Deck 12: Drugs for the Treatment of Cardiovascular Disease

Question 1

Which of the following choices are effects of digoxin on the heart?

A)Digoxin accelerates atrioventricular (AV)conduction.
B)Digoxin prolongs the refractory period of the atrioventricular (AV)node.
C)Digoxin increases the rate of the sinoatrial (SA)node.
D)Both A and B are effects.
E)Both B and C are effects.

Answer 1

Digoxin prolongs the refractory period of the atrioventricular (AV)node.

Question 2

Which of the following statements is true of heart failure?

A)Usually the right side fails first.
B)If the left side of the heart fails,the blood backs up into the pulmonary circulation.
C)If the right side of the heart fails,then the left ventricle is unable to remove all the blood from the right side of the heart.
D)Left-sided heart failure causes systemic congestion.

Answer 2

If the left side of the heart fails,the blood backs up into the pulmonary circulation.

Question 3

Which of the following classes of antiarrhythmics is associated with gingival enlargement?

A)Amiodarone
B)Calcium channel blockers
C)Disopyramide
D)Procainamide
E)Quinidine

Answer 3

Calcium channel blockers

Question 4

MI refers to

A)injury or necrosis of the heart muscle.
B)transient lack of oxygen to the heart.
C)congestive heart failure (CHF).
D)abnormal sinus rhythm of the heart.

Question 5

The cells of cardiac muscles have an intrinsic rhythm called

A)spontaneity.
B)automaticity.
C)anarchy.
D)hierarchy.

Question 6

Hypersalivation is a sign of toxicity for which of the following agents?

A)Clonidine
B)Digoxin
C)Enalapril
D)Hydrochlorothiazide
E)Nifedipine

Question 7

The use of nitroglycerin (NTG)is contraindicated if sildenafil (Viagra)has been administered within 24 hours.This is because the NTG-sildenafil combination can precipitate a hypertensive crisis.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true,the second is false.
D)The first statement is false,the second is true.

Question 8

Nitroglycerine (NTG)is a(n)_____ that produces relaxation of vascular smooth muscle throughout the body.

A)vasoconstrictor
B)vasodilator
C)beta-blocker
D)angiotensin-converting enzyme inhibitor
E)angiotensin receptor blocker

Question 9

A patient has a cardiovascular disorder for which a physician prescribes a local anesthetic drug.What might this cardiovascular disorder be?

A)Coronary artery disease
B)Hypertension
C)Arrhythmia
D)Angina pectoris

Question 10

Dental patients with left heart failure may need to be positioned in the dental chair

A)with their left hip elevated.
B)with their right hip elevated.
C)in a semireclined position.
D)with their feet at a higher elevation than their head.
E)lying flat.

Question 11

Nitroglycerine (NTG)is used for what cardiovascular disease?

A)Atherosclerosis
B)Coronary artery disease
C)Arrhythmias
D)Angina pectoris

Question 12

Which of the following is true concerning what research has shown regarding the relationship between periodontal disease and cardiovascular disease?

A)Studies have shown a very strong positive correlation between periodontal disease and cardiovascular disease.
B)Studies have shown a weak but positive correlation between periodontal disease and cardiovascular disease.
C)Studies both support and reject the relationship between periodontal disease and cardiovascular disease.
D)Studies have shown that there is no correlation between periodontal disease and cardiovascular disease.

Question 13

To prevent tolerance,prophylactic nitrates should be given with at least a(n)

A)week off every month.
B)day off every week.
C)8- to 12-hour "vacation" every day.
D)1 hour "vacation" every 12 hours.

Question 14

How long should a person who has had a myocardial infarction wait before receiving dental care?

A)2 weeks
B)2 months
C)6 months
D)12 months
E)24 months

Question 15

Nitroglycerin (NTG)should be

A)stored in plastic.
B)kept in the refrigerator.
C)administered once every 5 minutes until the anginal attack is stopped.
D)available to the dental team for treatment of an acute anginal attack.
E)All of the above

Question 16

The _____ has the fastest rate of depolarization and therefore directs all the other cells of the heart.

