أسئلة العاشرة فارما PPPM (قبل التعديل)

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Questions and Answers

Which of the following is NOT a selective alpha-1 adrenergic receptor blocker?

Yohimbine (correct)
Prazosin
Tamsulosin
Terazosin

A patient is prescribed a non-selective alpha-adrenergic blocker. What are the most likely pharmacological effects you would anticipate?

Increased peripheral vascular resistance and bradycardia.
Mydriasis and decreased nasal stuffiness.
Lowered peripheral vascular resistance, postural hypotension, and reflex tachycardia. (correct)
Increased blood pressure and decreased heart rate.

Why is surgical removal of a pheochromocytoma considered a significant intervention?

It only provides temporary relief from hypertension.
It has minimal effect on blood pressure.
It is effective in less than 10% of patients.
It is curative in the majority of patients and significantly impacts hypertension-related mortality and morbidity. (correct)

A patient presents with a rare tumor causing hypertension. Which drug would be appropriately administered along with a beta-blocker in preparation for surgery?

Phenoxybenzamine (B) Signup and view all the answers

Which of the following drugs is an irreversible non-selective alpha-1 and alpha-2 antagonist?

Phenoxybenzamine (D) Signup and view all the answers

A patient taking an alpha-adrenergic blocker reports experiencing nasal congestion. What is the most likely cause of this side effect?

Vasodilation (D) Signup and view all the answers

A patient is prescribed Prazosin. What primary effect does this medication have on blood pressure and peripheral vascular resistance?

Decreases blood pressure by decreasing peripheral vascular resistance. (D) Signup and view all the answers

A doctor wants to prescribe a drug that will lower a patient's blood pressure but is concerned about reflex tachycardia. Which class of drugs should they consider and why?

Selective alpha-1 blockers, as they are less likely to cause reflex tachycardia compared to non-selective blockers. (C) Signup and view all the answers

Which mechanism primarily contributes to the reduction of arterial blood pressure by alpha-1 receptor blockers?

Vasodilation of both arterial and venous smooth muscles (C) Signup and view all the answers

A patient taking an alpha-1 blocker experiences postural hypotension. Which physiological effect of the drug is most directly responsible for this?

Vasodilation leading to decreased venous return (B) Signup and view all the answers

Which of the following is an advantage of using alpha-1 blockers, besides their antihypertensive effect?

Improved lipid profile (decreased LDL and triglycerides) (C) Signup and view all the answers

Why is tamsulosin preferred over other alpha-1 blockers for treating benign prostatic hyperplasia (BPH)?

It selectively targets alpha-1A receptors in the prostate, minimizing effects on blood pressure. (A) Signup and view all the answers

What is the recommended strategy to mitigate the 'first-dose hypotension' associated with alpha-1 blockers?

Start with a small dose at bedtime and gradually increase it. (B) Signup and view all the answers

How do alpha-1 blockers contribute to ejaculatory dysfunction in some patients?

By blocking alpha-1 receptors in the ejaculatory ducts, inhibiting ejaculation (A) Signup and view all the answers

What is the mechanism of action of alpha-methyl dopa in reducing blood pressure?

Stimulating central alpha-2 receptors after conversion to alpha-methyl norepinephrine (C) Signup and view all the answers

Terazosin and doxazosin alleviate BPH symptoms by acting on both α1A and α1B receptors. Which of the following effects contributes MOST to this alleviation?

Relaxation of vascular smooth muscles, decreasing peripheral vascular resistance. (C) Signup and view all the answers

What is the primary mechanism by which alpha-methyl dopa reduces blood pressure?

Stimulation of central alpha-2 adrenergic receptors, reducing sympathetic outflow. (A) Signup and view all the answers

Which of the following is a key pharmacological effect directly attributed to the blockade of alpha-1 receptors in the ejaculatory ducts?

Ejaculatory dysfunction (A) Signup and view all the answers

Why are small initial doses of alpha-adrenergic blockers, administered at bedtime, recommended to mitigate 'first-dose hypotension'?

