Pharmacology Interactions Quiz
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Questions and Answers

In patients with hypotension, which agent may be the most effective management option according to the text?

  • Epinephrine
  • Phenylephrine
  • Dopamine
  • Norepinephrine (correct)

    • Which of the following statements regarding tricyclic antidepressants (TCAs) and anesthetics is correct?

  • TCAs have no effect on the risk of cardiac arrhythmias during anesthesia.
  • The dose of exogenous epinephrine necessary to produce cardiac dysrhythmias during anesthesia with a volatile anesthetic is increased by TCAs.
  • Induction of anesthesia may be associated with an increased risk of cardiac arrhythmias in patients treated with TCAs. (correct)
  • There is no potential for an increase in cardiac arrhythmias in patients treated with halothane, pancuronium, and TCAs.

    • Which of the following statements regarding TCAs and anticholinergics is correct?

  • Glycopyrrolate is a quaternary ammonium compound, which limits its passage across the blood-brain barrier, potentially reducing the risk of drug interactions with TCAs. (correct)
  • The use of centrally acting anticholinergic agents for preoperative medication in patients treated with TCAs is associated with decreased risk of postoperative delirium and confusion.
  • Scopolamine and atropine sulfate are less likely to have drug interactions with TCAs compared to glycopyrrolate.
  • The anticholinergic effects of drugs are not additive when used in combination with TCAs.

    • Which of the following statements regarding TCAs and opioids is correct?

    <p>Doses of opioids and barbiturates should be decreased in the presence of TCAs to avoid exaggerated or prolonged depressant effects.</p> Signup and view all the answers

    Which of the following statements regarding TCAs and antihypertensives is correct?

    <p>TCAs given in conjunction with α1 adrenergic antagonists increase the risk of hypotension.</p> Signup and view all the answers

    Which of the following statements regarding TCA overdose is correct?

    <p>TCA overdose can be life-threatening, and both CNS and cardiotoxicity can be life-threatening.</p> Signup and view all the answers

    When administering sympathomimetic agents to patients recently started on a tricyclic antidepressant (TCA), which of the following responses should be anticipated?

    <p>An exaggerated pressor response from both direct and indirect-acting sympathomimetics</p> Signup and view all the answers

    Which of the following statements is true regarding the administration of sympathomimetic agents in patients chronically treated with tricyclic antidepressants (TCAs)?

    <p>Conventional sympathomimetics may not be effective in restoring systemic blood pressure</p> Signup and view all the answers

    When administering direct-acting sympathomimetics to patients who have been on tricyclic antidepressants (TCAs) for more than 6 weeks, which of the following dosing strategies is recommended?

    <p>Administer a lower than usual dose, approximately 1/3rd of the usual dose</p> Signup and view all the answers

    Which of the following statements is true regarding the administration of indirect-acting sympathomimetics, such as ephedrine, in patients chronically treated with tricyclic antidepressants (TCAs)?

    <p>Pressor responses are likely to be more pronounced compared to direct-acting agents</p> Signup and view all the answers

    Which of the following factors may contribute to the potential ineffectiveness of conventional sympathomimetics in restoring systemic blood pressure in patients chronically treated with tricyclic antidepressants (TCAs)?

    <p>Both desensitization/down-regulation of adrenergic receptors and depletion of catecholamine stores</p> Signup and view all the answers

    When administering sympathomimetic agents to patients chronically treated with tricyclic antidepressants (TCAs), which of the following statements is correct?

    <p>The administration of either direct-acting or indirect-acting sympathomimetics is acceptable, but initial doses may need adjustment</p> Signup and view all the answers

    Which of the following is a contraindication for the use of droperidol?

    <p>All of the above</p> Signup and view all the answers

    How do phenothiazines affect the ventilatory, miotic, and analgesic effects of opioids?

    <p>Phenothiazines exaggerate the ventilatory effects, increase the miotic effects, and potentiate the analgesic effects of opioids</p> Signup and view all the answers

    What is the recommended approach for managing hypotension in a patient taking phenothiazines?

    <p>Use direct-acting vasopressors</p> Signup and view all the answers

    Why are phenothiazines generally not used as anti-emetic agents?

    <p>They have a higher incidence of adverse effects like hypotension compared to butyrophenones</p> Signup and view all the answers

    What is the hypothesized mechanism of action for antidepressant medications?

    <p>Inhibition of neurotransmitter reuptake, leading to increased neurotransmitter levels in the synaptic cleft</p> Signup and view all the answers

    What is the effect of chronic administration of antidepressants on the autoreceptors on neurons?

    <p>Downregulation of the autoreceptors</p> Signup and view all the answers

    Tricyclic antidepressants (TCAs) can increase the effects of sympathomimetic agents.

    <p>True</p> Signup and view all the answers

    Patients recently started on a tricyclic antidepressant (TCA) will have a blunted response to sympathomimetic agents.

    <p>True</p> Signup and view all the answers

    Indirect-acting sympathomimetics, such as ephedrine, are the preferred choice for managing hypotension in patients chronically treated with tricyclic antidepressants (TCAs).

    <p>False</p> Signup and view all the answers

    Concomitant use of phenothiazines and opioids can lead to increased miotic (pupillary constriction) and sedative effects of opioids.

    <p>True</p> Signup and view all the answers

    Phenothiazines can enhance the ventilatory effects of opioids.

    <p>False</p> Signup and view all the answers

    Droperidol is contraindicated in patients with a prolonged QTc interval.

    <p>True</p> Signup and view all the answers

    Phenothiazines are commonly used as anti-emetic agents due to their lower incidence of adverse effects compared to butyrophenones.

    <p>False</p> Signup and view all the answers

    The analgesic effects of opioids are decreased when co-administered with phenothiazines.

    <p>False</p> Signup and view all the answers

    Chronic administration of antidepressants leads to upregulation or sensitization of the autoreceptors on neurons.

    <p>False</p> Signup and view all the answers

    Phenothiazines are contraindicated in patients with Parkinson's disease.

    <p>True</p> Signup and view all the answers

    What is the main reason for avoiding the concomitant use of droperidol and phenothiazines?

    <p>Exaggerated CNS depressant effects</p> Signup and view all the answers

    Why should phenothiazines be avoided in patients with Parkinson's disease?

    <p>Antagonism with dopamine</p> Signup and view all the answers

    Which neurotransmitters play a crucial role in the normal brain neurochemistry according to the text?

    <p>Serotonin and norepinephrine</p> Signup and view all the answers

    What effect does chronic administration of antidepressants have on autoreceptors on neurons?

    <p>Desensitization</p> Signup and view all the answers

    Why are phenothiazines not commonly used as anti-emetic agents as per the text?

    <p>Higher incidence of hypotension</p> Signup and view all the answers

    Which adverse effect is most likely when combining phenothiazines with opioids?

    <p>Respiratory depression</p> Signup and view all the answers

    Which neurotransmitter's reuptake inhibition is hypothesized to increase with chronic antidepressant use?

    <p>Serotonin</p> Signup and view all the answers

    What effect do phenothiazines have on the overall opioid use when combined?

    <p>Reduces opioid analgesia</p> Signup and view all the answers

    Which class of drugs' ventilatory effects are amplified by phenothiazines according to the text?

    <p>Opioids</p> Signup and view all the answers

    Why is glycopyrrolate recommended if an anticholinergic agent is needed?

    <p>Prevention of bradycardia</p> Signup and view all the answers

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