16
35. Propranolol (Inderal) can be useful in the treatment of hypertension
because it blocks
a. Alpha-1 adrenergic receptors
b. Sodium reabsorption in the kidney
c. The release of renin from juxtaglomerular cells
d. The release of norepinephrine from nerve terminals
e. The reflex tachycardia seen with the use of other
antihypertensives
i.
(a) and (b)
ii.
(a) and (d)
iii. (b), (c) and (d)
iv. (c), (d) and (e)
v. (c) and (e) only
(v) Answer is (v)- You should immediately recognize that
propranolol is the prototypic beta-adrenergic receptor blocker,
thus any answer with alternative a (i and ii) is wrong. Similarly, d
is wrong as well-propranolol is a competitive beta- receptor
blocker- it has no effect on NE release. Another drug used for
hypertension, Clonidine, acts via this mechanism by stimulating
alpha-2 autoreceptors. Thus ii, iii, and iv are wrong. This leaves
(v) as the only possible right answer. Indeed, aside from
blocking beta-1 receptors, blocking of renin release is thought to
be the other mechanism whereby beta-blockers alter
hypertension.
36. One of the proposed mechanisms of the antihypertensive effect of
beta-adrenergic receptor blocking agents is
a. Sedation
b. A diuretic effect
c. An antirenin effect
d. A vagal blocking effect
e. An increase in cardiac output
(c)
37. Selective beta-1 adrenergic agonists will produce which of the
following effects?
a. Glycogenolysis
b. Increased cardiac output
c. Decreased diastolic pressure
d. Decreased peripheral resistance
e. Relaxation of bronchial smooth muscle
(b)
Miscellaneous Side Effect Questions
38. Ototoxicity with deafness may encountered occasionally in patients
taking which of the following diuretic agents?
a. Osmotic
b. Thiazide
c. Mercurial
d. High-ceiling
(d) answer is (d)- straight memorization- deafness is typically
associated with use of ethacrynic acid, a loop or high-ceiling
diuretic. How the hell are you supposed to remember all of this
stuff???
39. Symptoms of digitalis toxicity include all of the following EXCEPT
a. Extrasystoles
b. Nausea and vomiting
c. Yellow-green vision
d. A-V conduction block
e. Decreased P-R interval
(e)
40. Administration of which of the following drugs increases the likelihood
of a toxic response to digitalis?
a. Diazepam
b. Lidocaine
c. Spironolactone
d. Chlorothiazide
e. Acetylsalicylic acid
(d) Chlorthiazide is a diuretic which causes potassium loss or
hypokalemia. This results in greater penetration of digitalis into
the myocardium, and thus potential toxicity.
41.
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