A)sinoatrial (SA)node
B)atrioventricular (AV)node
C)bundle of His
D)Purkinje fibers

Question 17

Which of the following is the primary type of drug recommended for patients who have edema or fluid retention with heart failure (HF)?

A)Angiotensin-converting enzyme inhibitor
B)Angiotensin receptor antagonist
C)Beta-blocker
D)Aldosterone antagonist
E)Diuretic

Question 18

In a normally functioning heart,the bundle of His receives its electrical input from the

A)Purkinje fibers.
B)atrioventricular (AV)node.
C)sinoatrial (SA)node.
D)cardiac muscle.

Question 19

Each of the following conditions is an absolute contraindication to dental treatment until a consultation with the patient's medical provider has determined any special treatment alterations that might be warranted except one.Which is the exception?

A)Chronic,stable angina
B)Uncontrolled heart failure
C)Uncontrolled arrhythmia
D)Significant,uncontrolled hypertension

Question 20

Which of the following categories of drug is the best choice to relieve the acute symptoms of angina?

A)Nitroglycerin (NTG,Nitrostat,Nitrolingual)
B)Nitroglycerin (Nitro-Bid)
C)Propranolol
D)Verapamil (Calan,Isoptin)
E)Nifedipine (Procardia)

Question 21

If the _____ tablet of sublingual nitroglycerin (NTG)does not stop the anginal attack,the patient should be taken to the emergency room.

A)first
B)second
C)third
D)fourth
E)fifth

Question 22

Which of the following is a b-adrenergic blocking drug that also has a-receptor blocking activity?

A)Atenolol
B)Labetalol
C)Doxazosin
D)Minoxidil

Question 23

b₁-Receptor stimulation is associated with

A)vasodilation in skeletal muscles.
B)bronchodilation in pulmonary tissues.
C)a decrease in heart rate.
D)an increase in cardiac contractility.

Question 24

Which b-adrenergic blocking agent has partial agonist activity and causes some â-stimulation while blocking catecholamine action?

A)Atenolol
B)Acebutolol
C)Metoprolol
D)Carvedilol

Question 25

Essential hypertension is

A)of unknown cause.
B)iatrogenic hypertension.
C)precipitated by another disorder.
D)a rapidly developing form of hypertension,requiring aggressive therapy.

Question 26

Which of the following statement is true concerning the use of b-adrenergic blocking agents for the treatment of angina pectoris?

A)These drugs block the g response to catecholamine stimulation,thereby reducing both the chronotropic and inotropic effects.
B)b-adrenergic blockers are effective in reducing exercise but not stress-induced anginal episodes.
C)Adverse effects of b-adrenergic blocking agents include tachycardia,headache,and excessive salivation.
D)The net result of the use of b-adrenergic blocking agents for the treatment of angina pectoris is a reduced myocardial oxygen demand.

Question 27

Which of the following agents can worsen asthma?

A)Propranolol (Inderal)
B)Calcium channel blocker
C)ACEIs
D)Anticholinergics

Question 28

Which of the following groups of diuretics are called the "puny" diuretics?

A)Thiazide
B)Loop
C)Potassium-sparing
D)Both A and B
E)Both B and C

Question 29

Before administering nitroglycerine (NTG),the dental team should make sure that the patient has not used a _____ within the past 24 hours.

A)phenothiazine
B)PDE5 inhibitor
C)ranolazine
D)guanethidine

Question 30

Which of the following is the most important dental drug interaction with the thiazide diuretics?

A)Aspirin
B)Nonsteroidal antiinflammatory drugs (NSAIDs)
C)Penicillin
D)Chlorhexidine

Question 31

Approximately _____% of people with hypertension are properly treated.

