ABCP Perfusion Pharmacology practice Test Questions With Correct Answers

pharmacokinetics - Answer what the body does to the drug Pharmacodynamics - Answer what the drug does to the body upregulation - Answer increase density of receptors chronic decrease in receptor stimulation ex. chronic use of beta-blockers increases the number of B-receptors downregulation - Answer decrease density of receptors caused by a chronic increase in receptor activation ex. chronic treatment of asthma with albuterol (beta 2 agonist) reduces the number of B-receptors what protein does alpha-adrenergic agonists increase - Answer protein kinase C which faciliates an increase in contraction in smooth muscle cells what do beta-adrenergic receptor agonists increase? - Answer intracellular cAMP increases heart rate, contraction, and relaxation Factors that reduce cellular response to receptor activation - Answer acidosis (need bicarb to decrease acidosis for drugs to work during CPR) hypoxia drug interactions Where are alpha 1 receptors located? - Answer vascular smooth muscle constrict peripheral blood vessels both arterial and venous where are alpha 2 receptors located - Answer presynaptic nerve terminals inhibit NE release through negative feedback loop Where are beta 1 receptors located? - Answer primarily in the heart increase: HR contractility conduction velocity automaticity risk of arrhythmias (bad) Where are beta 2 receptors found - Answer bronchiole smooth muscle vasodilation and bronchodilation increase HR and contraclity (less potent than B1) phenylephrine -- MOA -- metabolism -- advantages -- disadvantages -- indications for use -- dosing - Answer -- MOA: alpha 1 agonist causing vasoconstriction in mostly arterioles -- metabolism: MAO (monoamine oxidase) metabolism -- advantages: direct agonist with short duration, increases coronary perfusion pressure w/o affecting contractility, MVO2 does not increase significantly -- disadvantages: may decrease SV and CO due to increase in afterload, may decrease renal, mesenteric, and extremity perfusion -- indications for use: hypotension, oppose acute R--L shunting in cyanotic spells in TOF patients -- dosing: IV infusion: 0.5 to 10 mcg/kg/min, bolus: 1 to 10 mcg/kg (40-100mcg/ml) ephedrine -- MOA -- metabolism -- advantages -- disadvantages -- indications for use -- dosing - Answer plant derived alkaloid with sympathomimetic effects - MOA: mild alpha, beta 1, and beta 2 agonist, increases: HR, contractility, BP, CO, preload -metabolism: renal -SAFE IN PREGNANCY (does not reduce blood flow to the placenta) - disadvantages: use is reduced when NE stores are depleted - indications: hypotension due to low SVR or low CO, especially if HR is low and particularly with spinal and epidural anesthesia -- dosing: 5 to 10 mg IV bolus Norepinephrine -- MOA -- metabolism -- advantages -- disadvantages -- indications for use -- dosing - Answer MOA: direct alpha 1 and alpha 2 adrenergic actions, beta 1 agonist, increases BP, contractility, SVR, PVR metabolism: MOA and COMT, neural uptake advantages: direct agonist, redistributes blood flow to brain and heart becuase all other vessels are constricted disadvantages: risk of ischemia to kidneys, skin, liver, bowel, adn extremities, arrhythmias, pulmonary vasoconstriction, myocardial ischemia