PART VII Drugs for Angina Pectoris treatment
01. Angina pectoris is:
a) Severe constricting chest pain, often radiating from the precordium to the left shoulder and down the arm, due to insufficient blood supply to the heart that is usually caused by coronary disease
b) An often fatal form of arrhythmia characterized by rapid, irregular fibrillar twitching of the ventricles of the heart instead of normal contractions, resulting in a loss of pulse
c) The cardiovascular condition in which the heart ability to pump blood weakens
d) All of the above
02. All these drug groups useful in angina both decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm), EXCEPT:
a) Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)
b) Calcium channel blockers (Nifedipine, Nimodipine)
c) Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol)
d) Potassium channel openers (Minoxidil)
03. This drug group useful in angina decreases myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and does not increase myocardial oxygen delivery (by reversing coronary arterial spasm):
a) Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)
b) Myotropic coronary dilators (Dipyridamole)
c) Potassium channel openers (Minoxidil)
d) Beta-adrenoceptor-blocking drugs (Atenolol, Mtoprolol)
04. This drug group useful in angina increase myocardial oxygen delivery (by reversing coronary arterial spasm) and does not decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand):
a) Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol):
b) Myotropic coronary dilators (Dipyridamole)
c) Calcium channel blockers (Nifedipine, Nimodipine)
d) Potassium channel openers (Minoxidil)
05. Which of the following statements concerning nitrate mechanism of action is True?
a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to vascular smooth muscle target tissues
b) Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly through this mechanism
c) Nitrates useful in angina decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)
d) All of the above
06. Which of the following nitrates and nitrite drugs are long-acting?
a) Nitroglycerin, sublingual
b) Isosorbide dinitrate, sublingual (Isordil, Sorbitrate)
c) Amyl nitrite, inhalant (Aspirols, Vaporole)
d) Sustac
07. Which of the following nitrates and nitrite drugs is a short-acting drug?
a) Nitroglycerin, 2% ointment (Nitrol)
b) Nitroglycerin, oral sustained-release (Nitrong)
c) Amyl nitrite, inhalant (Aspirols, Vaporole)
d) Sustac
08. Which of the following nitrates and nitrite drugs is used for prevention of angina attack?
a) Nitroglycerin, 2% ointment (Nitrol)
b) Nitroglycerin, oral sustained-release (Nitrong)
c) Isosorbide mononitrate (Ismo)
d) All of the above
09. Duration of nitroglycerin action (sublingual) is:
a) 10-30 minutes
b) 6-8 hours
c) 3-5 minutes
d) 1.5-2 hours
10. The following statements concerning mechanism of nitrate beneficial clinical effect are true, EXCEPT?
a) Decreased myocardial oxygen requirement
b) Relief of coronary artery spasm
c) Improved perfusion to ischemic myocardium
d) Increased myocardial oxygen consumption
11. Side effect of nitrates and nitrite drugs are, EXCEPT:
a) Orthostatic hypotension, tachycardia
b) GI disturbance
c) Throbbing headache
d) Tolerance
12. The following statements concerning mechanism of calcium channel blockers’ action are true, EXCEPT:
a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in vascular smooth muscle target tissues
b) Calcium channel blockers bind to L-type calcium channel sites
c) Calcium channel blockers useful in angina decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)
d) Calcium channel blockers decrease transmembrane calcium current associated in smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
13. Which of the following antianginal agents is a calcium channel blocker?
a) Nitroglycerin
b) Dipyridamole
c) Minoxidil
d) Nifedipine
14. Which of the following cardiovascular system effects refers to a calcium channel blocker?
a) The reduction of peripheral vascular resistance
b) The reduction of cardiac contractility and, in some cases, cardiac output
c) Relief of coronary artery spasm
d) All of the above
15. Main clinical use of calcium channel blockers is:
a) Angina pectoris
b) Hypertension
c) Supraventricular tachyarrhythmias
d) All of the above
16. Which of the following antianginal agents is a myotropic coronary dilator:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
17. Which of the following antianginal agents is a beta-adrenoceptor-blocking drug:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
18. The following agents are cardioselective beta1-adrenoceptor-blocking drugs labeled for use in angina, EXCEPT:
a) Metoprolol
b) Talinolol
c) Atenolol
d) Propranolol
19. Which of the following statements concerning beta-adrenoceptor-blocking drugs are true:
a) These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
b) These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
c) Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise
d) These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential
20. Which of the following antianginal agents refers to reflex coronary dilators:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
21. Which of the following statements concerning Validol is true:
a) Validol has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
b) At sublingual administration the effect is produced in five minutes and 70 % of the preparation is released in 3 minutes
c) It is used in cases of angina pectoris, motion sickness, nausea, vomiting when seasick or airsick and headaches due to taking nitrates
d) All of the above
22. Which of the following antianginal agents is the specific bradycardic drug:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
23. Following statements concerning specific bradycardic agents (Falipamil, Alinidine) are true, EXCEPT:
a) Bradycardic drugs have a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
b) The predominant effect of bradycardic drugs is a decrease in heart rate without significant changes in arterial pressure
c) The protective effect of bradycardic drugs is likely due to a reduced O2 demand
d) Specific bradycardic agents are used in the management of a wide range of cardiovascular disorders, including sinus tachyarrhythmias and angina pectoris
24. Which of the following statements concerning Dipyridamole is true?
a) Dipyridamole is an agent that blocks the reabsorption and breakdown of adenosine that results in an increase of endogenous adenosine and vasodilatation
b) The drug causes relative hypoperfusion of myocardial regions served by coronary arteries with haemodynamically significant stenoses
c) Dipyridamole is a platelet aggregation inhibitor
d) All of the above
25. Which of the following antianginal agents is a potassium channel opener:
a) Dipyridamole
b) Validol
c) Atenolol
d) Minoxidil
26. Which of the following statements concerning potassium channel openers is true?
a) These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
b) These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
c) Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise
d) These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential
