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Epinephrine Pharmacology and Clinical Applications
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Epinephrine Pharmacology and Clinical Applications
Epinephrine Pharmacology and Clinical Applications
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1
Question
A 25-year-old patient presents to the emergency department with severe anaphylactic shock after a peanut allergy exposure. Which preparation and route of epinephrine is most appropriate?
Page 1
Answer
SC or IM 1:1,000 solution
2
Question
A 60-year-old man collapses with cardiac arrest. The resuscitation team prepares epinephrine. Which concentration and route is correct?
Page 1
Answer
IV 1:10,000
3
Question
A patient with asthma is prescribed epinephrine inhalation therapy. Which concentration is used?
Page 1
Answer
1:100
4
Question
Why is epinephrine ineffective when given orally?
Page 1
Answer
Rapid inactivation by intestinal enzymes (MAO & COMT)
5
Question
Epinephrine has a rapid onset but short duration of action. What explains this pharmacokinetic property?
Page 2
Answer
Rapid degradation by MAO & COMT enzymes
6
Question
A 30-year-old patient is given epinephrine during resuscitation. Shortly after, his ECG shows ventricular arrhythmias. Which receptor stimulation explains this adverse effect?
Page 2
Answer
β1 receptor stimulation
7
Question
A patient receives epinephrine for hypotension. Which vascular beds will show the strongest vasoconstriction?
Page 3
Answer
Skin, mucosa, splanchnic, and renal arterioles
8
Question
A hypertensive effect of epinephrine is mainly due to?
Page 3
Answer
α1 and β1 receptor stimulation
9
Question
Why does epinephrine not cause reflex bradycardia despite raising blood pressure?
Page 3
Answer
Its β1 chronotropic effect antagonizes reflex bradycardia
10
Question
A patient with asthma receives epinephrine. Which receptor action contributes to bronchodilation and vasodilation in skeletal muscle?
Page 3
Answer
β2 receptor stimulation
11
Question
A 55-year-old hypertensive patient is treated with phenoxybenzamine (an α-blocker). Later, he receives epinephrine for hypotension. Instead of raising blood pressure, his BP falls. What phenomenon explains this?
Page 4
Answer
Epinephrine reversal
12
Question
In epinephrine reversal, which receptor action becomes dominant after α-blockade?
Page 4
Answer
β2 vasodilation
13
Question
A patient on α-blocker therapy receives epinephrine. Which vascular effect is expected?
Page 5
Answer
Vasodilation in skeletal muscle and coronary vessels
14
Question
Why does epinephrine normally cause hypertension at therapeutic doses?
Page 5
Answer
Dominant α1 and β1 stimulation
15
Question
Which clinical situation best illustrates epinephrine reversal?
Page 5
Answer
Epinephrine given after α-blocker therapy → hypotension
16
Question
A 22-year-old asthmatic presents with acute bronchospasm. Which adrenergic receptor activation provides therapeutic bronchodilation?
Page 6
Answer
β2
17
Question
A patient with nasal congestion is prescribed a decongestant spray. Which receptor action explains relief of congestion?
Page 6
Answer
α1 vasoconstriction of mucosal vessels
18
Question
An ophthalmologist prescribes an adrenergic agonist for mydriasis during eye examination. Which receptor is responsible?
Page 6
Answer
α1 contraction of dilator pupillae
19
Question
A patient with glaucoma is treated with an adrenergic agonist. Which mechanism lowers intraocular pressure?
Page 7
Answer
Decreased aqueous humor formation
20
Question
A patient with irritable bowel syndrome is given a drug that relaxes the GIT wall. Which receptor contributes to this effect?
Page 7
Answer
β2 receptors in GIT wall
21
Question
A pregnant woman in her last trimester is prescribed a β2 agonist. What is the expected effect?
Page 7
Answer
Decreased uterine tone and contractions
22
Question
A diabetic patient experiences hypoglycemia. Epinephrine is released and raises blood glucose. Which receptor action explains this?
Page 8
Answer
β2 stimulation of hepatic glycogenolysis
23
Question
A patient on clonidine therapy shows reduced insulin release. Which receptor is responsible for this effect?
Page 8
Answer
α2 receptor stimulation
24
Question
A patient with obesity is prescribed a drug that enhances lipolysis. Which receptor actions contribute to this effect?
Page 9
Answer
β1 and β3 stimulation
25
Question
A patient receiving β2 agonist therapy develops hypokalemia. Which mechanism explains this?
Page 9
Answer
Hepatic uptake of K+ stimulated by β2 receptors
26
Question
A young man taking salbutamol for asthma complains of hand tremors. Which receptor action explains this side effect?
Page 9
Answer
β2 stimulation in skeletal muscle
27
Question
A 28-year-old man develops severe anaphylactic shock after a bee sting. He is hypotensive and wheezing. Which drug and route is lifesaving?
Page 10
Answer
Epinephrine SC/IM 1:1,000
28
Question
A patient with asthma has worsening bronchospasm after overuse of a β2-agonist inhaler. Epinephrine is prescribed. Which dual receptor action explains its benefit?
Page 10
Answer
α1 vasoconstriction (mucosal decongestant) + β2 bronchodilation
29
Question
A 65-year-old man collapses with cardiac arrest. Which preparation of epinephrine is indicated?
Page 10
Answer
IV 1:10,000
30
Question
A patient with epistaxis (nosebleed) is treated with topical epinephrine. What is the mechanism?
Page 11
Answer
α1 vasoconstriction → hemostasis