Deck 25: Cardiovascular Drugs

Question 1

Dianna Whitfield, a 37-year-old African-American, has been diagnosed with hypertension. Her physician discusses various options for pharmacologic treatment. What antihypertensives are known to be less effective in African-Americans than in other groups

A) Beta-adrenergic blockers
B) Antiadrenergics
C) ACE inhibitors
D) Peripheral vasodilators

Answer 1

Beta-blockers are a class of drugs that prevent the action of adrenergic receptors, which increase the cardiac action. It is primarily used control heart rhythm and reduces high blood pressure. As they have various functions
Hence, the option (a) is incorrect.
Antiadrenergic agents inhibit the stimulation of central nervous system and decrease sympathetic stimulation to the vessels. It does not act on all people.
Hence, the option (b) is incorrect.
Peripheral vasodilators are agents that act on most of the distal parts of the vascular system like venules and arterioles.
Hence, the option (d) is incorrect.
An angiotensin-converting-enzyme inhibitor (ACE inhibitor) is a class of drug that is used to treat hypertension and congestive heart failure. They decrease blood volume by relaxing the blood vessels.
Hence, the option (c) ACE inhibitors is correct.

Question 2

Which drug is least effective in reducing the mortality associated with heart failure a. Metoprolol
B) Atenolol
C) Bisoprolol
D) Carvedilol

Answer 2

Metoprolol, carvedilol and bisoprolol are beta-adrenergic blockers. These are given to the patients as a first line treatment for angina, post-myocardial infarction, heart failure, ischemic heart disease, and certain arrhythmias.
These drugs are most effective in reducing mortality when they are used in patient with heart failure.
Hence, the options (a), (c) and (d) are incorrect.
Atenolol is also a beta-adrenergic blocker but it has no effect in reducing mortality and cardiovascular events. Recent studies have shown that atenolol may in deed, increase mortality in some people. Moreover, it is shown that beta-clockers have no role or very little role in reducing hypertension.
Hence, the option (b) Atenolol is correct.

Question 3

Isaac Doniego, a 77-year-old widower with heart failure, has been treated successfully with a combination of ACE inhibitors and diuretics. However, his symptoms worsen and became life threatening despite pharmacologic treatment, so he is hospitalized for evaluation and stabilization on a cardiac glycoside. Isaac should be advised to avoid certain medications because they can potentiate digoxin toxicity. Which of the following are in this category

A) Cholestyramine, neomycin, and rifampin
B) Diuretics, calcium, and corticosteroids
C) Macrolides and antiarrhythmics
D) Adrenergics

Answer 3

Digoxin toxicity is a life-threatening condition that produces visual, gastrointestinal, central nervous system, and cardiac manifestations. The most common symptoms include Vomiting, Nausea, and drowsiness.
The drugs, cholestyramine, neomycine, and rifampin reduce absorption of digoxin. Diuretics are used to trigger production of urine by promoting calcium and corticosteroids. Adrenergic drugs are the medicines that stimulate sympathetic nervous system but not central nervous system. These drug do not interact with digoxin.
Hence, the options (a), (b), and (d) are incorrect.
Macrolides and antiarrhythmics are the only drugs that potentiate the action of digoxin toxicity.
Hence, the option (c) Macrolides and antiarrhythmics is correct.

Question 4

What is one purpose of International Normalized Ratio (INR) monitoring a. To monitor warfarin therapy
B) To monitor kidney function for persons on antilipemics
C) To determine the need for pharmacologic treatment of angina
D) To determine the effectiveness of antihypertensives

Question 5

Dianna Whitfield, a 37-year-old African-American, has been diagnosed with hypertension. Her physician discusses various options for pharmacologic treatment. Dianna also has lupus. What class of antihypertensive should be avoided

A) Beta-adrenergic blockers
B) Antiadrenergics
C) ACE inhibitors
D) Thiazides

Question 6

How are low-molecular-weight heparins usually administered a. Orally
B) Sublingually
C) Subcutaneously
D) As a skin patch

Question 7

Isaac Doniego, a 77-year-old widower with heart failure, has been treated successfully with a combination of ACE inhibitors and diuretics. However, his symptoms worsen and became life threatening despite pharmacologic treatment, so he is hospitalized for evaluation and stabilization on a cardiac glycoside. Isaac should be cautioned about taking antacids because of the risk of:

A) Reduced absorption of digoxin
B) Arrhythmia
C) Digoxin toxicity
D) Increased force of cardiac contraction

Question 8

What is an advantage of the new oral anticoagulants a. Slow onset for long-term therapy
B) Fewer food and drug interactions
C) Ability to monitor with standard laboratory equipment
D) Availability of numerous reversal agents

Question 9

Dianna Whitfield, a 37-year-old African-American, has been diagnosed with hypertension. Her physician discusses various options for pharmacologic treatment. Suppose Dianna is pregnant and experiences preeclampsia. Under this circumstance, the antihypertensive of choice would likely be:

A) Chlorthalidone
B) Hydralazine
C) Losartan
D) Enalapril

Question 10

Why is digoxin the only cardiac glycoside and digitalis product still marketed for clinical use a. It is safe at higher doses.
B) It is effective on cardiac arrhythmias.
C) It is slow acting.
D) It can be administered orally and parenterally.

