Midterm Study from Quiz 4
The oral analgesic effect of Oxycodone is approximately ____________________ that or morphine.
2x stronger
The "First-Dose Phenomenon" is associated with what drug class of antihypertensive drug?
Alpha 1 adrenergic antagonists
T/F? for both statements 1.Beta Blockade of Beta-1 receptors decreases RENIN release which leads to a decrease in both Angiotensin II and Aldosterone....which lowers blood pressure. #2. Beta Blockade of Beta-1 receptors in the heart decreases HR and Force of Contraction,...lowering cardiac output and blood pressure.
Both are true
T/F? For Inhalation Anesthetic Drugs, the higher the Minimum Alveolar Concentration ( MAC ), the more potent the drug is.
False requires less drug so its more potent
T/F? GENERAL INHALATION ANESTHESIA DRUGS have a clearly identified mechanism of action on specific CNS receptors.
False
T/F? The Angiotensin Receptor Blockers ( ARB's ), in addition to blocking the effects of Angiotensin II, increase bradykinin levels and are associated with dry coughs.
False *its the ACE inhibitors
All of the following statements about Tramadol ( Ultram) are TRUE, EXCEPT: Tramadol ( Ultram) is an agonist at the mu opiod receptor & inhibitor of Serotonin and Norepinephrine reuptake Tramadol ( Ultram) is now a Schedule III Opiod Agonist Tramadol ( Ultram) is used to manage moderate to severe pain The respirtatory depressant effects of Tramadol ( Ultram) are less than that or morphine All of the above are TRUE with respect to Tramadol ( Ultram)
Schedule 3
match the Stage/Depth of anesthesia to the corresponding characteristics of the Stage of Anesthesia: Stage 1 Stage 2 Stage 3 Stage 4
Stage 1=analgesia to unconsciousness Stage 2=excitable, tense, combative Stage 3=Muscle relaxation, ready for surgery Stage 4=too much med. respiratory depression, death
A non scheduled CNS Stimulant for ADHD with a mechanism of action associated primarily with the inhibition of presynaptic neurepinephrine reuptake. ( lack of dopamine reuptake inhibition associated with less dependancy and habit formation)
Strattera
T/F? In addition to the physiological responses associated with Morphine's effect on Opiod Receptors, Morphine causes histamine release from mast cells, which produces vasodilation and anaphylactoid reactions.
True
T/F? Compared to morphine................, Fentanyl is 100 times more potent, and has a much shorter time to peak effect and duration of action.
True
T/F? Dantrolene is the only drug to treat Malignant Hyperthermia.
True
T/F? In treating HTN, current recommendations are to initate therapy with a diuretic.
True
T/F? Inhalation Anesthetic Drug "Wash Out" will occur much more slowly with an Inhalation Anesthetic Drug that is HIGHLY soluble in blood.
True
T/F? Local anesthetic drugs act mainly by inhibiting sodium influx thru sodium-specific voltage gated ion channels in the neuronal cell membrane & this inhibits the subsequent firing of action potentials in the neuronal cell.
True
T/F? Maintainance of Anesthesia is commonly accomplished via Inhalation Anesthesic drugs, and not IV Anestheic agents.
True
T/F? Malignant Hyperthermia can be associated with either the Halogenated Anesthetic Inhalation Drugs or with the Depolarizing Neuromuscular Blocker Drug.............., Succinylcholine.
True
T/F? Most Induction of Anesthesia is accomplished via IV Anesthesic drugs, and not Inhalation agents.
True
T/F? Much Slower changes in the depth of anesthesia are observed with Inhalation Anesthetic Drugs that have a HIGH Solubility in Blood ( high blood/gas partition coeffecient)
True
T/F? Respiratory Depression is the most common cause of death in acute opiod overdosage via reducing the sensitivity of the respiratory center neurons to Carbon Dioxide.
True
T/F? for both statements 1.Meperidine ( Demerol ) has a faster time to to peak effect , when compared to morphine. 2. Meperidine ( Demerol ) is indicated for ACUTE pain,...... as long term use is associated with accumulation of an active metabolite ( Normeperidine) that has significant neurotoxic effects that can cause siezures.
