Question 1

Variant angina that is caused by coronary artery vasospasm (known also Prinzmetal ischemia)is best treated with:&#10;A)nitrates such as nitroglycerin.&#10;B)beta blockers.&#10;C)calcium channel blockers.&#10;D)alpha-1 agonists.&#10;E)alpha-2 antagonists.

Accepted Answer

Variant angina (Prinzmetal ischemia) is caused by coronary artery vasospasm. Calcium channel blockers are the drug of choice as they relax smooth muscle cells in the coronary arteries and prevent vasospasms. Nitrates such as nitroglycerin can also be used to relieve symptoms, but do not prevent future episodes. Beta blockers may exacerbate vasospasm and are not recommended. Alpha-1 agonists and alpha-2 antagonists are not indicated for the treatment of variant angina.

Question 2

Angina pectoris can be permanently resolved (cured)in most patients after short-term (2-week)use of:&#10;A)organic nitrates such as nitroglycerin.&#10;B)organic nitrates such as isosorbide nitrate.&#10;C)beta blockers.&#10;D)calcium channel blockers.&#10;E)none of the above;antianginal drugs do not cure this disease,they only treat symptoms of myocardial ischemia.

Accepted Answer

Angina pectoris is a chronic condition caused by reduced blood flow to the heart muscle. It cannot be permanently cured by medication, though medications like organic nitrates, beta blockers, and calcium channel blockers can be effective in managing symptoms and improving blood flow to the heart. However, these medications do not permanently resolve the underlying cause of the condition. Long-term changes to diet, exercise, and lifestyle may also help manage symptoms and improve overall heart health.

Question 3

Nitroglycerin patches are typically used intermittently (e.g. ,12 hours on,12 hours off)to prevent:&#10;A)skin irritation from the patch.&#10;B)liver toxicity.&#10;C)kidney damage.&#10;D)pulmonary toxicity.&#10;E)drug tolerance.

Accepted Answer

Nitroglycerin patches can lead to drug tolerance if used continuously without breaks. Intermittent use helps prevent the development of tolerance, allowing the patch to maintain its effectiveness over time.

Question 4

Nitrates such as nitroglycerin exert their primary beneficial effects in patients with angina pectoris because these drugs ______ myocardial oxygen demand by vasodilating the ______.&#10;A)decrease;coronary arteries&#10;B)increase;coronary arteries&#10;C)decrease;peripheral vasculature&#10;D)increase;peripheral vasculature&#10;E)decrease;cerebral vasculature

Accepted Answer

Nitrates like nitroglycerin primarily decrease myocardial oxygen demand by vasodilating the peripheral vasculature, which reduces the workload on the heart.

Question 5

Aspirin and other antiplatelet drugs are often administered to people with angina pectoris to:&#10;A)prevent headache.&#10;B)decrease myocardial oxygen demand.&#10;C)prevent coronary artery infarction.&#10;D)all of the above&#10;E)none of the above;aspirin and antiplatelet drugs are contraindicated in people with angina pectoris.

Accepted Answer

Aspirin and other antiplatelet drugs are used to prevent coronary artery infarction by reducing the risk of blood clots, which can lead to heart attacks.

Question 6

To avoid the first-pass effect,nitroglycerin can be administered:&#10;A)sublingually.&#10;B)buccally.&#10;C)via transdermal patches.&#10;D)all of the above&#10;E)none of the above

Accepted Answer

Nitroglycerin can bypass the first-pass effect by being administered sublingually, buccally, or via transdermal patches. Sublingual and buccal administration allows the drug to enter the systemic circulation directly through the oral mucosa, while transdermal patches deliver the drug through the skin and into the bloodstream. This bypasses the liver and allows for more of the drug to reach its intended target, resulting in a more potent and effective response. Therefore, all three options are viable choices to avoid the first-pass effect.

Question 7

Beta blockers help prevent angina pectoris in certain patients because these drugs:&#10;A)decrease myocardial oxygen demand.&#10;B)increase myocardial oxygen supply.&#10;C)decrease oxygen demand in peripheral tissues (skeletal muscle).&#10;D)increase cardiac output.&#10;E)decrease blood flow to the heart.

Accepted Answer

Beta blockers decrease the workload on the heart by reducing heart rate and contractility, which in turn decreases myocardial oxygen demand. This reduction in oxygen demand can help prevent angina pectoris in certain patients.

Deck 22: Treatment of Angina Pectoris