A)20
B)40
C)50
D)60

Question 32

Which of the following categories of antihypertensive agents end in the suffix -dipine?

A)Diuretics
B)b-Adrenergic blockers
C)Calcium channel blockers
D)Angiotensin receptor blockers (ARBs)

Question 33

Which of the following statements is true regarding hypertension?

A)High blood pressure eventually damages internal organs.
B)Complications of hypertension are greatly increased with concomitant smoking.
C)In most cases of hypertension,the cause can be identified and associated with a specific disease process.
D)Both A and B are true.
E)Both B and C are true.

Question 34

Which diuretic acts at the ascending loop of Henle of the kidney nephron to cause rapid diuresis?

A)Hydrochlorothiazide
B)Triamterine
C)Furosemide
D)Spironolactone

Question 35

Which of the following is the most common cardiovascular disease?

A)Heart failure
B)Cardiac arrhythmia
C)Angina
D)Hypertension

Question 36

Eating bananas when taking thiazide diuretics will

A)deplete calcium.
B)prevent diuresis.
C)replenish potassium.
D)inhibit the drug's metabolism.

Question 37

Nonselective b-blockers can have a drug interaction with epinephrine,causing a two- to fourfold increase in vasopressor response.A gingival retraction cord containing epinephrine may be used,however.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true,the second is false.
D)The first statement is false,the second is true.

Question 38

Common adverse reactions associated with thiazides include

A)hypokalemia and hypouricemia.
B)hyperkalemia and hypouricemia.
C)hypokalemia and hyperuricemia.
D)hyperkalemia and hyperuricemia.

Question 39

b-Adrenergic blockers lower blood pressure primarily by

A)reducing peripheral resistance.
B)decreasing cardiac output.
C)lowering plasma volume.
D)lowering plasma renin levels.

Question 40

_____ should not be given to persons taking potassium supplements because hyperkalemia will occur.

A)Thiazides
B)b-Blockers
C)Angiotensin-converting enzyme inhibitors (ACEIs)
D)Angiotensin receptor blockers (ARBs)
E)Calcium channel blockers

Question 41

Which of the following categories of agents may be used to treat both hypertension and benign prostatic hypertrophy?

A)Diuretic agents
B)b-Adrenergic blocking agents
C)A₁-Adrenergic blocking agents
D)Calcium channel blocking agents

Question 42

Which agent is most likely to cause xerostomia?

A)Losartan
B)Clonidine
C)Enalapril
D)Atenolol

Question 43

Severe hypotension and reflex tachycardia are caused by combination of sympathomimetics,such as epinephrine,with which antihypertensive agent class?

A)Calcium channel blockers
B)A₁-Adrenergic blocking agents
C)Angiotensin receptor blockers (ARBs)
D)Potassium-sparing diuretics

Question 44

Which agent reduces serum cholesterol by increasing its utilization for bile acid synthesis?

A)Niacin
B)Atorvastatin
C)Gemfibrozil
D)Cholestyramine
E)Clopidogrel

Question 45

NSAIDs can antagonize the effects of which of the following antihypertensive medications?

A)Angiotensin-converting enzyme inhibitors (ACEIs)
B)b-Adrenergic antagonists
C)Calcium channel blockers
D)Loop diuretics
E)Centrally acting hypertensive agents

Question 46

Which of the following is the first choice of therapy for most patients with atherosclerotic heart disease and elevated cholesterol levels?

A)Fenofibrate
B)Niacin
C)Colestipol (Colesevelam)
D)Omega-3 fish oil
E)3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor

Question 47

Many _____ end in the suffix -pril.

A)b-adrenergic blockers
B)calcium channel blockers
C)angiotensin-converting enzyme inhibitors (ACEIs)
D)angiotensin receptor blockers (ARBs)

Question 48

Which of the following antihyperlipidemic agents can promote gallstone formation?

