Pharm II Quiz 2

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Pharm II Quiz 2

A review of the material for pharm test 2. Includes: local anesthetics, alpha and beta antagonists, antihypertensives, diuretics. Most questions come directly from notes.


Questions and Answers
  • 1. 
    What are the two classifications of local anesthetics?
    • A. 

      Esters

    • B. 

      Ethers

    • C. 

      Amides

    • D. 

      Carboxylic Acids

    • E. 

      Thiols

  • 2. 
    Which of the following local anesthetic agents are Esters? (more than one answer)
    • A. 

      Lidocaine

    • B. 

      Chloroprocaine

    • C. 

      Cocaine

    • D. 

      Mepivicaine

    • E. 

      Prilocaine

  • 3. 
    Which of the following local anesthetic agents are Amides? (More than one answer)
    • A. 

      Lidocaine

    • B. 

      Chloroprocaine

    • C. 

      Cocaine

    • D. 

      Mepivicaine

    • E. 

      Prilocaine

  • 4. 
    What is the mechanism of action of local anesthetics?
    • A. 

      Mimics acetylcholinesterase to Cause sustained depolarization rendering the NMJ unable to conduct further impulses=Muscle relaxation

    • B. 

      Produces skeletal muscle relaxation by a direct action on excitation-contraction coupling, presumably by decreasing the amount of calcium released from the sarcoplasmic reticulum

    • C. 

      Dependent upon type of anesthetic as ester and amides have different MOA’s

    • D. 

      Prevents passage of sodium ions through ion selective channels in nerve membranes to block nerve conduction.

  • 5. 
    How is Procaine metabolized?
    • A. 

      By hydrolysis via pseudocholinesterase

    • B. 

      Via hepatic enzymes P450

    • C. 

      Via proteins present within CSF

    • D. 

      Via renal metabolism and excretion

  • 6. 
    How is Bupivicaine metabolized?
    • A. 

      By hydrolysis via pseudocholinesterase

    • B. 

      Via hepatic enzymes P450

    • C. 

      Via proteins present within CSF

    • D. 

      Via renal metabolism and excretion

  • 7. 
    Depolarization is due to inflow of ____ ions from the extracellular to the intracellular space while repolarization is due to outflow of ____ ions from intracellular to extracellular space.
    • A. 

      Cl , K

    • B. 

      Na, Cl

    • C. 

      Na, K

    • D. 

      K, Na

  • 8. 
    You are doing a pre-op on a pt who will be receiving spinal anesthesia today for surgery. When interviewing the patient they state they previously had a serious allergic reaction to Procaine. You question the patient further and verify it is indeed a true allergy. What do you do now? The surgeon and patient both want spinal anesthesia but what about the allergy?
    • A. 

      Use Tetracaine instead, since this is a different class of anesthetic

    • B. 

      This pt may not receive any spinal anesthetics and will need to have GA

    • C. 

      Cancel procedure for today and reschedule for a later time.

    • D. 

      Use Ropivacaine instead, since this is a different class of anesthetic

  • 9. 
    You are about to perform regional anesthesia when the patient informs you they are allergic to local anesthetics. You question the patient and discover that while having some dental work done a few years back the patient experienced palpitations, anxiety, sweating and tremors after receiving Procaine. (Which coincidentally is what you were going to use today!) What is your response to this?
    • A. 

      Use the procaine anyway! The patient is being a spazz since palpitations are a normal side effect and not an allergic reaction.

    • B. 

      Realize this patient has a true allergy and switch to bupivacaine which is less likely to cause an allergy.

    • C. 

      Put the pt under general anesthesia since she can not receive any local anesthetics and because she is talking WAY too much.

    • D. 

      None of the above

  • 10. 
    Which of the following is responsible for the potency of local anesthetics?
    • A. 

      Degree of protein binding

    • B. 

      Lipid Solubility

    • C. 

      Degree of Ionization

    • D. 

      Size of Molecule

  • 11. 
    Which of the following is  mainly responsible for the duration of action of local anesthetics?
    • A. 

      Degree of protein binding

    • B. 

      Lipid Solubility

    • C. 

      Degree of Ionization

    • D. 

      Size of Molecule

  • 12. 
    Which of the following is responsible for time until onset of action for local anesthetics?
    • A. 

      Degree of protein binding

    • B. 

      Lipid Solubility

    • C. 

      Degree of Ionization

    • D. 