To minimize the risk of falls during peak drug effect. (C) Signup and view all the answers

A patient with benign prostatic hyperplasia (BPH) also has concerns about potential blood pressure changes. Which alpha-1 blocker would be most suitable to minimize hypotensive effects?

Tamsulosin (A) Signup and view all the answers

What is the most likely reason for fluid retention observed as a side effect in patients treated with alpha-adrenergic antagonists?

Compensatory salt and water retention. (C) Signup and view all the answers

How do terazosin and doxazosin's actions on both α1A and α1B receptors contribute to the symptomatic relief of BPH?

By relaxing prostatic smooth muscle and reducing peripheral vascular resistance. (A) Signup and view all the answers

What is the clinical significance of alpha-adrenergic blockers causing a false-positive test for antinuclear antibodies (ANA) and rheumatoid factor (RF)?

It requires further testing to confirm actual autoimmune disease, as the drug may interfere with test results. (B) Signup and view all the answers

A researcher is investigating the effects of a novel alpha-adrenergic drug on blood pressure and observes a significant decrease in peripheral vascular resistance without a corresponding increase in heart rate. Which of the following mechanisms is LEAST likely to explain this observation?

The drug possesses significant beta-adrenergic agonist activity, counteracting the effects of alpha-1 blockade on heart rate. (B) Signup and view all the answers

A patient with benign prostatic hyperplasia (BPH) and concomitant hypertension is being considered for alpha-1 adrenergic blocker therapy. Considering the receptor subtypes involved, which of the following strategies would be MOST effective in managing both conditions while minimizing potential side effects?

Using a selective alpha-1A blocker like tamsulosin to target the prostate, combined with lifestyle modifications for hypertension. (B) Signup and view all the answers

What underlies the improvement of lipid profiles, specifically a reduction in LDL and triglycerides, observed with some alpha-adrenergic blockers?

The exact mechanisms are not fully understood, but are likely related to improved insulin sensitivity and metabolic effects. (C) Signup and view all the answers

A patient undergoing treatment with phenoxybenzamine for pheochromocytoma is scheduled for elective surgery. What is the MOST critical consideration regarding the continued use of phenoxybenzamine in the perioperative period?

Adjusting the phenoxybenzamine dose based on intraoperative blood pressure monitoring to avoid both hypotension and hypertension. (B) Signup and view all the answers

A researcher aims to develop a novel drug that selectively blocks alpha-2 adrenergic receptors to enhance norepinephrine release. Which of the following potential adverse effects would be of GREATEST concern during the drug's preclinical development?

Uncontrolled hypertension and tachycardia due to excessive norepinephrine release. (B) Signup and view all the answers

A patient with a history of orthostatic hypotension is prescribed terazosin for BPH. Which of the following instructions would be MOST appropriate to minimize the risk of syncope?

Take the medication immediately before bedtime and avoid rising quickly from a sitting or lying position. (A) Signup and view all the answers

A patient with Raynaud's phenomenon, a condition characterized by vasospasm in the extremities, is being considered for alpha-adrenergic blocker therapy. Which agent would be LEAST appropriate?

Yohimbine, due to its alpha-2 adrenergic blockade. (B) Signup and view all the answers

Following the administration of an alpha-adrenergic blocker, a patient exhibits exaggerated nasal congestion and difficulty breathing through their nose. Which of the following physiological mechanisms BEST explains these symptoms?

Blockade of alpha-1 receptors in nasal blood vessels, causing vasodilation and mucosal swelling. (A) Signup and view all the answers

A researcher is evaluating the effects of a novel alpha-adrenergic antagonist in an experimental model. They observe that the drug effectively reduces blood pressure but also causes a significant increase in plasma renin activity. Which of the following mechanisms BEST explains the observed increase in renin activity?

Decreased renal perfusion pressure stimulating renin release via the baroreceptor mechanism. (D) Signup and view all the answers

Flashcards

Adrenergic receptor blockers

Drugs that block adrenergic receptors, thus inhibiting sympathetic nervous system effects.

Centrally acting sympatholytics

Drugs acting on the central nervous system to reduce sympathetic outflow.