Vasopressors & Inotropes Practice Test

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• Which statement about norepinephrine and the pulmonary vasculature is true?
• Digoxin’s inotropic effect results from inhibition of Na+/K+ ATPase.
• Which statement best describes the beta-2 receptor involvement differentiating epinephrine from norepinephrine?
• Which of the following is an advantage of isoproterenol when given by nebulized administration?
• Where is glucagon produced, and what is its intracellular effect?
• Indirect MOA of ephedrine interacts with which receptors?
• What is the active form of thyroid hormone?
• Which receptor mediates the vasoconstrictive effect of vasopressin on vascular smooth muscle?
• What is the typical duration of action for phenylephrine?
• Which statement is true about elemental calcium per dose?
• Angiotensin II causes vasoconstriction by activating which intracellular signaling pathway in vascular smooth muscle?
• Glucagon can increase heart rate even when a patient is on beta-blockers.
• Citrate used in blood products reduces ionized calcium.
• What is the B2 effect of ephedrine?
• Epinephrine given in the presence of volatile anesthetics can predispose to which dangerous cardiac event?
• Which hemodynamic consequence is associated with phenylephrine due to its pure alpha-1 vasoconstriction?
• How is dobutamine metabolized?
• What is the expected hemodynamic effect of isoproterenol administration?
• Phenylephrine can be useful in which situation due to its reflex bradycardic effect?
• Milrinone causes systemic and pulmonary vasodilation by which action?
• Which of the following are the main disadvantages of norepinephrine?
• Which receptor primarily mediates dobutamine's inotropic effect?
• Angiotensin II has what effect on norepinephrine release from presynaptic neurons?
• What is the primary mechanism of action of ephedrine?
• Which receptors are activated by dopamine at high doses (>10 mcg/kg/min)?
• Which receptor mediates norepinephrine's vascular effects?
• Which two drugs should not be given with ephedrine, and why?
• Norepinephrine acting on post-synaptic alpha-1 receptors signals through which pathway to cause vasoconstriction?
• During low systemic vascular resistance, phenylephrine increases perfusion pressure to which organ systems?
• In a digoxin-treated heart, increased extracellular calcium will lead to what?
• What is the effect of norepinephrine on peripheral vascular resistance (PVR)?
• Vasopressin can cause uterine smooth muscle contractions by binding weakly to which receptors?
• Which statement best contrasts dobutamine and dopamine regarding their hemodynamic effects?
• At low-dose dopamine, which receptor type is primarily activated?
• What is the infusion dose range for epinephrine?
• Dobutamine primarily activates which receptor?
• At moderate-dose epinephrine infusion (0.03-0.15 mcg/kg/min), which receptors are activated and how does SVR typically change?
• What percentage of patients show digoxin toxicity at some point?
• Phenylephrine can be used as a temporary measure for hypovolemia until volume replacement can be given.
• Milrinone is a non-catecholamine.
• Which statement best describes the effects of the negative enantiomer of dobutamine?
• Does ephedrine cross the blood-brain barrier?
• What is a typical intravenous bolus dose of epinephrine?
• What is the function of phosphodiesterases?
• What is a common disadvantage of dobutamine therapy?
• Which vasopressor is preferred for a pregnant patient with hypotension during spinal or epidural anesthesia?
• What is the first-line drug for anaphylaxis and why?
• Vasopressin may contribute to lactic acidosis by causing which of the following?
• Norepinephrine is released from which sites?
• Which receptor mediates vasodilation in the pulmonary vasculature at low epinephrine concentrations?
• Under which condition might hypotension occur with dobutamine therapy?
• Beta-2 receptor stimulation results in which effects?
• Active metabolite with alpha-1 antagonism and vasodilation arises from which enantiomer?
• Dobutamine is best described as which category of drug?
• What is the B1 effect of ephedrine?
• What is the receptor effect pattern of epinephrine?
• Moderate-dose dopamine (3-10 mcg/kg/min) activation involves which receptors and effects?
• Where is dopamine primarily found in the body?
• What is the net effect when both calcium rise and potassium disturbances are present?