      Size of Molecule

  • 13. 
    Which nerve fibers are likely to be the first blocked after administration of local anesthetic?
    • A. 

      A delta fibers

    • B. 

      B Fibers

    • C. 

      A Alpha fibers

    • D. 

      C Fibers

  • 14. 
    What would be the max dose of mepivacaine plain to give to a pt who weighs 45 kg?
    • A. 

      225 mg

    • B. 

      112 mg

    • C. 

      450 mg

    • D. 

      315 mg

  • 15. 
    Which of the following has the longest duration of action?
    • A. 

      Chloroprocaine

    • B. 

      Tetracaine

    • C. 

      Bupivacaine

    • D. 

      Lidocaine

  • 16. 
    What would be the max dose of chloroprocaine with epi to give to a pt weighing 32 kg?
    • A. 

      256 mg

    • B. 

      160 mg

    • C. 

      320 mg

    • D. 

      480 mg

  • 17. 
    What is the max dose of tetracaine plain to give to a pt weighing 70 kg?
    • A. 

      175 mg

    • B. 

      350 mg

    • C. 

      105 mg

    • D. 

      560 mg

  • 18. 
    You perform an ankle block for amputation of a toe secondary to nonhealing diabetic ulceration and sepsis. The block technique looked good but the patient almost jumped off the OR table when the surgeon made the incision. What went wrong?
    • A. 

      The technique must have been wrong, try again.

    • B. 

      The acidic environment of the foot cause a greater concentration of ionized anesthetic, which can not cross cell membrane.

    • C. 

      The basic environment of the foot cause a greater concentration of ionized anesthetic, which can not cross cell membrane.

    • D. 

      Pt must have a tolerance to local anesthetics, try again using a larger dose.

  • 19. 
    How does epinephrine prolong spinal anesthesia?
    • A. 

      By blocking passage of sodium ions into nerve cells

    • B. 

      Through beta1 agonistic effects

    • C. 

      Through vasoconstriction and decreasing vascular absorption

    • D. 

      All the above

  • 20. 
    Risk for toxicity is directly proportionate to potency.
    • A. 

      True

    • B. 

      False

  • 21. 
    What would you expect a pt to say to you as an early sign of toxicity due to accidental vascular injection during administration of spinal anesthesia? (more than one answer)
    • A. 

      “My legs are starting to feel really numb….”

    • B. 

      “I can’t feel my tongue anymore… weird.”

    • C. 

      “It feels a little hard to breathe... is this normal with an epidural?”

    • D. 

      “My ears just started ringing really bad.”

    • E. 

      "Ow! ow! Ouch!!! What the heck are you hitting back there?"

  • 22. 
    Which of the following patients would be at greatest risk for toxicity?
    • A. 

      Pt receiving intercostal nerve block

    • B. 

      Pt receiving caudal block

    • C. 

      Pt receiving brachial plexus nerve block

    • D. 

      Pt receiving sub-q local anesthetic

  • 23. 
    Which of the following will have the greatest amount of unionized molecules when injected into physiologic pH?
    • A. 

      Procaine – pKa 8.9

    • B. 

      Lidocaine – pKa 7.7

    • C. 

      Chloroprocaine – pKa 9.1

    • D. 

      Bupivacaine – pKa 8.1

  • 24. 
    Which of the following will have the most rapid onset?
    • A. 

      Procaine – pKa 8.9

    • B. 

      Bupivacaine – pKa 8.1

    • C. 

      Mepivacaine- pKa7.6

    • D. 

      Ropivacaine- pKa 8.1

  • 25. 
    How will mixing your local anesthetic with bicarbonate effect the anesthetic?
    • A. 

      Greater degree of protein binding and thus longer duration

    • B. 

      No effect at all

    • C. 

      Decreased lipid solubility resulting in decreased potency

    • D. 

      Increased unionized drug causing more rapid onset

  • 26. 
    How would you perform local anesthesia on a patient with a known pseudocholinesterase deficiency?
    • A. 

      Administer local anesthesia with Bupivacaine

    • B. 

      This has no effect on local anesthetics, only on succinylcholine.

    • C. 

      Administer local anesthesia with Procaine

    • D. 

      Patient may not receive any local anesthetics

  • 27. 
    You are the SRNA caring for a pt about to undergo local anesthesia, and were planning to use Rpivacaine. On their medication list you see Fluoxetine, Insulin, Cardizem and nexium. Will any of these effect your plan of care?
    • A. 

      I will use a higher dose of Ropivacaine due to induction of P450

    • B. 

      I will plan to use Tetracaine due to inhibition of cytochrome P450

    • C. 

      Use ropivacaine due to inhibition of pseudocholinesterase

    • D. 

      Use higher dose of tetracaine due to induction of pseudocholinesterase

  • 28. 
    Which of the following tissues has the highest blood flow?
    • A. 

      Intercostal

    • B. 

      Paracervical

    • C. 

      Subarachnoid

    • D. 

      Tracheal

  • 29. 
    Which of the following has the lowest blood flow?
    • A. 

      Subcutaneous

    • B. 

      Sciatic

    • C. 

      Caudal

    • D. 

      Epidural

  • 30. 
    Which of the following may cause methemoglobinemia?
    • A. 

      Lidocaine

    • B. 

      Prilocaine

    • C. 

      Bupivacaine

    • D. 

      Cocaine

  • 31. 
    What could you add to increase the duration of local anesthetic on a pt with mild aortic stenosis whose HR you do not wish to elevate?
    • A. 

      Epinephrine

    • B. 

      Metoprolol

    • C. 

      Phenylephrine

    • D. 

      Ephedrine

  • 32. 
    In response to hypovolemia, or hypotension the juxtaglomerular cells of the kidney release what enzyme?
    • A. 

      Angiotensin I

    • B. 

      Angiotensin II

    • C. 

      Angiotensin converting enzyme

    • D. 

      Renin

  • 33. 
    Where does angiotensin converting enzyme act upon angiotenin I?
    • A. 

      Lungs

    • B. 

      Kidneys

    • C. 

      Liver

    • D. 

      Coronary Vessels

  • 34. 
    What is the MOA of ACE inhibitor drugs such as captopril?
    • A. 

      Blocks the vasoconstrictor and aldosterone-secretion effects of Angiotensin II to the AT1 receptors in the smooth muscles

    • B. 

      Blocks the conversion of angiotensin I to angiotensin II to prevent vasoconstriction

    • C. 

      Inhibits reabsorption of sodium and chloride ions in the loop of Henle

    • D. 

      Increases the osmolarity of the renal tubular fluid and prevents reabsorption of water

  • 35. 
    What is the most common side effect associated with ACE inhibitors?
    • A. 

      Bradycardia

    • B. 

      Bronchospasm

    • C. 

      Chronic Cough

    • D. 

      Hypokalemia

  • 36. 
    For a patient who is taking Captopril, you would expect see a decrease in serum ______ while seeing a compensatory increase in _____.
    • A. 

      Angiotensin I, angiotensin II

    • B. 

      Angiotensin II, Aldosterone

    • C. 

      Renin, Angiotensin I

    • D. 

      Aldosterone, Renin

  • 37. 
    Which of the following may antagonize the effects of Captopril?
    • A. 

      Aspirin

    • B. 

      Tylenol

    • C. 

      Furosemide

    • D. 

      Mannitol

  • 38. 
    Which of the following is a pro-drug which must be metabolized by the liver before reaching its active form?
    • A. 

      Captopril

    • B. 

      Enalapril

    • C. 

      Losartan

    • D. 

      Hydrochlorothiazide

  • 39. 
    What is the MOA of Losartan?
    • A. 

      Blocks the vasoconstrictor and aldosterone-secretion effects of Angiotensin II to the AT1 receptors in the smooth muscles

    • B. 

      Blocks the conversion of angiotensin I to angiotensin II to prevent vasoconstriction

    • C. 

      Inhibits reabsorption of sodium and chloride ions in the loop of Henle

    • D. 

      Increases the osmolarity of the renal tubular fluid and prevents reabsorption of water

  • 40. 
    Which of the following side effects is not usually associated with thiazide diurectics?
    • A. 

      Hypokalemia

    • B. 

      Metabolic Alkalosis

    • C. 

      Skeletal muscle weakness

    • D. 

      Hemodilution

  • 41. 
    Which of the following is not a clinical use of furosemide?
    • A. 

      Prophylaxis against acute renal failure

    • B. 

      Mobilization of Edema

    • C. 

      Treatment of increased ICP

    • D. 

      Differential diagnosis of acute oliguria

  • 42. 
    Which of the following would be the best choice for a 60 kg patient with acute pulmonary edema?
    • A. 

