2/12/201612:13:00 PM Buzbee pharmacology Unit 2 part I page 1
Review of Unit 2 pharmacology Beta II [part 1]
Corrected 6/27/07 corrected 2/26/08
1.
Name:
date:
2007
The receptors that will cause bronchospasm when triggered by acetylcholine are called:
a. cholinergic receptors
b. muscarinic receptors
c. M3 receptors
d. Beta I receptors
e. All but d
2. Once the muscarinic receptor on the smooth muscle is stimulated:
a. GTP converts int0 cyclic -GMP which results in an increase of free intracellular
Ca++.
b. ATP converts into cyclic-AMP which triggers protein kinase A to reduce
intercellular Ca ++.
c. Both happen at once; the result is a balance of intracellular Ca ions
3. The resorcinol and saligenin families of bronchodilators have:
a. Rapid onset and prolonged duration of action
b. Rapid onset and shorter duration of action
c. Slower onset and shorter duration of action
d. Slower onset and prolonged duration of action
4. The resorcinol and saligenin families of bronchodilators are:
a. Less susceptible to MAO so they have longer duration of action
b. Less susceptible to MAO so that they can be given orally
c. Both
d. none
5.
The resorcinol and saligenin families of bronchodilators have:
a. More specific action at the Beta II
b. More specific action at the Beta I
c. Widespread adrenergic action at alpha, Beta I and II receptors
6. The rise of free intercellular Ca ions in the bronchial smooth muscle results in:
a. Bronchospasm
b. Bronchodilation
7.
The catecholamine family of bronchodilators have:
a. Rapid onset and prolonged duration of action
b. Rapid onset and shorter duration of action
c. Slower onset and shorter duration of action
d. Slower onset and prolonged duration of action
8. Because epinephrine is known for its tachyphylaxis:
a. The drug doses must be given closely together for there to be an effect
b. The drug wears off slowly so doses need to be pretty far apart
c. The drug is only effective for a couple of treatments
d. b and c
9. Your patient has an exacerbation of asthma. You would best give him which drug by subQ
shot?
a. Racemic epinephrine
b. Epinephrine
c. Terbutaline sulfate
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10. Your patient is going into anaphylactic shock due to allergy to iodine during a procedure.
You would best given him which drug by subQ shot?
a. Racemic epinephrine
b. Epinephrine
c. Terbutaline sulfate
11. Stimulation of the alpha receptors on the blood vessels will result in:
a. Vasoconstriction
b. Vasodilation
12. [correction]Stimulation of Beta II receptors can result in:
a. Vomiting from simulation of the receptors located in the gastric smooth muscles
b. Shaking from simulation of the receptors are located in the skeletal muscles
c. Urinary retention of the receptors are located in the bladder
d. A and c
e. A and b
13. T/F During CPR, a patient is given epinephrine by IV to restart the heart and to increase
the blood pressure by vasodilation.
14. Headache, insomnia, nervousness caused by adrenergic agonists is caused by stimulation
of:
a. Alpha receptors
b. Beta I receptors
c. Beta II receptors
d. Direct simulation of the CNS
e. muscarinic
15. The hypokalemia associated with administration of a Beta II agonist could aggravate:
a. Pre-existing heart disease.
b. Pre-existing renal disease
c. Skeletal muscle paralysis
d. None of these
16. [correction] Someone with an allergy to soy beans or peanut, cannot not use --bronchodilators.
a. Beta II agonists
b. Adrenergic agonist
c. Cholinergic antagonist
d. Xanthines
e. Drugs with a combination of a and d
17. Beta I stimulation of the SA node
a. raises the heart rate & increases contractility thus increases the cardiac output.
b. could just trigger dangerous cardiac arrhythmias.
18. Administration of Atropine Sulfate
i. Could raise the heart rate & increase changes of serious ventricular
arrhythmias
ii. Start shaking
iii. Headache & dizzy
iv. Dry mouth
v. Blurred vision
a. iv and v
b. i, iii, iii
c. i, ii only
d. i, ii, iii, iv
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e.
i, ii, iii, iv & v
19. correction: T/F Use adrenergic agonists with care with concurrent use of MOA inhibitors
[psychiatric drugs] because the level of endogenous catecholamines could rise to toxic
levels.
20. Racemic epinephrine 2.25% is used to:
a. Restart a stopped heart during CPR
b. Treat subglottic edema
c. Treat asthma
d. Prevent wheezing, rather than treat it
21. Metaproterenol 5% is used to:
a. Restart a stopped heart during CPR
b. Treat subglottic edema
c. Treat asthma
d. Prevent wheezing, rather than treat it.
22. Levalbuterol:
a. Has only S-isomer
b. Has only R-isomer
c. Has both S and R isomer
23. The trade name for Levalbuterol is:
a. Atrovent®
b. Combivent®
c. Xopenex®
d. Ventolin®
e. Maxiair MDI®
24. Beta I stimulation of the ventricles could:
a. raises the heart rate & increases contractility thus increases the cardiac output.
b. could just trigger dangerous cardiac arrhythmias.
25. Terbutaline sulfate is used to:
a. Restart a stopped heart during CPR
b. Treat subglottic edema
c. Treat asthma
d. Prevent wheezing, rather than treat it.
