Katzung Pharmacology - Chapter 9 Qs
Questions 1 and 2. A 7-year-old boy with a previous history of bee sting allergy is brought to the emergency department after being stung by 3 bees. Which of the following are probable signs of the anaphylactic reaction to bee stings? (A) Bronchodilation, tachycardia, hypertension, vomiting, diarrhea (B) Bronchospasm, tachycardia, hypotension, laryngeal edema (C) Diarrhea, bradycardia, vomiting (D) Laryngeal edema, bradycardia, hypotension, diarrhea (E) Miosis, tachycardia, vomiting, diarrhea
*(B) Bronchospasm, tachycardia, hypotension, laryngeal edema*
A group of volunteers are involved in a phase 1 clinical trial of a new autonomic drug. When administered by intravenous bolus, the blood pressure increases. When given orally for 1 week, the blood pressure decreases. Which of the following standard agents does the new drug most resemble? (A) Atropine (B) Clonidine (C) Phentolamine (an α blocker) (D) Phenylephrine (E) Propranolol (a β blocker)
*(B) Clonidine*
10. A new drug was given by subcutaneous injection to 25 nor- mal subjects in a phase 1 clinical trial. The cardiovascular effects are summarized in the table below. Which of the following drugs does the new experimental agent most resemble? (A) Atropine (B) Epinephrine (C) Isoproterenol (D) Phenylephrine (E) Physostigmine
*(B) Epinephrine*
2. If this child has signs of anaphylaxis, what is the treatment of choice? (A) Diphenhydramine (an antihistamine) (B) Ephedrine (C) Epinephrine (D) Isoproterenol (E) Methylprednisolone (a corticosteroid)
*(C) Epinephrine*
3. A 65-year-old woman with impaired renal function and a necrotic ulcer in the sole of her right foot is admitted to the ward from the emergency department. She has long-standing type 2 diabetes mellitus and you wish to examine her retinas for possible vascular changes. Which of the following drugs is a good choice when pupillary dilation—but not cyclople- gia—is desired? (A) Isoproterenol (B) Norepinephrine (C) Phenylephrine (D) Pilocarpine (E) Tropicamide
*(C) Phenylephrine*
Questions 8 and 9. Several new drugs with autonomic actions were studied in preclinical trials in animals. Autonomic drugs X and Y were given in moderate doses as intravenous boluses. The systolic and diastolic blood pressures changed as shown in the diagram below. 8. Which of the following drugs most resembles drug X? (A) Atropine (B) Bethanechol (C) Epinephrine (D) Isoproterenol (E) Phenylephrine
*(D) Isoproterenol*
A 60-year-old immigrant from Latin America was told she had hypertension and should be taking antihypertensive medication. She decides to take an herbal medication from an online "holistic pharmacy." One week after starting the medication, she is found unconscious in her apartment. In the emergency department, her blood pressure is 50 over 0 mm Hg and heart rate is 40 bpm. Respirations are 20/min; pupils are slightly constricted. Bowel sounds are present. Which of the following would be the most effective cardiovascular stimulant? (A) Amphetamine (B) Clonidine (C) Isoproterenol (D) Norepinephrine (E) Tyramine
*(D) Norepinephrine*
Your 30-year-old patient has moderately severe new onset asthma, and you prescribe a highly selective β2 agonist inhaler to be used when needed. In considering the possible drug effects in this patient, you would note that β2 stimulants frequently cause (A) Direct stimulation of renin release (B) Hypoglycemia (C) Itching due to increased cGMP (cyclic guanine mono-phosphate) in mast cells (D) Skeletal muscle tremor (E) Vasodilation in the skin
*(D) Skeletal muscle tremor*
9. Which of the following most resembles drug Y? (A) Atropine (B) Bethanechol (C) Epinephrine (D) Isoproterenol (E) Phenylephrine
*(E) Phenylephrine*
Mr Green, a 54-year-old banker, had a cardiac transplant 6 months ago. His current blood pressure is 120/70 mm Hg and heart rate is 100 bpm. Which of the following drugs would have the least effect on Mr Green's heart rate? (A) Albuterol (B) Epinephrine (C) Isoproterenol (D) Norepinephrine (E) Phenylephrine
*(E) Phenylephrine*