      Mannitol 30g IV

    • B. 

      Furosemide 40 mg IV

    • C. 

      Aldactone 250mg PO

    • D. 

      Enalapril 2.5 mg IV

  • 43. 
    You are SRNA today for a patient who has been taking Furosemide. When your preceptors asks you if this drug effects any of the common anesthesia drugs what do you say?
    • A. 

      Has potential to cause angioedemia if given with propofol

    • B. 

      It does not effect any of our drugs! I’ll just watch their volume status closely though.

    • C. 

      May potentiate Non depolarizing NMB’s

    • D. 

      Interacts with neosynephrine to cause arrhythmias

  • 44. 
    What is the MOA of Mannitol?
    • A. 

      Blocks the vasoconstrictor and aldosterone-secretion effects of Angiotensin II to the AT1 receptors in the smooth muscles

    • B. 

      Blocks the conversion of angiotensin I to angiotensin II to prevent vasoconstriction

    • C. 

      Inhibits reabsorption of sodium and chloride ions in the loop of Henle

    • D. 

      Increases the osmolarity of the renal tubular fluid and prevents reabsorption of water

  • 45. 
    Mannitol should be given with extreme caution to patients with which of the following?
    • A. 

      CHF

    • B. 

      Renal Failure

    • C. 

      Increased ICP

    • D. 

      COPD

  • 46. 
    What would be an appropriate dose of mannitol to give to a 58 yr old pt weighing 80 kg to reduce ICP?
    • A. 

      8 g IV

    • B. 

      40 g IV

    • C. 

      160 g IV

    • D. 

      1.6 g IV

  • 47. 
    Which of the following drugs can inhibit seizure activity?
    • A. 

      Urea

    • B. 

      Captopril

    • C. 

      Acetazolamide

    • D. 

      Furosemide

  • 48. 
    What is the post synaptic neurotransmitter for the sympathetic nervous system?
    • A. 

      Acetycholine

    • B. 

      Serotonin

    • C. 

      Glutamate

    • D. 

      Norepinephrine

  • 49. 
    What is the post synaptic neurotransmitter of the parasympathetic nervous system?
    • A. 

      Acetycholine

    • B. 

      Serotonin

    • C. 

      Glutamate

    • D. 

      Norepinephrine

  • 50. 
    The nerves of the sympathetic nervous system arise from where?
    • A. 

      Craniosacral nerves

    • B. 

      T1-L2

    • C. 

      Cauda Equina

    • D. 

      All the above, these nerves are throughout the body

  • 51. 
    The nerves of the parasympathetic nervous system arise from where?
    • A. 

      T1-L2

    • B. 

      Cauda Equina

    • C. 

      Craniosacral nerves

    • D. 

      All the above, these nerves are throughout the body

  • 52. 
    Alpha 1 receptor agonism will result in all of the following except what?
    • A. 

      Vasoconstriction

    • B. 

      Pupillary Dilation

    • C. 

      Uterine Contracture

    • D. 

      Bronchodilation

  • 53. 
    Blockade of Alpha 2 receptors will have what effect on norepinephrine?
    • A. 

      Increased secretion of norepi

    • B. 

      Decreased secretion of norepi

    • C. 

      No effect, these receptors primarily act upon ACH

  • 54. 
    Which of the following is likely to cause bronchoconstriction and should be used cautiously in asthmatics?
    • A. 

      Alpha 1 receptor blockers

    • B. 

      Beta 2 receptor Blockers

    • C. 

      Beta 1 receptor blockers

    • D. 

      All the above will cause bronchoconstriction

  • 55. 
    Parasympathetic stimulation results in all of the following except…
    • A. 

      Pupillary Constriction

    • B. 

      Decreased HR

    • C. 

      Reduced Peristalsis

    • D. 

      Bronchoconstriction

  • 56. 
    Sympathetic stimulation results in all of the following except?
    • A. 

      Increased HR

    • B. 

      Decreased urine secretion

    • C. 

      Secretion of norepi

    • D. 

      Increased Saliva and mucus production

  • 57. 
    The first chemical involved in production of norepinephrine is what?
    • A. 

      Tyrosine

    • B. 

      DOPA

    • C. 

      Epinephrine

    • D. 

      Hydroxylase

  • 58. 
    Dopamine B-hydroxylase acts upon Dopamine to convert it into what substance?
    • A. 

      Dihydroxyphenylalanine

    • B. 

      Norepinephrine

    • C. 

      Epinephrine

    • D. 

      N-methyltransferase

  • 59. 
    You were administering a levophed drip to a very sick pt which infiltrated into the pts arm. Which medication would be appropriate to give SQ to help prevent tissue necrosis?
    • A. 

      Phenoxybenzamine 1mg/kg

    • B. 

      Propanolol 0.05 mg/kg

    • C. 

      Phentolamine 5mg

    • D. 

      Labetolol 10 mg

  • 60. 
    Which of the following is best to give for intra-op treatment of Pheochromocytoma?
    • A. 

      Phenoxybenzamine 1mg/kg

    • B. 

      Propanolol 0.05 mg/kg

    • C. 

      Labetolol 10 mg

    • D. 

      Phentolamine 50 mcg/kg

  • 61. 
    What would be an appropriate pre-op treatment to give to a pt with Pheochromocytoma?
    • A. 

      Phenoxybenzamine 1mg/kg PO

    • B. 

      Propanolo 1mg/kg PO

    • C. 

      Phentolamine 50 mcg/kg IV

    • D. 

      Esmolol 0.5 mg/kg IV

  • 62. 
    Which of the following is a selective alpha 1 receptor blocker?
    • A. 

      Phenoxybenzamine

    • B. 

      Prazosin

    • C. 

      Esmolol

    • D. 

      Labetolol

  • 63. 
    How will a pt who has been taking beta blockers for the past 2 years for HTN respond to administration of norepi during surgery?
    • A. 

      Pt will have a blunted response

    • B. 

      Pt will have an exaggerated response

    • C. 

      Response will be no different than normal

  • 64. 
    Which of the following is not true regarding  Propanolol?
    • A. 

      Decreases clearance of Amide local anesthetics

    • B. 

      Optimal plasma concentration is evidenced by resting HR of 55-60

    • C. 

      A much higher dose of fentanyl than normal will be required for pts on propanolol

    • D. 

      Has extensive hepatic first pass metabolism

  • 65. 
    Which of the following is given only in IV form?
    • A. 

      Labetolol

    • B. 

      Phenoxybenzamine

    • C. 

      Atenolol

    • D. 

      Esmolol

  • 66. 
    What would be an appropriate dose of esmolol to give to a pt with renal insufficiency who weighs 54 kg?
    • A. 

      27 mg IV

    • B. 

      54 mg IV

    • C. 

      108 mg PO

    • D. 

      5 mg IV

  • 67. 
    Non-selective beta blockers would be safe to give to which of the following pts?
    • A. 

      Mr. J who came in for emergent sx following MVA and has had massive blood loss

    • B. 

      Ms. Y who has renal failure

    • C. 

      Mr. P who has COPD

    • D. 

      Ms. B who has diabetes and PVD

  • 68. 
    What is the half life of Esmolol?
    • A. 

      5 minutes

    • B. 

      9 minutes

    • C. 

      17 minutes

    • D. 

      2 hours

  • 69. 
    Which of the following is an alpha and beta blocker?
    • A. 

      Propanolol

    • B. 

      Yohimbine

    • C. 

      Labetolol

    • D. 

      Metoprolol

  • 70. 
    When given IV, the beta to alpha potency ratio of labetolol is _______, while when given PO the ratio is _____.
    • A. 

      1:1, 3:1

    • B. 

      3:1, 7:1

    • C. 

      3:1, 1:1

    • D. 

      7:1, 3:1

  • 71. 
    What is the half life of labetolol?
    • A. 

      5-8 hours

    • B. 

      30-40 minutes

    • C. 

      2-3 hours

    • D. 

      12-16 hours

  • 72. 
    Administration of non-selective betablockers would have all the following effects except what?
    • A. 

      Decreased cardiac conduction

    • B. 

      Increased cardiac contractility

    • C. 

      Bronchoconstriction

    • D. 

      Sedation

  • 73. 
    Which form of the local anesthetic is most active at the intracellular receptor site?
    • A. 

      Anionic Form

    • B. 

      Lipophilic form

    • C. 

      Cationic form

    • D. 

      Polar form

  • 74. 
    Which portion of the Local anesthetic molecules makes the cationic form which is most active at the intracellular site?
    • A. 

      Lipophilic aromatic group

    • B. 

      Esther linkage

    • C. 