26. Albuterol:
a. Has only S-isomer
b. Has on R-isomer
c. Has both S and R isomer
27. The trade name for racemic epinephrine is:
a. Atrovent®
b. Vaponefrine®
c. Xopenex®
d. Ventolin®
e. Maxiair MDI®
28. The trade name for Ipratropium bromide is:
a. Atrovent®
b. Vaponefrine®
c. Xopenex®
d. Ventolin®
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e.
Maxiair MDI®
29. It is safer to raise the bradycardiac patient’s heart rate by:
a. Beta II stimulation of the SA node
b. Beta I stimulation of the SA
c. Cholinergic blocking of the SA node
d. None of these; it is never safe to treat bradycardia.
30. [correction] Administration of racemic epinephrine:
i. Could raise the heart rate
ii. Cause headaches
iii. Increase the blood pressure
iv. Drop the heart rate
a. i, ii, iii, iv
b. ii, iii only
c. iii, iv
d. i, ii, iii
31. correction: Administration of Isoproterenol .5%:
i. Could raise the heart rate & increase chances of serious ventricular
arrhythmias
ii. Start shaking
iii. Headache & dizzy
iv. Dry mouth
v. Blurred vision
a. iv and v
b. i, ii, iii
c. i, ii only
d. i, ii, iii, iv
e. i, ii, iii, iv & v
Complete this table
drug
Pirbuterol
Trade
name
Maxiair
MDI®
indications
Adverse hazards
Treat bronchospasm;
Rescue beta II
tachycardia, headache, dizzy, hypokalemia,
lots of shaking & nervousness, nausea &
vomiting [beta II].
Salmeterol
Serevent®
Advair®
with a
steroid
Prevent bronchospasm;
maintenance beta II
tachycardia, headache, dizzy, hypokalemia,
lots of shaking & nervousness, nausea &
vomiting [beta II]. Sudden death if dose
increased
Tiotropium
Bromide
Spiriva®
Cholinergic antagonist;
maintenance
bronchodilator
dry mouth, blurred vision, tachycardia at
moderate doses, confusion and paralysis at
high doses
glaucoma is complicated
Urine retention
Levalbuterol
Xopenex®
Treat bronchospasm;
Rescue beta II
tachycardia, headache, dizzy, hypokalemia,
lots of shaking & nervousness, nausea &
vomiting [beta II].
R isomer only
Ipratropium
bromide
Atrovent®
Cholinergic antagonist;
maintenance
dry mouth, blurred vision, tachycardia at
moderate doses, confusion and paralysis at
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bronchodilator
Albuterol
high doses
Narrow-angle glaucoma is complicated by
administration of these drugs.
Urine retention
Proventil®,
Ventolin®
& Proventil
HFA® MDI
Treat bronchospasm;
Rescue beta II
tachycardia, headache, dizzy, hypokalemia,
lots of shaking & nervousness, nausea &
vomiting [beta II].
Terbutaline
Brethaire®
Treat bronchospasm;
Rescue beta II
tachycardia, headache, dizzy, hypokalemia,
lots of shaking & nervousness, nausea &
vomiting [beta II].
Metaproterenol
Alupent®
Treat bronchospasm;
Rescue beta II
tachycardia, headache, dizzy, hypokalemia,
lots of shaking & nervousness, nausea &
vomiting [beta II].
Racemic
epinephrine
MicroNefrin,
Asthma
Nefrin & “S”
[Correction] Treat swelling
& edema
associated with larynx &
croup
HTN, tachycardia, headache, dizzy,
hypokalemia, lots of shaking & nervousness,
nausea & vomiting [beta II].
R & S isomers
32. [correction] Stimulation of Beta I receptors on the myocardium will result in:
a. bradycardia
b. tachycardia
c. hypertension [also due to Alpha stimulation of vessels]
d. both a and c
e. both b and c
Complete this table:
drug
classification
Dose/frequency
Pirbuterol
Beta II agonist [pro-drug]
1.25 ml BID or QID.
Onset of
action
3-4 minute
duration
Salmeterol
Beta II agonist; long-action
Puffs BID
20 minutes
12 hours
Tiotropium
Bromide
Cholinergic antagonist
DPI Q day
30 minutes [per
insert]
24 hours
Levalbuterol
Beta II agonist
.63 mg & 1.25 mg
15 minutes
5-8 hours
Ipratropium
bromide
Cholinergic antagonist
500 micrograms in 2.5 ml sterile
saline QID
15 minutes[per
insert]
3-6 hours [per
insert]
Albuterol
Beta II agonist
15 minutes
5-8 hours
Terbutaline
Beta II agonist
2.5 mg
5 ml of .5%
.25-.5 ml of 1mg/vial unit dose
5-30 minutes
3-6 hours
Metaproterenol
Beta II agonist
.25-.30 ml of 5% TID/QID
1- 5 minutes
Racemic
epinephrine
Beta I, II and Alpha
agonists [decongestant
due to Alpha]
.o5 mg/kg IBW max .75 ml of
2.25% may be given Q2 for a few
TX
About 3 minutes
2 hours – 6
hours
.5 hour to 2
hours
5-8 hours
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