True for both
T/F? for both statements Activation of opiod receptors causes a decreased presynaptic neuron Calcium Influx, which inhibits release of excitatory neurotransmitters involved in pain transmission. 2. Activation of opiod receptors causes an increased postsynaptic neuron Potassium Efflux, which hyperpolarizes the cell, which inhibits post-synaptic neuron firing.
True for both
All of the following are complications of persistent HTN, EXCEPT: Myocardial Infarct ( heart attack ) Hypertensive Cardiomyopathy Hypoglycemia Hypertensive nephropathy Cerebrovascular Accident ( stroke) hypertensive retinopathy
hypoglycemia
Match the Anti-Hypertensive Drugs with their associated Mechanism of Action. 1. Losartan ( Cozaar) , Valsartan ( Diovan ) , Olmesartan ( Benicar ) 2. Hydrochlorothiazide ( HCTZ) 3.Lisinopril ( Prinivil ) , Enalapril ( Vasotec), Captopril ( Capoten 4.Verapamil ( Calan ) , Diltiazem ( Cardizem), Nifedipine ( Procardia) 5. Aliskeren ( Tekturna) 6. Prazocin ( minipress), Doxazocin ( Cardura) and Terazocin ( Hytrin) 7. Clonidine ( Catapres) and Guanfacine ( Tenex) 8. Metoprolol (Lopressor), Propranolol (Inderal), Atenolol (Tenormin)
1. ARBs 2. Thiazide Diuretic 3. ACE Inhibitors 4. Ca+ Channel Blockers 5. Direct Renin Inhibitor 6. Alpha 1 Blocker 7. Central Alpha 2 Agonist 8. Beta Blockers
All of the following are Goals of General Anesthesia................ EXCEPT. Deep Sedation ( hypnosis) / Unconsciousness Lack of Awareness and Amnesia Skeletal Muscle Relaxation/Immobility Suppresssion of Undesirable Side Effects Analgesia All of the above ARE goals of General Anesthesia
All of the above
Stimulates the CNS via stimulating release of neurotransmitters from the storage vesciles within the pre-synaptic vesicles... and .....by Inhibiting the metabolizing effects of Mono Amine oxidases within the neuron. CAFFEINE NICOTINE COCAINE AMPHETAMINES ( Dexedrine, Vyvanse, Adderall ) STRATTERA METHYLPHENIDATE
Amphetamines
Which of the following statements is FALSE with respect to the Renin-Angiotensin-Aldosterone The Renin-Angiotensin-Aldosterone System provides for long term control of the blood pressure by altering blood volume Renin converts Angiotensinogen to Angiotensin I Angiotensin I is converted to Angiotensin II via Angiotensin Converting Enzyme ( ACE ) Angiotensin II is a potent vasodilator Angiotensin II stimulates Aldosterone secretion form the adrenal cortex, which leads to an increase in renal sodium absorption and an increased BP
Angiotensin II is a potent vasodilator **vasoconstrictor
All of the following drug classes are examples of Pre-Anesthetic Adjuncts....EXCEPT. Anti-cholinergics Anti-Emetics Antihistamines ( Histamine H1 receptor blocker) Opiods Beta-Blockers Histamine H2 Receptor blockers
Beta Blockers
Chronic COCAINE usage leads to addiction and dependancy via what physiological response?
Both a decrease in the synthesis of endogenous dopamine and the "Down-Regulation" of dopamine receptors.
Stimlulates CNS by Antagonizing Adensosine in the CNS that plays a protective role in reducing neural activity levels
Caffeine
Stimulates the CNS by blocking the reuptake ( termination of effect) of Norepinephrine, Dopamine and Serotonin back into the presynaptic neuron.
Cocaine
A drug that can act as an agonist on some opiod receptors giving analgesia, and as a weak antagonist on other opiod receptors blunting euphoria and physical dependance is :
Correct Pentazocine ( Talwin)
Which of the following is NOT a category of a Hallucinogenic? Psychodelic Dissociative Deliriant Euphoriant
Euphoria
T/F? for both statements Inhalation Anesthetic Drugs allow for a rapid alteration in the depth of anesthesia. Inhalation Anesthetic Drugs are safe, and have a wide and safe Therapeutic Index.