A)HGM CoA reductase inhibitors
B)Niacin
C)Cholestyramine
D)Gemfibrozil

Question 49

Which of the following agents is an a₁-adrenergic receptor antagonist?

A)Amlodipine (Norvasc)
B)Benazepril (Lotensin)
C)Candesartan (Atacand)
D)Terazosin (Hytrin)
E)Atenolol (Tenormin)

Question 50

Niacin works by

A)inhibiting HMG-CoA reductase.
B)inhibiting the intestinal absorption of cholesterol.
C)inhibiting the secretion of very-low-density lipoproteins (VLDLs)without accumulation of triglycerides in the liver.
D)increasing lipolysis of triglycerides,decreasing lipolysis in adipose tissue,and inhibiting secretions of VLDLs from the liver.

Question 51

Each of the following agents is associated with development of gingival hypertrophy except one.Which is the exception?

A)Verapamil
B)Phenytoin
C)Clonidine
D)Felodipine

Question 52

When a physician finds out that his female patient wishes to start a family,he decides to change her cholesterol-lowering medication.He changes her medication from

A)niacin to simvastatin.
B)simvastatin to atorvastatin.
C)simvastatin to niacin.
D)gemfibrozil to losartan.

Question 53

Each of the following effects is characteristic of channel-blocking agents except one.Which is the exception?

A)Reduction in afterload on the heart
B)Inhibition of calcium influx
C)Decrease in cardiac contractility
D)Orthostatic hypotension
E)Peripheral edema

Question 54

A serious lupus-like reaction is associated with which cardiovascular drug?

A)Clonidine
B)Hydralazine
C)Isosorbide dinitrate
D)Spironolactone

Question 55

Patients taking antihypertensive agents who have been supine for some time should be slowly raised from that position.They should dangle their legs over the side of the chair and wiggle them before rising to the standing position.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true,the second is false.
D)The first statement is false,the second is true.

Question 56

Angiotensin receptor blockers (ARBs)end with the suffix

A)-olol.
B)-dipine.
C)-pril.
D)-artan.

Question 57

The newest guidelines from the ACC/AHA recommend using HMG-coA reductase inhibitors (statins)as the drugs of first choice for treating patients with atherosclerotic cardiovascular disease based on

A)a total cholesterol level of over 240 mg/dL.
B)a low-density lipoprotein level over 190 mg/dL.
C)the patient's estimated 10-year atherosclerotic cardiovascular disease risk.
D)poor lifestyle factors such as being overweight and smoking.

Question 58

Which class of agents is of special benefit to a diabetic with nephropathy?

A)b-Adrenergic blockers
B)Calcium channel blocker (CCB)
C)Angiotensin-converting enzyme inhibitors (ACEIs)
D)Anticholinergics

Question 59

Which of the following statements is true of ezetimibe?

A)It is an HMG Co-A reductase inhibitor.
B)This drug decreases total cholesterol,HDL cholesterol,and decreases HDL cholesterol levels.
C)It is currently available in combination with simvastatin or atorvastatin to treat cholesterol with two different mechanisms of action.
D)Ezetimibe/simvastatin has been found to lower low-density lipoprotein (LDL)cholesterol and has a marked effect on plaque buildup.

Question 60

Which of the following statements is true concerning hyperlipidemia and cholesterol?

A)Hyperlipidemia includes elevations in cholesterol or triglycerides and is associated with the development of arteriosclerosis.
B)High-density lipoprotein (HDL)is good cholesterol.
C)Foam cells become filled with lipid.
D)Both A and B are correct.
E)Both B and C are correct.

Question 61

Some studies have found that the presence of periodontal disease predicts an increase in morbidity and mortality resulting from cardiovascular disease.Other studies have failed to show a relationship.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true,the second is false.
D)The first statement is false,the second is true.

Question 62

There is a danger of _____ if the dose of anticoagulant is too small.

