Question

Later Monday Afternoon Detective Sam Garrison returned to police headquarters and, after reading the medical examiner’s complete report, began the process of writing his own explanation of what happened to the Underhills. As he wrote, he thought about all that had happened and began to wonder about the physiology associated with the couple’s death. From the lung autopsy analysis, it was clear the Underhills were still breathing and alive when they went under water. This suggests that they became unconscious in the hot tub and subsequently drowned. The level of alcohol found by the medical examiner was high but was not necessarily sufficient to cause their death, but was it a contributing factor? Sam knew that nitroglycerin could cause low blood pressure and that both alcohol and heat would reduce blood pressure, but he was unsure of the mechanism. He also wondered whether the furosemide found on the night table was involved in this hot tub mystery. Question 8 (10 points) If the paramedics had found the Underhills still alive despite their low blood pressure, which of the following medication could have been used to save them and why? Pilocarpine, a muscarinic agonist, which would activate muscarinic receptors on arterioles and therefore dilate arterioles. Epipen, which delivers epinephrine, would stimulate beta-adrenergic receptors on the heart and therefore increase cardiac output. Viagra® (sildenafil citrate), which would increase the local production of nitric oxide and therefore decrease total peripheral resistance. Acebutolol, a beta-blocker, which would antagonize beta-adrenergic receptors on arterioles and therefore constrict arterioles. Hydrochlorothiazide, a diuretic (or “water pill”), which would increase urine output and therefore restore blood volume to normal.

Later Monday Afternoon
Detective Sam Garrison returned to police headquarters and, after reading the medical examiner’s complete report, began the process of writing his own explanation of what happened to the Underhills. As he wrote, he thought about all that had happened and began to wonder about the physiology associated with the couple’s death. From the lung autopsy analysis, it was clear the Underhills were still breathing and alive when they went under water. This suggests that they became unconscious in the hot tub and subsequently drowned. The level of alcohol found by the medical examiner was high but was not necessarily sufficient to cause their death, but was it a contributing factor? Sam knew that nitroglycerin could cause low blood pressure and that both alcohol and heat would reduce blood pressure, but he was unsure of the mechanism. He also wondered whether the furosemide found on the night table was involved in this hot tub mystery.

Question 8 (10 points)
If the paramedics had found the Underhills still alive despite their low blood pressure, which of the following medication could have been used to save them and why?

Pilocarpine, a muscarinic agonist, which would activate muscarinic receptors on arterioles and therefore dilate arterioles.

Epipen, which delivers epinephrine, would stimulate beta-adrenergic receptors on the heart and therefore increase cardiac output.

Viagra® (sildenafil citrate), which would increase the local production of nitric oxide and therefore decrease total peripheral resistance.

Acebutolol, a beta-blocker, which would antagonize beta-adrenergic receptors on arterioles and therefore constrict arterioles.

Hydrochlorothiazide, a diuretic (or “water pill”), which would increase urine output and therefore restore blood volume to normal.

Later Monday Afternoon
Detective Sam Garrison returned to police headquarters and, after reading the medical examiner’s complete report, began the process of writing his own explanation of what happened to the Underhills. As he wrote, he thought about all that had happened and began to wonder about the physiology associated with the couple’s death. From the lung autopsy analysis, it was clear the Underhills were still breathing and alive when they went under water. This suggests that they became unconscious in the hot tub and subsequently drowned. The level of alcohol found by the medical examiner was high but was not necessarily sufficient to cause their death, but was it a contributing factor? Sam knew that nitroglycerin could cause low blood pressure and that both alcohol and heat would reduce blood pressure, but he was unsure of the mechanism. He also wondered whether the furosemide found on the night table was involved in this hot tub mystery.

Question 8 (10 points)
If the paramedics had found the Underhills still alive despite their low blood pressure, which of the following medication could have been used to save them and why?

Pilocarpine, a muscarinic agonist, which would activate muscarinic receptors on arterioles and therefore dilate arterioles.

Epipen, which delivers epinephrine, would stimulate beta-adrenergic receptors on the heart and therefore increase cardiac output.

Viagra® (sildenafil citrate), which would increase the local production of nitric oxide and therefore decrease total peripheral resistance.

Acebutolol, a beta-blocker, which would antagonize beta-adrenergic receptors on arterioles and therefore constrict arterioles.

Hydrochlorothiazide, a diuretic (or “water pill”), which would increase urine output and therefore restore blood volume to normal.

Added by Karen N.

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