Question 11

About what percentage of adults in the United States are considered to have prehypertension a. 27%
B) 37%
C) 47%
D) 57%

Question 12

Digoxin toxicity can usually be treated sufficiently by: a. Discontinuing digoxin
B) Administering atropine
C) Treating potassium and magnesium disturbances
D) Administering digoxin-specific Fab fragments

Question 13

Fibrillation refers to: a. Rapid heartbeat
B) Irregular heart beat
C) Slow heart beat
D) Insufficient heart beat

Question 14

Most drugs given to counteract arrhythmias have the potential for: a. Causing hypertensive crisis
B) Deranging calcium levels
C) Slowing the heart rate
D) Increasing glucose metabolism

Question 15

Isaac Doniego, a 77-year-old widower with heart failure, has been treated successfully with a combination of ACE inhibitors and diuretics. However, his symptoms worsen and became life threatening despite pharmacologic treatment, so he is hospitalized for evaluation and stabilization on a cardiac glycoside. How will the cardiac glycoside act to lessen Isaac's heart failure

A) By increasing his heart rate
B) By increasing the force of cardiac contraction
C) By increasing his oxygen utilization
D) By suppressing possible cardiac arrhythmias

Question 16

Which of the following is especially important to monitor in patients receiving antiarrhythmic drugs a. Electrolytes
B) Glucose
C) Platelets
D) Lipids

Question 17

Dianna Whitfield, a 37-year-old African-American, has been diagnosed with hypertension. Her physician discusses various options for pharmacologic treatment. What class of drugs is Dianna's physician most likely to prescribe first

A) Thiazides
B) Beta-blockers
C) ACE inhibitors
D) Calcium channel blockers

Question 18

Which of the following has been widely accepted as the most effective treatment for patients with life-threatening ventricular tachycardia or fibrillation a. Insertion of an AICD
B) Amiodarone
C) Adenosine
D) Propranolol

Question 19

Match the medication in the first column with the condition in the second column that it is used to treat. Conditions may be used more than once.
MedicationClassification
_____ isosorbide a. Elevated cholesterol
_____ Zetia b. Hypertension
_____ Lovenox c. Angina
_____ Cardizem d. Pulmonary emboli
_____ Zocor e. Cardiac arrhythmia
_____ Plavix f. Stroke prevention (platelet inhibitor)
_____ Crestor
_____ hydralazine
_____ quinidine
_____ procainamide

Question 20

Inhibition of ACE lowers blood pressure by: a. Decreasing cardiac output
B) Increasing cardiac output
C) Decreasing vasoconstriction
D) Increasing vasoconstriction

Question 21

Isaac Doniego, a 77-year-old widower with heart failure, has been treated successfully with a combination of ACE inhibitors and diuretics. However, his symptoms worsen and became life threatening despite pharmacologic treatment, so he is hospitalized for evaluation and stabilization on a cardiac glycoside. What type of cardiac glycoside is Isaac's physician most likely to prescribe

A) Synthetic adenosine
B) Lidocaine or a related drug
C) Digitalis product
D) Thiazide

Question 22

Side effects from beta-blockers are most common in: a. Patients of age 50 or younger
B) Patients receiving IV administration of the drug
C) Patients with pre-existing arrhythmia
D) Patients who suffer from migraines

Question 23

Dianna Whitfield, a 37-year-old African-American, has been diagnosed with hypertension. Her physician discusses various options for pharmacologic treatment. What antihypertensives are known to be more effective in African-Americans and older adult:

A) Thiazides
B) Angiotensin receptor blockers
C) Nonthiazide diuretics
D) Calcium channel blockers

Question 24

Coronary vasodilators are used for the: a. Treatment of hypotension
B) Reduction of intracranial pressure
C) Prevention of tachycardia and resulting syncope
D) Treatment of angina

Question 25

Isaac Doniego, a 77-year-old widower with heart failure, has been treated successfully with a combination of ACE inhibitors and diuretics. However, his symptoms worsen and became life threatening despite pharmacologic treatment, so he is hospitalized for evaluation and stabilization on a cardiac glycoside. Isaac's physician alerts him that cardiac glycosides should be avoided if he has which of the following conditions

A) Hyperthyroidism
B) Hyperkalemia
C) Hypermagnesemia
D) Impaired renal function

Question 26

Increased risk of new-onset diabetes mellitus is most associated with high doses of: a. Statins
B) Cardiac glycosides
C) Calcium channel blockers
D) Bile acid sequestrants