      Amide Linkage

    • D. 

      Hydrophilic amine group

  • 75. 
    In regard to local anesthetics their _______ nature allows them pass through cell membranes, but once inside the cell membrane their ______ portion binds inside the cell.
    • A. 

      Lipophilic, hydrophilic

    • B. 

      Hydrophilic, lipophilic

    • C. 

      Ionized, unionized

    • D. 

      None of above

  • 76. 
    Local anesthetic toxicity is most often due to which of the following?
    • A. 

      Absorption from tissues during nerve blocks

    • B. 

      Inadvertent intravascular injection

    • C. 

      Inadvertent administration of epidural dose into subdural space

    • D. 

      Drug interactions between pt meds and LA’s

  • 77. 
    LA toxicity is more likely to occur in area of the body that have…
    • A. 

      Access to CSF

    • B. 

      Increased fat stores

    • C. 

      Increased blood flow

    • D. 

      None of above

  • 78. 
    Which of the following will occur first following administration of a LA?
    • A. 

      Loss of touch and pressure sensation

    • B. 

      Loss of Pain and temperature sensations

    • C. 

      Loss of proprioception

    • D. 

      Sympathetic block

  • 79. 
    Accidental IV injection of bupivacaine would result in which of the following?
    • A. 

      Precipitous Hypotension

    • B. 

      Cardiac Dysrhythmias

    • C. 

      AV Heart block

    • D. 

      All the above

  • 80. 
    Patients taking beta adrenergic blockers, such as propanolol, are at an increased risk for bupivacaine toxicity.
    • A. 

      True

    • B. 

      False

  • 81. 
    You have just performed spinal anesthesia and find your patient has experienced total spinal anesthesia. What do you do?
    • A. 

      Prepare for the patient to be placed on cardiac bypass due to arrhythmias.

    • B. 

      Intubate the patient and wait it out.

    • C. 

      Deliver neo and glyco to reverse the paralysis.

    • D. 

      Begin delivering pain medication to counteract the headache.

  • 82. 
    You are delivering spinal anesthetic to a patient when they begin to complain of feeling light headed and ringing in their ears. What should you do?
    • A. 

      Slow down your rate of injection, and then administer rest of anesthetic.

    • B. 

      Immediately notify MD and prepare pt for cardiac bypass, your plasma concentration is most likely too high now.

    • C. 

      Immediately stop injection, start lipid infusion, monitor patient, your plasma concentration should still be low enough to reverse this.

    • D. 

      Comfort the patient that this is normal to experience and deliver rest of anesthetic quickly.

  • 83. 
    Which of the following is not true regarding ACE inhibitors?
    • A. 

      May cause left ventricular hypertrophy to decrease

    • B. 

      Delay progression of diabetic renal disease

    • C. 

      First line treatment for HTN and mitral regurge

    • D. 

      Commonly used to treat renal stenosis

  • 84. 
    For a patient who is taking losartan, you would expect to see a 2-3 fold increase in plasma _____ activity and an increase in ______ activity due to removal of negative feedback system.
    • A. 

      Renin, Angiotensin II

    • B. 

      Angiotensin II, Angiotensin I

    • C. 

      Angiotensin I, Renin

    • D. 

      None of above

  • 85. 
    What is the MOA of Loop diuretics?
    • A. 

      Inhibits reabsorption of sodium and chloride ions in the medullary portion of the ascending loop of Henle

    • B. 

      Blocks the conversion of angiotensin I to angiotensin II to prevent vasoconstriction

    • C. 

      Inhibits reabsorption of sodium and chloride ions in the cortical portion of the ascending loop of Henle

    • D. 

      Increases the osmolarity of the renal tubular fluid and prevents reabsorption of water

  • 86. 
    Which of the following would be the best choice to treat a pt diagnosed with essential hypertension?
    • A. 

      Hydrochlorothiazide

    • B. 

      Urea

    • C. 

      Spironolactone

    • D. 

      Acetazolamide

  • 87. 
    Which diuretic would be the best choice for a patient who suffers from chronic hypokalemia?
    • A. 

      Hydrochlorothiazide

    • B. 

      Furosemide

    • C. 

      Triamterene

    • D. 

      Ethacrynic Acid

  • 88. 
    Which of the following describes an appropriate oral dose of furosemide?
    • A. 

      0.1 mg/kg

    • B. 

      1mg/kg

    • C. 

