Melanie Grynsztejn
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Quiz on Angina Pharmacotherapy, created by Melanie Grynsztejn on 05/12/2017.

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Melanie Grynsztejn
Created by Melanie Grynsztejn over 6 years ago
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Angina Pharmacotherapy

Question 1 of 39

1

Which beta blockers block both beta & alpha receptors?

Select one or more of the following:

  • Labetol

  • Carvedilol

  • Propanolol

  • Metroprolol

Explanation

Question 2 of 39

1

Beta‐1, found primarily in , results in increased heart rate, contractility, and atrioventricular (AV) conduction

Drag and drop to complete the text.

    heart muscle
    bronchial & peripheral smooth muscle
    adipose

Explanation

Question 3 of 39

1

Beta‐2, found in smooth muscle; results in vasodilatation and bronchodilation.

Drag and drop to complete the text.

    bronchial and peripheral vascular
    heart muscle
    adipose

Explanation

Question 4 of 39

1

Beta‐3, found in may reduce cardiac contractility.

Drag and drop to complete the text.

    adipose tissue and the heart;
    heart muscle
    bronchial and peripheral vascular smooth

Explanation

Question 5 of 39

1

Beta blockers MOA:

Select one of the following:

  • Competitively inhibiting catecholamines from binding to these receptors.

  • Dilate veins, arteries, and coronary arteries by relaxing vascular smooth muscle

  • Act on vascular smooth muscle to reduce contraction of the arteries and cause vasodilation

Explanation

Question 6 of 39

1

Which of the following Beta Blockers are eliminated by hepatic metabolism and are lipid soluble

Select one or more of the following:

  • Propranolol

  • Metoprolol

  • Atenolol

  • Sotalol

Explanation

Question 7 of 39

1

Why is important to know which BB are eliminated by hepatic metabolism and more lipid soluble?

Select one of the following:

  • Enter CNS in high concentrations, possibly resulting in an increased incidence of CNS side effects

  • Are eliminated and do not as readily enter the CNS so can be prescribed more readily

  • Can cause hepatic damage if prescribed in too high a dosage

Explanation

Question 8 of 39

1

Which of the following beta blockers are excreted unchanged by the kidney?

Select one or more of the following:

  • Atenolol

  • Sotalol

  • Propranolol

  • Metoprolol

Explanation

Question 9 of 39

1

Select from the dropdown lists to complete the text.

Metoprolol tartrate is ( shorter‐acting, longer-acting ) and dose ( *twice*, *once* ) daily and
Metoprolol succinate ( longer‐ acting, shorter-acting ) and dosed ( *once*, *twice* ) daily

Explanation

Question 10 of 39

1

Atenolol and sotalol are more water soluble and are eliminated unchanged by the kidney. What is the effect of this on plasma half-lives & bioavailability?

Select one or more of the following:

  • Longer plasma half-life

  • Shorter plasma half-life

  • Greater bioavailability

  • Lesser bioavailability

Explanation

Question 11 of 39

1

True or False:
BB are first-line therapy to reduce angina episodes & increase exercise tolerance

Select one of the following:

  • True
  • False

Explanation

Question 12 of 39

1

BB & CCB are antianginal drugs proven to prevent reinfarction and improve survival in patients who have sustained a MI

Select one of the following:

  • True
  • False

Explanation

Question 13 of 39

1

BB should NOT be used in which type of angina patient

Select one of the following:

  • Stable

  • Unstable

  • Vasospastic (Prinzmetal)

Explanation

Question 14 of 39

1

Fill the blank space to complete the text.

It is important to BB when discontinuing BB therapy

Explanation

Question 15 of 39

1

What are some potential Adverse Effects of Beta Blockers

Select one or more of the following:

  • Decreased heart rate, contractility & AV node conduction

  • Increased heart rate, contractility & AV node conduction

  • Bronchoconstriction

  • Bronchodilation

  • Nightmares, Insomnia, hallucinations

  • Depression

  • Weight loss

  • Weight gain

  • Erectile dysfunction

Explanation

Question 16 of 39

1

T or F
CCB are less effective than BB when treating stable angina

Select one of the following:

  • True
  • False

Explanation

Question 17 of 39

1

When are CCB used to treat stable angina?

Select one or more of the following:

  • When BB is not successful

  • When BB is contraindicated

  • When BB are causing SE

  • Are never combined with BB

Explanation

Question 18 of 39

1

What is the caution for using both non‐dihydropyridine and BB?

Select one of the following:

  • Additive bradycardia

  • Orthostatic hypotension

  • Weakness

  • N/V/D

Explanation

Question 19 of 39

1

Select from the dropdown lists to complete the text.

CCB improve anginal symptoms by causing coronary and ( peripheral, central ) vasodilatation and ( reducing, increasing ) contractility

Explanation

Question 20 of 39

1

Select the non-dihydropyridine CCB:

Select one or more of the following:

  • Diltiazem

  • Verapamil

  • Amlodipine

  • Felodipine

  • Nifedipine

Explanation

Question 21 of 39

1

Which types of CCB are preferred for angina

Select one or more of the following:

  • Long-acting non-dihydropyridine CCB - Verapamil & Diltiazem

  • Second generation CCB - Amlodipine or Felodipine

  • 1st generation CCB - Nifidepine

Explanation

Question 22 of 39

1

What is the most concerning adverse effect of dihyrdropyridine (amlodipine, felodipine, nifedipine

Select one of the following:

  • Peripheral edema

  • Lightheadedness

  • Flushing

Explanation

Question 23 of 39

1

What are potential adverse effects of Dihydropyridines

Select one or more of the following:

  • Constipation

  • Bradycardia

  • Peripheral edema

  • Lightheadness

  • Flushing

  • Headache

Explanation

Question 24 of 39

1

What are potential adverse effects of non-dihydropyridines

Select one or more of the following:

  • Bradycardia

  • Constipation

  • Peripheral edema

  • Headache

  • Lightheadedness

  • Flushing

Explanation

Question 25 of 39

1

What are a prescribers options if a patient gets peripheral edema on a dihydropyridines?

Select one or more of the following:

  • Reduce dose

  • Add an angiotensin‐converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB)

  • Switch to a non‐dihydropyridine agent

  • Add a metered dose spray nitrate

Explanation

Question 26 of 39

1

MOA for nitrate used for stable angina is

Select one of the following:

  • Dilate veins, arteries, and coronary arteries by relaxing vascular smooth muscle.

  • Competitively inhibiting catecholamines from binding to these receptors.

  • Act on vascular smooth muscle reducing contraction of the arteries and causing vasodilation

Explanation

Question 27 of 39

1

Select the cardioselective beta blockers

Select one or more of the following:

  • Atenolol

  • Metoprolol

  • Propranolol

Explanation

Question 28 of 39

1

Select the non-cardioselective beta blockers

Select one or more of the following:

  • Meoprolol

  • Atenolol

  • Propranolol

Explanation

Question 29 of 39

1

Nitrates are used as

Select one or more of the following:

  • First‐line therapy for the treatment of acute anginal

  • Prophylactically for activities known to elicit angina

  • Ongoing management of stable angina

Explanation

Question 30 of 39

1

Select from the dropdown lists to complete the text.

Usually in the form of a sublingual preparation, nitrates onset of action is within ( 2‐5 minutes, 5 - 10 minutes, 1 - 2 minutes ) and duration of action ( 15 ‐ 30 minutes, 5 - 10 minutes, 10 - 20 minutes, 15 - 20 minutes )

Explanation

Question 31 of 39

1

Select the potential adverse effects of nitrates

Select one or more of the following:

  • Hypotension

  • Flushing

  • Bradycardia

  • Headache

  • N/V/D

  • LIghtheadedness

Explanation

Question 32 of 39

1

American College of Cardiology/American Heart Association (ACC/AHA) guidelines for calling the emergency services are

Select one of the following:

  • Contact EMS if chest pain or discomfort is unimproved or worsening 5 minutes after *one* nitroglycerin dose has been taken sublingually

  • Take one nitroglycerin dose sublingually every 5 minutes for up to *3 doses* before calling for emergency medical services evaluation.

Explanation

Question 33 of 39

1

Fill the blank spaces to complete the text.

Nitroglycerin tablets are both and sensitive

Explanation

Question 34 of 39

1

Nitroglycerin tablets should be stored in a tightly capped dark bottle in the refrigerator with only a small supply being carried by the patient and discarded after 12 months

Select one of the following:

  • True
  • False

Explanation

Question 35 of 39

1

The following are longer-acting nitrate therapies

Select one or more of the following:

  • Nitroglycerin table

  • Isosorbide dinitrate

  • Isosorbide mononitrate

  • Transdermal nitroglycerin patch

Explanation

Question 36 of 39

1

How can a patient address the issue of nitrate tolerance with long-term therapies like the transdermal nitroglycerin patch?

Select one of the following:

  • Nitrate‐free interval (at least approx 8‐10 hours)

  • Use patch on different sites on the body

  • Increase dosage of transdermal patch

  • Switch to short-term nitroglycerin tablet

Explanation

Question 37 of 39

1

What is a REALLY IMPORTANT nitrate contraindication drug

Select one of the following:

  • Warfarin (Coumadin)

  • Erectile dysfunction drugs, PDE-5, Sildenafil, Vardenafil or Tadalafil within 24 hours

  • Second generation dihydropyridine CCB drugs Amlodipine and Felodipine

  • Cardioselective BB drugs Atenolol and Metoprolol

Explanation

Question 38 of 39

1

Ranolazine is a new drug for stable angina that is recommended for patients that have failed all other antianginal therpies. However, it is contraindicated for the following patients

Select one or more of the following:

  • Pre-existing QT interval

  • Hepatic disease

  • Renal disease

  • Tachycardia

Explanation

Question 39 of 39

1

The following are angina PREVENTIVE therapies

Select one or more of the following:

  • ASA

  • Clopidogrel (Plavix) if allergic to aspirin

  • Verapamil if allergic to aspirin

  • Propranolol if allergic to aspiring

Explanation

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