• Which form of calcium is physiologically active?
• What are the effects of thyroid hormone T3 on the heart, and what is notable about its mechanism?
• During dopamine therapy, the low-dose range (dopaminergic activity) is which of the following?
• Dopamine is metabolized by which pathways?
• Which of the following can decrease ionized calcium concentration?
• Milrinone's effects on cardiac electrical activity include which of the following?
• In what situations would you administer calcium? (three main indications)
• Which of the following is NOT a primary mechanism by which isoproterenol increases cardiac output?
• At low-dose epinephrine infusion (0.01-0.03 mcg/kg/min), which receptors are activated and what is the net effect on heart rate, contractility, SVR, and blood pressure?
• Vasopressin's V2 receptor in the kidney mediates water reabsorption.
• Common adverse effects of isoproterenol include tachycardia with potential proarrhythmia and reduced diastolic filling time.
• Which vasopressor is more likely to cause tachycardia due to beta-adrenergic activity?
• Isoproterenol MOA involves which receptor activity?
• Phenylephrine is indicated for which condition to support blood pressure in patients with hypotension and low SVR?
• B1 receptor activation on the heart produces which effect?
• What is the net vascular effect of dobutamine due to its receptor activity?
• Metabolism of ephedrine by MAO or COMT?
• If norepinephrine extravasates, what tissue injury may occur and what is the recommended treatment?
• Which receptor mediates vasoconstriction in vascular smooth muscle when activated by a vasopressor?
• Epinephrine has positive lusitropy.
• Milrinone lowers LV filling pressures due to which effect?
• Epinephrine activating beta-2 receptors on post-synaptic vascular smooth muscle produces what effect?
• Which statement is NOT an effect of milrinone?
• Isoproterenol increases heart rate primarily through activation of which receptor?
• Ephedrine's effect on myocardial oxygen consumption (MVO2)?
• Which best describes the mechanism by which digoxin increases cardiac contractility?
• Which drug is considered an 'ino-dilator'?
• A hematologic adverse effect of vasopressin is thrombocytopenia due to what mechanism?
• Does epinephrine commonly cause tachyphylaxis?
• In which patients is vasopressin most likely to be used?
• Beta-2 receptor activation leads to which combination of effects?
• What is the primary physiologic postganglionic sympathetic neurotransmitter?
• Norepinephrine does not significantly activate which receptor subtype?
• Isoproterenol has what effect on systemic vascular resistance (SVR)?
• Beta-1 receptor stimulation results in which cardiovascular changes?
• Dobutamine's effect on LVEDP and LVEDV is best described as which?
• Which description best characterizes malignant hypertension due to ephedrine?
• Which statement reflects the effect of increased intracellular calcium on cardiac contractility?
• Norepinephrine primarily acts on which receptor subtypes?
• Glucagon's effect on cardiac performance includes which of the following?
• Can epinephrine be administered via the endotracheal tube?
• Most calcium is metabolized.
• Isoproterenol tends to decrease mean arterial pressure (MAP) due to what effect?
• In the lungs, epinephrine has what effect?
• In cardiac myocytes, milrinone increases contractility by what mechanism?
• Epinephrine acts on which receptor subtypes?
• What is the typical IV bolus dose of ephedrine?
• At high-dose epinephrine infusion (>0.15 mcg/kg/min), what are the predominant receptor effects and the hemodynamic consequence?
• Milrinone produces pulmonary vasodilation, thereby decreasing pulmonary vascular resistance (PVR).
• Which mediator decreases norepinephrine release from presynaptic sympathetic neurons?
• Direct MOA receptors ephedrine interacts with?
• Which statement describes a disadvantage of ephedrine?
• Which statement explains why epinephrine can cause pulmonary vasoconstriction at moderate to high doses?
• What is a typical norepinephrine infusion rate?
• According to the CRAP mnemonic for dobutamine, which letter indicates no change in beta-2 activity?
• At high doses (>10 mcg/kg/min), what are the hemodynamic effects of dopamine?
• In norepinephrine indications, which scenario best describes its use?
• The effect of phenylephrine on myocardial oxygen consumption is best described as which of the following when hypertension is avoided?
