Question 1

Which of the following nitrate formulations is not used to prevent angina symptoms?&#10;A) Oral isosorbide dinitrate controlled-release tablets&#10;B) Oral isosorbide mononitrate controlled-release tablets&#10;C) Transdermal glyceryl trinitrate&#10;D) Sublingual isosorbide dinitrate

Accepted Answer

Sublingual isosorbide dinitrate is used to treat angina symptoms, not prevent them. The other options listed are used to prevent or reduce the frequency of angina symptoms.

Question 2

The cardiac glycoside digoxin is also known as:&#10;A) digitalis.&#10;B) ACE.&#10;C) carvedilol.&#10;D) captopril.

Accepted Answer

Digoxin is a type of cardiac glycoside that is derived from the digitalis plant. Therefore, it is also commonly known as digitalis. Choices B, C, and D are all medications for heart failure, but they do not belong to the same drug class as digoxin.

Question 3

In the treatment of erectile dysfunction,phosphodiesterase inhibitors:&#10;A) act to trigger the release of nitric oxide.&#10;B) are used when the cause is psychological.&#10;C) may interact negatively with organic nitrate therapy.&#10;D) must be administered directly into the penis.

Accepted Answer

Phosphodiesterase inhibitors such as sildenafil, tadalafil, and vardenafil work by inhibiting an enzyme called phosphodiesterase type 5, which increases the levels of cyclic guanosine monophosphate (cGMP) in the body. This leads to relaxation of smooth muscle in the penis, allowing increased blood flow and hence an erection. However, these drugs may interact negatively with organic nitrate therapy, which is used for angina and other cardiovascular conditions. Therefore, caution must be exercised when prescribing phosphodiesterase inhibitors to patients taking organic nitrates. Choices A and B are incorrect, as the drugs do not trigger the release of nitric oxide and are not specifically used for psychological causes of erectile dysfunction. Choice D is also incorrect, as phosphodiesterase inhibitors are taken orally, not administered directly into the penis.

Question 4

To avoid tolerance associated with continuous use of nitrate patches,the patient should be advised to:&#10;A) only apply the patches in the morning and evening.&#10;B) only apply the patches when the angina symptoms become apparent.&#10;C) have a nitrate-free period from the patches for about 12 hours each day.&#10;D) only apply the patches at bedtime.

Accepted Answer

This option suggests a nitrate-free period of about 12 hours each day, which can help prevent tolerance associated with continuous use of nitrate patches. This will allow the body to reset and reduce the risk of developing tolerance to the medication. Applying the patches only in the morning and evening (A) or only at bedtime (D) does not provide a long enough nitrate-free period to prevent tolerance. Applying the patches only when symptoms become apparent (B) may lead to inadequate symptom control and is not a recommended dosing strategy.

Question 5

Nimodipine is a calcium channel blocker that:&#10;A) is used widely in the management of angina.&#10;B) is relatively selective for cerebral blood vessels.&#10;C) increases cardiac workload.&#10;D) is most beneficial when it is administered prophylactically.

Accepted Answer

Nimodipine is relatively selective for cerebral blood vessels, meaning it primarily affects blood vessels in the brain. It is used to prevent and treat vasospasm after subarachnoid hemorrhage. It is not commonly used for angina or to increase cardiac workload. It is most beneficial when administered prophylactically to prevent vasospasm.

Question 6

The form of angina pectoris that is associated with coronary vasospasm is called ________ angina.&#10;A) variant&#10;B) exertional&#10;C) classic&#10;D) stable

Accepted Answer

Variant (also known as Prinzmetal's) angina is caused by coronary artery spasm, which can occur at rest and is not necessarily triggered by physical activity or emotional stress. Exertional angina (B) is caused by an imbalance between myocardial oxygen demand and supply during physical exertion. Classic (C) angina and stable (D) angina are synonyms for typical exertional angina.

Question 7

Which two factors can be the root cause of angina pectoris?&#10;A)Vasospasm and atherosclerotic plaque&#10;B)Vasodilation and atherosclerotic plaque&#10;C)Vasospasm and hypolipidaemia&#10;D)Vasodilation and hypolipidaemia

Accepted Answer

Angina pectoris is typically caused by reduced blood flow to the heart muscle due to atherosclerotic plaque buildup in the coronary arteries. In some cases, vasospasm can also contribute to angina by constricting the coronary arteries and further reducing blood flow. Therefore, both vasospasm and atherosclerotic plaque can be the root cause of angina pectoris. Vasodilation and hypolipidaemia are generally not associated with angina as they do not cause significant narrowing or obstruction of the coronary arteries.

Deck 46: Medicines Used to Promote Tissue Perfusion