Deck 23: Antianginal Drugs

Question 1

Identify an accurate statement about arrhythmias.

A) Arrhythmias are often caused by electrolyte disturbances and overstimulation of the heart.
B) Arrhythmias result in an increase in cardiac output and blood pressure.
C) All arrhythmias originate in the atria of the heart.
D) The arrhythmias that originate below the atrioventricular node are known as supraventricular arrhythmias.

Answer 1

Arrhythmias are often caused by electrolyte disturbances and overstimulation of the heart.

Question 2

During Phase 2 of the cardiac action potential,_____.

A) calcium ions move into the muscle cells
B) calcium ion channels close
C) potassium ions move into the muscle cells
D) sodium ions influx into the muscle cells

Answer 2

calcium ions move into the muscle cells

Question 3

_____ is an adverse syndrome produced by quinidine in overdosage or in patients who are sensitive to the drug.

A) Hypertension
B) Tachypnea
C) Cinchonism
D) Dry mouth

Answer 3

Cinchonism

Question 4

Which of the following is an example of a life-threatening arrhythmia caused by electrical conduction disturbances?

A) Atrial fibrillation
B) Ventricular fibrillation
C) Ectopic foci
D) Premature ventricular contraction

Question 5

Which of the following statements is true of antiarrhythmic drugs?

A) Antiarrhythmic drugs that decrease the duration of Phase 0 of the cardiac action potential are the most effective therapeutically.
B) Most antiarrhythmic drugs exert their major antiarrhythmic action on a specific phase of the action potential.
C) Very few antiarrhythmic drugs have the potential to make any existing arrhythmia worse.
D) Antiarrhythmic drugs that reduce the durations of Phases 1-3 of the cardiac action potential produce effective antiarrhythmic actions.

Question 6

Antiarrhythmic drugs produce effective antiarrhythmic actions by:

A) slowing Phase 0.
B) prolonging Phases 1-3.
C) decreasing Phase 4 automaticity.
D) all of these

Question 7

Identify an accurate statement about disopyramide.

A) Disopyramide produces a prolongation of the cardiac refractory period.
B) Disopyramide produces an increase in conduction.
C) Disopyramide is only approved for treating atrial arrhythmias.
D) Disopyramide is the most frequently used 1A antiarrhythmic drug.

Question 8

Counting the number of QRS waves in an electrocardiogram (ECG)that occur within a 1-minute period helps determine the _____.

A) cardiac output
B) heart rate
C) stroke volume
D) number of premature atrial contractions

Question 9

Ectopic foci are often caused due to:

A) an increase in the activity of the sinoatrial (SA) node.
B) an increase in the activity of the atrioventricular (AV) node.
C) a delay or blockage in the conduction of electrical impulses.
D) a decrease in the number of cholinergic neurons innervating the heart.

Question 10

Which of the following is true of Class 2 antiarrhythmic drugs?

A) They tend to shorten the cardiac refractory period.
B) They increase the excitability, conduction, and automaticity of ventricular muscle.
C) They decrease heart rate, atrioventricular (AV) conduction, and automaticity of the sinoatrial (SA) and AV nodes.
D) They are mainly indicated for arrhythmias that originate below the AV node.

Question 11

The excessive prolongation of the QT interval by antiarrhythmic drugs can lead to all of the following except:

A) hypoglycemia.
B) hypotension.
C) fainting.
D) ventricular arrhythmias.

Question 12

Dr.Cooper notices some irregularities in Alex's heartbeat.After a thorough examination,he diagnoses Alex with ventricular arrhythmia.Dr.Cooper advises Alex to start taking a Class 1A antiarrhythmic drug in an extended-release tablet form once every 12 hours.On being asked about the drug's mechanism of action by an assistant,Dr.Cooper states that the drug slows conduction in the heart and prolongs the cardiac refractory period.Based on the information provided in this scenario,which of the following drugs has Dr.Cooper most likely prescribed?

A) Sotalol
B) Amiodarone
C) Esmolol
D) Procainamide

Question 13

Antiarrhythmic drugs primarily affect the activity of all of the following ions except:

A) chlorine ions.
B) sodium ions.
C) potassium ions.
D) calcium ions.

Question 14

What happens during Phase 4 of the cardiac action potential?

A) Potassium ions efflux out of the cardiac membrane as it undergoes repolarization.
B) Sodium ions enter the cardiac membrane as it undergoes depolarization.
C) The membrane potential returns to its resting level and prepares itself for the next action potential.
D) Calcium channels open and calcium ions pass into muscle cells.

Question 15

Which of the following ions plays a major role in bringing about myocardial contraction during Phase 2 of the cardiac action potential?

A) Sodium ions
B) Calcium ions
C) Magnesium ions
D) Chloride ions

Question 16

The duration of the PR interval on an electrocardiogram (ECG)reflects the time required for:

A) depolarization and conduction through the ventricles.
B) conduction from the sinoatrial (SA) to the atrioventricular (AV) node.
C) depolarization and repolarization of the ventricles.
D) conduction from the atrioventricular (AV) node to the sinoatrial (SA) node.

Question 17

In the context of supraventricular arrhythmias,which of the following is true of atrial flutter?

A) The atrial rate of a person with atrial flutter is between 150 and 200 beats per minute.
B) The ventricles of a person with atrial flutter contract at a slower rate.
C) In a person with atrial flutter, there are no effective atrial contractions.
D) The electrocardiogram of a person with atrial flutter will show larger, more interspaced P waves.

