Question 1

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

Accepted Answer

Nitroglycerin can be administered sublingually or buccally to avoid the first pass effect since it is absorbed directly into the bloodstream through the sublingual or buccal mucosa. It can also be administered via transdermal patches which release the drug through the skin, thus bypassing the liver. All three administration routes avoid the first pass effect.

Question 2

Sudden rupture of atherosclerotic plaques in the coronary artery is a characteristic of ______,and is typically treated with ____.&#10;A) stable; sublingual nitroglycerin combine with a beta blocker or calcium channel blocker&#10;B) unstable; beta blockers combined with nitrates, calcium channel blockers, and antithrombotic drugs&#10;C) stable; norepinephrine and epinephrine&#10;D) unstable; norepinephrine and epinephrine&#10;E) variant; calcium channel blockers

Accepted Answer

Sudden rupture of atherosclerotic plaques in the coronary artery is a characteristic of unstable angina or acute myocardial infarction. It is typically treated with a combination of beta blockers, nitrates, calcium channel blockers, and antithrombotic drugs. Sublingual nitroglycerin is more commonly used for the relief of acute chest pain in stable angina, whereas calcium channel blockers are primarily used for the treatment of variant (Prinzmetal's) angina. Norepinephrine and epinephrine are not specific treatments for coronary artery disease.

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) tolerance to the drug

Accepted Answer

Nitroglycerin is a medication that can develop tolerance with prolonged use. Therefore, intermittent use of nitroglycerin patches is recommended to prevent tolerance and maintain efficacy. The other options are not related to the reason for intermittent use of nitroglycerin patches.

Question 4

Nitrates such as nitroglycerin exert their primary beneficial effects in people 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

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 reduce the heart rate and contractility, which decreases myocardial oxygen demand and thus prevents angina pectoris.

Question 6

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 the above are true

Accepted Answer

Aspirin and other antiplatelet drugs are primarily used in patients with angina pectoris to prevent coronary artery infarction by inhibiting platelet aggregation, thus reducing the risk of clot formation that can lead to heart attacks.

Question 7

Variant angina that is caused by coronary artery vasospasm (known also Prinzmetal's 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

Calcium channel blockers are the preferred treatment for variant angina as they can effectively prevent coronary artery vasospasm. Nitrates like nitroglycerin can provide short-term relief but may not prevent further episodes. Beta-blockers are not effective in preventing vasospasm, and alpha-1 agonists and alpha-2 antagonists are not commonly used in the management of variant angina.

Question 8

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) antianginal drugs do not sure this disease but only treat symptoms of myocardial ischemia

Accepted Answer

Antianginal drugs, including organic nitrates (such as nitroglycerin and isosorbide nitrate), beta blockers, and calcium channel blockers, are used to manage the symptoms of myocardial ischemia associated with angina pectoris but do not cure the underlying disease. These medications help to relieve symptoms by improving blood flow to the heart muscle or by decreasing the heart's demand for oxygen.

Deck 22: Treatment of Angina Pectoris