Beta Blockers and Carvedilol Quiz

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Questions and Answers

Which enzymes are responsible for the metabolism of catecholamines?

  • Catecholamine oxidase [CO]
  • Monoamine oxidase [MAO] (correct)
  • Catecholamine reductase [CR]
  • Monosaccharide oxidase [MO]

What distinguishes catecholamines from noncatecholamines?

  • Duration of action
  • Ability to be used orally
  • Ability to cross the blood-brain barrier (correct)
  • Presence of benzene ring

What is the defining feature of a catechol group in catecholamines?

  • Amine component
  • Presence of hydroxyl groups on two adjacent carbons (correct)
  • Ethylamine component
  • Benzene ring

Which adrenergic agonist works by promoting norepinephrine release and blocking norepinephrine reuptake?

<p>Ephedrine (B)</p> Signup and view all the answers

What distinguishes indirect adrenergic agonists from direct ones?

<p>Inhibition of norepinephrine inactivation (B)</p> Signup and view all the answers

What is the cause of the pink or brown pigmentation in catecholamine-containing solutions over time?

<p>Oxidation of the catecholamine molecule (B)</p> Signup and view all the answers

Which type of receptors are located presynaptically in the central nervous system and their activation inhibits norepinephrine release?

<p>Alpha-2 receptors (A)</p> Signup and view all the answers

What is the therapeutic application of activating beta-2 receptors?

<p>Asthma (B)</p> Signup and view all the answers

What is the main adverse effect of overstimulation of beta-1 receptors?

<p>Tachycardia and dysrhythmias (B)</p> Signup and view all the answers

What is the primary therapeutic use of dopamine receptors activation?

<p>Cardiac arrest treatment (C)</p> Signup and view all the answers

What is the receptor specificity of epinephrine?

<p>Alpha-1, alpha-2, beta-1, and beta-2 (B)</p> Signup and view all the answers

Which adrenergic agonist is specifically indicated for the treatment of heart failure?

<p>Dobutamine (B)</p> Signup and view all the answers

What is the classification of norepinephrine as a medication?

<p>Catecholamine (D)</p> Signup and view all the answers

Which adrenergic agonist has receptor specificity for activation of dopamine receptors only at low doses, B1 at moderate doses, and A1 at high doses?

<p>Dopamine (C)</p> Signup and view all the answers

Which adrenergic agonist can benefit asthma through bronchodilation and improve hemodynamic status in patients with shock?

<p>Ephedrine (C)</p> Signup and view all the answers

Which type of adrenergic antagonist is used to reduce the contraction of smooth muscle in the prostatic capsule and bladder neck?

<p>Selective alpha adrenergic blocking agents (D)</p> Signup and view all the answers

What is the most significant adverse effect associated with alpha-2 blockade?

<p>Potentiation of reflex tachycardia (B)</p> Signup and view all the answers

What can be given prior to surgery for pheochromocytoma to prevent massive catecholamine release?

<p>Selective alpha adrenergic blocking agents (C)</p> Signup and view all the answers

What is the therapeutic application of nonselective alpha blockers like phentolamine?

<p>Blocking A1 and A2 receptors (C)</p> Signup and view all the answers

What is one of the therapeutic applications of alpha blockade mentioned in the text?

<p>Relief of symptoms of Raynaud's disease (C)</p> Signup and view all the answers

Which group of beta blockers is used to treat glaucoma?

<p>Second generation (cardioselective) (B)</p> Signup and view all the answers

What adverse effects are associated with non-selective beta adrenergic blocking agents?

<p>Hypoglycemia (B)</p> Signup and view all the answers

Why must beta blockers be used with caution in patients with heart failure or reduced cardiac reserve?

<p>They precipitate heart failure (B)</p> Signup and view all the answers

What is the potential complication of B-blocker therapy related to AV conduction?

<p>AV heart block (A)</p> Signup and view all the answers

What is the suggested method to minimize the risk of rebound excitation when withdrawing beta blockers?

<p>Gradual withdrawal over a period of one to two weeks (D)</p> Signup and view all the answers

What is the primary reason for the difficulty in establishing doses of propranolol?

<p>Patients have widely varying requirements for propranolol (C)</p> Signup and view all the answers

Which adverse effect is unique to metoprolol among the selective Beta blockers?

<p>Masking the signs and symptoms of hypoglycemia (C)</p> Signup and view all the answers

What sets carvedilol and labetalol apart from other Beta blockers?

<p>They block alpha adrenergic receptors in addition to Beta receptors (A)</p> Signup and view all the answers

Why are nadolol and atenolol less likely to penetrate the blood-brain barrier compared to propranolol and metoprolol?

<p>They are less lipid soluble (B)</p> Signup and view all the answers

Which characteristic makes sotalol and esmolol unsuited for treating HTN?

<p>They require maintenance of blood levels throughout the day, everyday (A)</p> Signup and view all the answers

What is the first dose recommendation for prazosin?

<p>No more than 1mg (C)</p> Signup and view all the answers

Which drug can prolong QT and should not be given with inhibitors of CYP34A?

<p>Alfuzosin (D)</p> Signup and view all the answers

What are the three beta blockers shown to be effective in the treatment of heart failure?

<p>Carvedilol, Bisoprolol, Metoprolol succinate (B)</p> Signup and view all the answers

What is the main therapeutic application of beta blockers in the context of hyperthyroidism?

<p>Suppression of tachydysrhythmia and angina caused by increased sensitivity of heart catecholamines (C)</p> Signup and view all the answers

For which condition can beta blockers be used prophylactically to reduce frequency and intensity of attacks?

<p>Migraine attacks (C)</p> Signup and view all the answers

What is the mechanism of action of clonidine in reducing blood pressure?

<p>Activating central A2 receptors to reduce sympathetic outflow to the blood vessels and heart (B)</p> Signup and view all the answers

What are the approved indications for clonidine?

<p>Hypertension, severe pain, and attention deficit hyperactivity disorder (D)</p> Signup and view all the answers

How does guanfacine lower blood pressure?

<p>By activating brainstem A2 adrenergic receptors to reduce sympathetic outflow to the heart and blood vessels (C)</p> Signup and view all the answers

What distinguishes methyldopa from clonidine and guanfacine in its mechanism of action?

<p>It inhibits sympathetic outflow from the CNS by causing alpha-2 activation in the brain (C)</p> Signup and view all the answers

What distinguishes methyldopa from methyldopate?

<p>Methyldopate is an IV agent that is almost identical to methyldopa in structure and pharmacologic effects (B)</p> Signup and view all the answers

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