrine (Neo-Synephrine)
5. isoproterenol (Isuprel)
Antihypertensive-Minimal orthostatic hypotension, increased plasma renin, norepinephrine (also water and sodium retention); increase heart rate, cardiac output (reflex-mediated)
1. amiloride (Midamor)
2. minoxidil (Loniten)
3. hydralazine (Apresoline)
4. B & C
5. A & C
Antihypertensive: direct acting, nonselective peripheral vasodilator -- acts on arteriole and venous vascular smooth muscle: 44% cyanide by weight --
1. labetalol (Trandate, Normodyne)
2. hydralazine (Apresoline)
3. minoxidil (Loniten)
4. nitroprusside sodium (Nipride)
Features of nitroprusside sodium (Nipride) mechanism of action:
1. reacts with oxyhemoglobin
2. forms methemoglobin
3. forms nitric oxide
4. nitric oxide activates guanylyl cyclase
5. all the above
Requires thio- containing agents to generate nitric oxide (NO):
1. nitroglycerin
2. nitroprusside sodium (Nipride)
3. both
4. neither
Concerning nitroprusside sodium (Nipride) metabolism:
1. unstable nitroprusside radical is formed
2. nitroprusside radical releases five cyanide ions
3. free cyanide ions require bromide for conversion to thiocyanate
4. A & B
5. A, B & C
Cardiovascular effects of nitroprusside sodium (Nipride):(direct and indirect actions)
1. decreased left ventricular ejection impedance
2. positive inotropic and chronotropic effects
3. increased venous capacitance
4. reduced systemic vascular resistance
5. all of the above