Question 1

Compare the routes of administration of the nitrates and determine the most common route of administration during attacks of angina.

Accepted Answer

The most common route of administration of the nitrates is sublingual.

Question 2

Use the adverse-effect profile of the nitrates to determine which of the following is not an adverse effect of this drug class.

Accepted Answer

The main adverse effects of the nitrates are related to the vasodilating action. Cutaneous flushing, dizziness, headache, weakness, and fainting are commonly experienced.

Question 3

Distinguish between the adverse effects of the beta-adrenergic blockers and those of the calcium channel blockers,and select the statement that does not correspond with an adverse effect that would result from an overdosage of the calcium channel blocker verapamil.

Accepted Answer

Overdosage of verapamil and diltiazem can cause bradycardia, AV block, and decreased myocardial contraction that can lead to heart failure.

Question 4

Differentiate between the classes of drugs available to treat angina,and select the drug that can be used in combination with the nitrates for patients who require more than one drug to control angina.

Accepted Answer

Beta-adrenergic blockers can be used in combination with nitrates in patients who require more than one drug to control angina.

Question 5

Alice is experiencing periods of angina,and she places a sublingual nitroglycerin tablet under her tongue as directed by her physician.After 5 minutes have passed,she is not feeling any relief.What step should be implemented next?

Accepted Answer

After administration of sublingual nitroglycerin, relief should occur within 5 minutes. If it does not, the patient should repeat the process with another tablet. If there is no relief after three tablets, the patient should notify the physician or seek medical assistance.

Question 6

The type of angina that is characterized by vasospasm is classified as:

Accepted Answer

Vasospasm is the major feature of variant or Prinzmetal angina.

Question 7

Identify the term used for the reduction in blood flow caused by atherosclerosis.

Accepted Answer

The reduction in coronary blood flow caused by atherosclerosis is referred to as ischemia.

Question 8

Select the mechanism of action of the calcium channel blockers in the treatment of angina and CAD.

Accepted Answer

The most important action of calcium channel blockers in the treatment of angina and CAD is to block the influx of calcium ions into vascular smooth muscle.

Question 9

Differentiate between onset of action and duration of action,and select the correct duration of action of nitroglycerin ointment.

Accepted Answer

Absorption of nitroglycerin ointment occurs through the skin, with an onset of action of 30 minutes and a duration of 4 to 8 hours, depending on the amount applied.

Question 10

Identify the term used to describe the fatty degeneration of the coronary arteries.

Accepted Answer

Atherosclerosis is the term used to describe the fatty degeneration of the coronary arteries.

Question 11

Samuel has been prescribed sublingual nitroglycerin for angina pain.You use the Physicians' Desk Reference and determine that the correct length of time that Samuel can expect to wait for the nitroglycerin's actions to take effect will be:

Accepted Answer

The effects of sublingual administration usually occur within 1 to 3 minutes, with the peak effect occurring at about 5 minutes.

Question 12

Distinguish between the available dosage forms and strengths of nitrogylcerin,and select the available strengths of the sublingual nitroglycerin tablet Nitrostat.

Accepted Answer

Nitroglycerin (Nitrostat) is available in 0.3-, 0.4-, and 0.6-mg sublingual tablets.

Question 13

Using the available treatment options for Prinzmetal angina,determine the preferred drug class for the treatment of variant or Prinzmetal angina.

Accepted Answer

The calcium channel blockers are primarily taken on a daily basis to prevent angina and are also the preferred drugs for treatment of variant or Prinzmetal angina.

Question 14

Describe the goal of the treatment of coronary artery disease.

Accepted Answer

The treatment of CAD is aimed at reducing the number and severity of anginal attacks, limiting progression of atherosclerosis, and preventing the occurrence of myocardial infarction and possible death.

Question 15

Use critical thinking to determine the correct nitrate drug that is used prophylactically to prevent the occurrence of anginal attacks.

Accepted Answer

The extended-release capsules are used daily to prevent the occurrence of anginal attacks (prophylaxis).

Question 16

Differentiate between the pharmacologic and nonpharmacologic treatments for angina,and select the nonpharmacologic treatment that the patient should consider to prevent the progression of angina attacks.

Accepted Answer

Important nondrug components to the treatment of CAD include diets that limit fat and cholesterol, exercise, elimination of smoking, and weight control.

Question 17

Describe the type of information that should be given to a newly diagnosed angina patient about nitroglycerin.

Accepted Answer

Since anginal attacks are unpredictable, it is important for patients to carry the prescribed medication at all times. Nitroglycerin is volatile, and tablets lose potency if exposed to air or light. Therefore, it is important that tablets be carried in light-resistant, airtight containers. Also, standard practice is not to use nitroglycerin tablets that are more than 6 months old since there may be significant loss of potency.

Question 18

Jason has been diagnosed by his physician with CAD and angina.He has been prescribed nitroglycerin for the angina.Select the drug that the physician can prescribe to treat Jason's CAD?

Accepted Answer

Beta-adrenergic blockers can be used in combination with nitrates in patients who require more than one drug to control angina. Propranolol, nadolol, metoprolol, and atenolol are usually the preferred beta blockers for the treatment of angina and CAD.

Question 19

Using the adverse-effects profile of the calcium channel blockers,determine the most common adverse effect associated with the use of the calcium antagonist agents.

Accepted Answer

Common adverse effects of the calcium antagonists include headache, facial flushing, dizziness, hypotension, and minor gastrointestinal (GI) disturbances.

Question 20

Differentiate between the commercially available nitrate products,and determine the nitrate drug most commonly used to treat angina and coronary artery disease.

Accepted Answer

Nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate are the three available nitrate drugs used to treat angina and CAD.

Quiz 24: Antianginal Drugs