      5 mg/kg

    • D. 

      0.5 mg/kg

  • 89. 
    Which of the following diuretics is associated with hypochloremic, hypokalemic, metabolic alkalosis?
    • A. 

      Potassium sparing diuretics

    • B. 

      Aldosterone Antagonists

    • C. 

      Osmotic Diuretics

    • D. 

      Thiazide Diuretics

  • 90. 
    Stimulation of Beta 1 receptors would result in all of the following except…
    • A. 

      Brochodilation

    • B. 

      Increase heart rate

    • C. 

      Increase contractility

    • D. 

      All the above result from Beta 1 stimulation

  • 91. 
    Which of the following is not a competitive alpha blocker?
    • A. 

      Phentolamine

    • B. 

      Phenoxybenzamine

    • C. 

      Yohimbine

    • D. 

      Prazosin

  • 92. 
    Which of the following is a cardioselective beta 1 blocker?
    • A. 

      Propanolol

    • B. 

      Metoprolol

    • C. 

      Nadalol

    • D. 

      Timolol

  • 93. 
    Which of the following beta blockers is not a partial antagonist?
    • A. 

      Pindolol

    • B. 

      Acebutolol

    • C. 

      Timolol

    • D. 

      Atenolol

  • 94. 
    Which of the following is not a cardiac effect associated with propanolol?
    • A. 

      Decreased peripheral vascular resistance

    • B. 

      Decreased HR

    • C. 

      Decreased cardiac output

    • D. 

      Decreased Contractility

  • 95. 
    Which of the following drugs is a non selective beta blocker that is a pure antagonist?
    • A. 

      Pindolol

    • B. 

      Propanolol

    • C. 

      Esmolol

    • D. 

      Labetolol

  • 96. 
    What  would be an appropriate drug to give to a patient with COPD to blunt the response to larnygoscopy?
    • A. 

      Propanolol IV

    • B. 

      Atenolol PO

    • C. 

      Esmolol IV

    • D. 

      Timolol PO

  • 97. 
    How is Esmolol metabolized?
    • A. 

      By plasma cholinesterase

    • B. 

      By cytochrome P450

    • C. 

      Through renal excretion

    • D. 

      By plasma esterases

  • 98. 
    Which of the following is not a side effect associated with use of labetolol?
    • A. 

      Chronic Cough

    • B. 

      Orthostatic hypotension

    • C. 

      Bronchospasm

    • D. 

      Heart block

  • 99. 
    What is the most selective beta 1 blocker?
    • A. 

      Esmolol

    • B. 

      Atenolol

    • C. 

      Metoprolol

    • D. 

      Propanolol

  • 100. 
    Which of the following would you give to a diabetic patient with an acute MI?
    • A. 

      Propanol 200 mg PO

    • B. 

      Metoprolol 25 mg IV

    • C. 

      Atenolol 5 mg IV (over 5 min)

    • D. 

      None of above

  • 101. 
    Stimulation of beta 2 receptors causes these effects except
    • A. 

      Bronchodilation

    • B. 

      Glycogenolysis/gluconeogenesis

    • C. 

      Activation of Na/K pump

    • D. 

      Vasoconstriction

  • 102. 
    Which of the following is true?
    • A. 

      Alpha 1 receptors are presynaptic adrenoreceptors

    • B. 

      Alpha 2 receptors are postsynaptic adrenoreceptors

    • C. 

      Alpha 1 receptors are postsynaptic adrenoreceptors

    • D. 

      Botha Alpha 1 and 2 are presynaptic and postsynaptic adrenoreceptors

  • 103. 
    Which of the following is not a means of inactivating Neurotransmitters?
    • A. 

      Enzymatic degradation

    • B. 

      Plasma cholinesterase

    • C. 

      Monoamine oxidase

    • D. 

      COMT

  • 104. 
    COMIC RELIEF:  Jizz in my pants
    • A. 

      Ha ha!!

    • B. 

      Kind of a catchy tune...

    • C. 

      I love the looks on their faces!

    • D. 

      All the above

  • 105. 
    Which of the following is appropriate treatment for CNS toxicity associated with Local anesthetics?
    • A. 

      Hyperoxygenate and give IV diazepam

    • B. 

      Intubate pt and wait it out, no treatment

    • C. 

      Administer Physostigmine gtt

    • D. 

      Give Bretylium 20 mg/kg IV