• What is the IV bolus dose range for phenylephrine?
• What are the signs commonly associated with hypocalcemia?
• What is the effect of beta-1 receptor activation on the heart?
• Which statement about hypokalemia's effect on repolarization is true?
• Vasopressin has actions on beta-adrenergic receptors.
• Calcium is considered cardioprotective in hyperkalemia.
• Milrinone enhances SERCA activity in cardiac myocytes, leading to improved relaxation.
• What does calcium do to digoxin?
• Which volatile anesthetic is most likely to sensitize the heart to epinephrine?
• What is the approximate half-life of digoxin?
• Which statement explains why diastolic blood pressure is lower with epinephrine compared to norepinephrine?
• Which statement describes a disadvantage of dopamine therapy?
• Phenylephrine exerts its vasoconstrictive effect primarily by activating which receptor?
• Which statement describes Angiotensin II's effect on norepinephrine release?
• Which statement best describes the effects of the positive enantiomer of dobutamine?
• What is the IV bolus dose of vasopressin?
• The net effect of vasopressin on cerebral blood flow depends on cerebral autoregulation status.
• Which vasopressor has no beta-adrenergic activity and increases systemic vascular resistance without vasodilation?
• Vasopressin can decrease splanchnic perfusion mainly through vasoconstriction in which vascular beds?
• How is phenylephrine metabolized?
• Direct vasopressin-induced cerebral vasoconstriction tends to decrease cerebral blood flow.
• Phenylephrine-induced vasoconstriction mainly occurs in which vascular beds?
• Milrinone MOA involves which mechanism?
• In which congenital heart disease can phenylephrine decrease hypoxia by reducing right-to-left shunting?
• Which statement best describes norepinephrine's effect on afterload and myocardial oxygen demand?
• How does alkalosis affect ionized calcium?
• What is the mechanism of action of T3 in the heart regarding adrenergic signaling and cAMP?
• Renal-dose dopamine is associated with which clinical outcome?
• Which vascular effect may occur with phenylephrine?
• In patients with coronary artery disease, epinephrine can contribute to myocardial ischemia by doing what?
• What percentage of ephedrine's mechanism is indirect?
• Strong alpha effects produce what clinical consequence?
• Which statement about phenylephrine's effect on heart rate is most accurate?
• Vasopressin can cause bronchoconstriction through stimulation of which receptors on bronchial smooth muscle?
• Activation of which receptor is primarily responsible for vasoconstriction in vascular smooth muscle?
• In hypotension, phenylephrine increases coronary perfusion pressure without altering which parameter?
• Citrate binds ionized calcium, resulting in decreased ionized calcium.
• What is the primary action of phosphodiesterase inhibitors in the heart and vasculature?
• Between epinephrine and ephedrine, which has greater bronchodilating effects due to beta-2 activation?
• Where is epinephrine produced in the body?
• What is the duration of action of an ephedrine IV bolus?
• Does vasopressin significantly increase intracranial pressure?
• In patients receiving beta-blocker therapy, dobutamine is likely to produce which hemodynamic change?
• Dobutamine decreases LVEDP; this contributes to which change in coronary perfusion pressure (CPP)?
• What is the primary effect of alpha-1 agonism?
• What is the direct effect of vasopressin on cerebral vasculature?
• Which statement about norepinephrine's effects on heart rate and blood pressure is true?
• What is the net effect of epinephrine on plasma potassium?
• What is the net effect of epinephrine on myocardial oxygen demand and supply?
• What is the primary presynaptic effect of alpha-2 agonism?
• Norepinephrine receptors activated include which subtypes?
• Dopamine exerts its effects through which mechanisms?
• Which is an advantage of using vasopressin?
• Dobutamine's effect on pulmonary vascular resistance (PVR) is which of the following?
• Dobutamine is best described as which of the following?
• What is the effect of calcium on the cardiac impact of hypokalemia?
• Epinephrine is primarily metabolized by which enzymes?
• Epinephrine's mechanism of action is which?
• Digoxin inhibits which membrane protein on cardiac myocytes?