First is true, second is false low margin of error (therapeutic to toxic)
All of the following are OPIOD RECEPTORS .......EXCEPT. Delta Gamma Kappa Mu
Gamma
Binding of OPIOD ANESTHETIC DRUGS TO OPIOD RECEPTORS provides all of the following physiological responses..... .....EXCEPT. Increased GI motility ( diarrhea) Respiratory Depression Analgesia Euphoria Sedation/Unconsciousness Pupil Constriction ( Miosis)
Increased GI motility
Which Intravenous General Anesthetics is associated with "Dissociative Anesthesia" .. and is classified as a NMDA Receptor Antagonist ?
Ketamine
OPIOD Anesthetic Drugs ( Morphine ) accomplish which 2 goals of General Anesthetia. ( choose more than 1 if applicable) Loss of Consciousness ( at higher doses) Analgesia Amnesia Muscle Relaxation
Loss of Consciousness Analgesia
All of the following are physiological effects of Morphine,.......... EXCEPT: Mydriasis ( pupil dilation ) Respiratory depression Reduced GI Motility analgesia euphoria
Mydriasis Opposite-constriction
The Inattentive subtype of Attention Deficit Hyperactivity Disorder ( ADHD) is associated with low levels of ____________________________ in the CNS, while the Hyperactivity -Impulsivity subtype of ADHD is associated with low levels of __________________________in the CNS
NE, Dopamine
a Pure Opiod Antagonist used for the treatment of ACUTE opiod overdosage:
Narcan (Naloxone)
Stimulates the CNS by stimulating the release of many chemical messengers such as acetylcholine, norepinephrine, epinephrine, vasopressin, histamine, arginine, serotonin, dopamine, autocrine agents, andbeta-endorphins.( Acts as a" volume control" for these Neurotransmitters centrally )
Nicotine
All of the following are preparations for Fentanyl, EXCEPT:
PO
Which of the following IV Anesthetic Induction Drugs is more preferable because it has LESS adverse effects, LESS incidence of Post-Operative nausea and vomiting, and a shorter elimination half-life which allows for a faster recovery of wakefulness. Thiopental ( Pentothal) Propofol ( Diprivan)
Propofol (lipid suspension) higher half life so quickly eliminated short duration of action
All of the following are OPIOD ANESTHETIC DRUGS .....EXCEPT. Morphine Fentanyl Propofol ( Diprivan) Sufentanil
Propofol
Stimulates the CNS primarily by inhibiting the reuptake of dopamine and..... to a lesser extent..... inhibiting the reuptake of norepinephrine, thereby retaining these neurotransmitters longer which increases the levels of these neurotransmitters in the brain. METHYLPHENIDATE ( Ritalin ) ( Concerta) CAFFEINE NICOTINE COCAINE AMPHETAMINES ( Dexedrine, Vyvanse, Adderall ) STRATTERA
Ritalin
A systolic BP of 140 - 159 or a diastolic BP of 90 -99 is what stage of HTN?
Stage 1
All of the following are Non-Depolarizing Neuromuscular Blockers......EXCEPT.
Succinylcholine = Depolarizing
All of the following drugs are Inhalation Anesthetic Drugs.....EXCEPT. Answers: Halothane Nitrous Oxide Sevoflurane Desflurane Thiopental Isoflurane
Thiopental
Inhalation Anesthetic Drugs provide what 2 goals of general anesthesia? ( pick 2 of the 4 options) Unconsciousness Amnesia Skeletal Muscle Relaxation Analgesia
Unconsciousness Analgesia
In treating HTN with Beta-Blockers, all of the following are adverse effects associated with beta blockers..............EXCEPT: decreased libido / impotence low blood glucose levels Increased triglyceride levels and decreased High Density Lipoproteins ( poor outcomes on serum lipids) Increased risk for stroke
low blood glucose *can be associated with worsening diabetes, and blocking insulin even with high blood glucose
In treating HTN in patients who are diabetic, the use of Beta-Blockers is ______________________.
not recommended
Baroreceptors located in the aortic arch and carotid sinuses are responsible for :
rapid moment to moment regulation of BP