A)embolism
B)hemorrhage
C)chronic obstructive pulmonary disease
D)angina

Question 63

Each of the following agents inhibits platelet function except one.Which is the exception?

A)Clopidogrel
B)Dipyridamole
C)Ticlopidine
D)Aspirin

Question 64

Which agent is contraindicated in pregnant women due to the risk of teratogenicity?

A)Methyldopa
B)Labetalol
C)Captopril
D)Nifedipine

Question 65

Each of the following is true for management of the dental patient taking warfarin except one.Which is the exception?

A)Use of aspirin should be avoided.
B)Most dental procedures do not require a change in the dose of warfarin.
C)Insure the patient is free of infection before scaling/root planing is performed.
D)Ask the patient to stop taking warfarin 3 days before the procedure.

Question 66

The presence of _____ in the oral cavity can be a sign of an adverse effect associated with the oral anticoagulants.

A)lichen planus
B)petechial hemorrhages
C)linear gingival erythema
D)hairy tongue

Question 67

GoNitro is administered to the patient as a

A)tablet.
B)spray.
C)powder.
D)injection.

Question 68

Blood returning from the peripheral circulation enters the

A)left atrium.
B)left ventricle.
C)right atrium.
D)right ventricle.

Question 69

Which is the treatment of choice for the treatment of heart failure (HF)?

A)Diuretics
B)Angiotensin-converting enzyme inhibitors
C)Angiotensin receptor blockers
D)Angiotensin II receptor neprilysin inhibitor
E)If channel inhibitor

Question 70

The percentage of Americans diagnosed with hypertension is which percentage according to the new recommendations of the American Heart Association (AHA)?

A)6%
B)16%
C)26%
D)36%
E)46%

Question 71

The therapeutic target international normalized ratio (INR)for most indications,such as thrombophlebitis,is

A)less than 1.
B)between 2 and 3.
C)between 3.5 and 4.5.
D)over 4.5.

Question 72

A patient taking warfarin (Coumadin)may experience interactions with which of the following?

A)Phenobarbital
B)Erythromycin
C)Aspirin
D)All of the above

Question 73

Which of the following agents has the most serious drug interaction with warfarin?

A)Omeprazole
B)Aspirin
C)Digitalis
D)Lomotil

Question 74

Based on the most recent recommendations of the American Heart Association (AHA),the percentage of American diagnosed with hypertension will

A)fall significantly (more than 20%).
B)fall slightly (about 5%).
C)remain the same.
D)rise.

Question 75

Long chain omega-3 polyunsaturated fatty acids can decrease fasting triglyceride concentrations by

A)5% to 10%.
B)10% to 20%.
C)20% to 50%.
D)50% to 70%.

Question 76

Which antihypertensive agent is associated with a nonproductive cough?

A)angiotensin receptor blocker
B)beta-adrenergic blocking agent
C)alphA₁-adrenergic blocking agent
D)angiotensin-converting enzyme inhibitor

Question 77

a-Methyldopa (Aldomet)and clonidine (Catapres [TTS])act in the central nervous system (CNS)as

A)alpha-adrenergic blocking agents.
B)alpha-adrenergic agonists.
C)beta-adrenergic blocking agents.
D)beta-blockers with alpha-blocking activity.

Question 78

Ivabradine (Corlanor)acts by inhibiting an ion channel in the

A)bundle of His.
B)sinoatrial node.
C)Purkinje fibers.
D)right atrium.
E)left atrium.

Question 79

Which of the following drugs is a direct inhibitor of thrombin?

A)Rivaroxaban (Xarelto)
B)Dabigatran (Pradaxa)
C)Clopidogrel (Plavix)
D)Ticlopidine (Ticlid)
E)Alteplase (Activase)

Question 80

Of the vitamin K-dependent clotting factors,which has the shortest circulating half-life?

A)Factor II
B)Factor VII
C)Factor VIII
D)Factor IX
E)Factor X