Question 18

Eva has been using a certain Class 1A antiarrhythmic drug for a very long time.However,over the past few weeks,Eva has lost a lot of weight and has been experiencing severe episodes of nausea and diarrhea.She has also developed a scaly red skin rash.She visits Dr.Redford's clinic for a consultation.Dr.Redford studies her electrocardiogram (ECG)and notices that the durations of the PR,QRS,and QT waves in Eva's heart are much longer than usual.He advises Eva to stop taking the drug.Which of the following drugs has Eva most likely been using?

A) Propranolol
B) Procainamide
C) Sotalol
D) Amiodarone

Question 19

Of the Class 1A antiarrhythmics,procainamide is favored over quinidine because procainamide:

A) is a natural product, whereas quinidine is not.
B) shows cardiac depressant activity at a much lower dose than quinidine does.
C) produces less anticholinergic and alpha-blocking actions than quinidine does.
D) exhibits more cholinergic activity than quinidine does.

Question 20

What type of pattern would one expect the P waves of the electrocardiogram (ECG)of a person with atrial flutter to have?

A) A sawtooth pattern
B) A pattern resembling a bag of worms
C) A pattern in which the P waves are clubbed together in triplets
D) An inverted pattern

Question 21

In the context of calcium channel blockers,how do dihydropyridines differ from nondihydropyridines?

A) Unlike dihydropyridines, nondihydropyridines increase heart rate and AV conduction.
B) Unlike nondihydropyridines, dihydropyridines do not have direct antiarrhythmic effects on the heart.
C) Unlike dihydropyridines, nondihydropyridines are not arterial vasodilators.
D) Unlike nondihydropyridines, dihydropyridines are widely used for their antiarrhythmic effects.

Question 22

Which of the following is an example of a Class 2 antiarrhythmic drug?

A) Sotalol
B) Esmolol
C) Amiodarone
D) Verapamil

Question 23

All of these drugs slow atrioventricular (AV)conduction to protect the ventricles in atrial fibrillation except:

A) beta-blockers.
B) atropine.
C) calcium channel blockers.
D) digoxin.

Question 24

Which of the following drugs is preferred for the treatment of supraventricular tachycardia?

A) Verapamil
B) Atropine
C) Amiodarone
D) Lidocaine

Question 25

Calcium channel blockers affect the sinoatrial (SA)node by:

A) slowing depolarization and decreasing the heart rate.
B) slowing repolarization and decreasing the heart rate.
C) increasing depolarization and increasing the heart rate.
D) increasing repolarization and increasing the heart rate.

Question 26

A potentially fatal problem that can occur with the use of amiodarone is:

A) malignant hyperthermia.
B) tachycardia.
C) pulmonary fibrosis.
D) constipation.

Question 27

Class 3 antiarrhythmic drugs work by blocking the:

A) adrenergic beta-1 receptors.
B) influx of calcium ions during Phase 2 of the cardiac potential.
C) influx of sodium ions during the depolarization phase.
D) efflux of potassium ions during the repolarization phase.

Question 28

What is the primary mechanism of action of Class 4 antiarrhythmic drugs?

A) They block sodium channels.
B) They block adrenergic beta-1 receptors.
C) They block calcium channels in the sinoatrial (SA) and atrioventricular (AV) nodes.
D) They block potassium channels.

Question 29

Atropine is used to treat sinus bradycardia because it increases all of the following except:

A) heart rate.
B) AV conduction.
C) blood pressure.
D) SA conduction.

Question 30

_____ refers to a type of arrhythmia that originates in the sinoatrial (SA)node and causes a sustained increased heart rate of over 100 beats per minute.

A) Supraventricular bradycardia
B) Atrial flutter
C) Supraventricular tachycardia
D) Sinus tachycardia

Question 31

_____ is defined as a heart rate below 60 beats per minute.

A) Supraventricular tachycardia
B) Paroxysmal supraventricular tachycardia
C) Sinus bradycardia
D) Ventricular arrhythmia

Question 32

A difference between dofetilide and ibutilide is that:

A) dofetilide acts by blocking sodium channels, whereas ibutilide acts by blocking potassium channels.
B) dofetilide is administered orally, whereas ibutilide is administered intravenously.
C) dofetilide is indicated for the treatment of atrial flutters, whereas ibutilide is indicated for the treatment of atrial fibrillation.
D) dofetilide is a Class 2 antiarrhythmic drug, whereas ibutilide is a Class 4 antiarrhythmic drug.

Question 33

Mia is rushed to the hospital after taking an overdose of a certain antiarrhythmic drug.On examining her condition,the doctors note that she has a blockage in her heart,corneal microdeposits,and a distinct blue-gray skin discoloration.Dr.Ross,the doctor in charge,immediately recognizes these adverse effects as those caused by a certain potassium channel blocker.Based on this information,which of the following drugs might Mia have ingested?

A) Esmolol
B) Amiodarone
C) Adenosine
D) Atropine

Question 34

Calcium channel blockers:

A) increase myocardial contractility.
B) cause vasoconstriction.
C) increase conduction.
D) reduce myocardial contractility.

Question 35

Which of the following is a Class 4 antiarrhythmic drug?

A) Amiodarone
B) Esmolol
C) Propranolol
D) Verapamil