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Angina Pharmacotherapy

Description

Quiz on Angina Pharmacotherapy, created by Melanie Grynsztejn on 05/12/2017.
Melanie Grynsztejn
Quiz by Melanie Grynsztejn, updated more than 1 year ago
Melanie Grynsztejn
Created by Melanie Grynsztejn over 6 years ago
20
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Resource summary

Question 1

Question
Which beta blockers block both beta & alpha receptors?
Answer
  • Labetol
  • Carvedilol
  • Propanolol
  • Metroprolol

Question 2

Question
Beta‐1, found primarily in [blank_start]heart muscle[blank_end], results in increased heart rate, contractility, and atrioventricular (AV) conduction
Answer
  • heart muscle
  • bronchial & peripheral smooth muscle
  • adipose

Question 3

Question
Beta‐2, found in [blank_start]bronchial and peripheral vascular[blank_end] smooth muscle; results in vasodilatation and bronchodilation.
Answer
  • bronchial and peripheral vascular
  • heart muscle
  • adipose

Question 4

Question
Beta‐3, found in [blank_start]adipose tissue and the heart;[blank_end] may reduce cardiac contractility.
Answer
  • adipose tissue and the heart;
  • heart muscle
  • bronchial and peripheral vascular smooth

Question 5

Question
Beta blockers MOA:
Answer
  • 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

Question 6

Question
Which of the following Beta Blockers are eliminated by hepatic metabolism and are lipid soluble
Answer
  • Propranolol
  • Metoprolol
  • Atenolol
  • Sotalol

Question 7

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

Question 8

Question
Which of the following beta blockers are excreted unchanged by the kidney?
Answer
  • Atenolol
  • Sotalol
  • Propranolol
  • Metoprolol

Question 9

Question
Metoprolol tartrate is [blank_start]shorter‐acting[blank_end] and dose [blank_start]*twice*[blank_end] daily and Metoprolol succinate [blank_start]longer‐ acting[blank_end] and dosed [blank_start]*once*[blank_end] daily
Answer
  • shorter‐acting
  • longer-acting
  • *twice*
  • *once*
  • longer‐ acting
  • shorter-acting
  • *once*
  • *twice*

Question 10

Question
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?
Answer
  • Longer plasma half-life
  • Shorter plasma half-life
  • Greater bioavailability
  • Lesser bioavailability

Question 11

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

Question 12

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

Question 13

Question
BB should NOT be used in which type of angina patient
Answer
  • Stable
  • Unstable
  • Vasospastic (Prinzmetal)

Question 14

Question
It is important to [blank_start]taper[blank_end] BB when discontinuing BB therapy
Answer
  • taper

Question 15

Question
What are some potential Adverse Effects of Beta Blockers
Answer
  • 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

Question 16

Question
T or F CCB are less effective than BB when treating stable angina
Answer
  • True
  • False

Question 17

Question
When are CCB used to treat stable angina?
Answer
  • When BB is not successful
  • When BB is contraindicated
  • When BB are causing SE
  • Are never combined with BB

Question 18

Question
What is the caution for using both non‐dihydropyridine and BB?
Answer
  • Additive bradycardia
  • Orthostatic hypotension
  • Weakness
  • N/V/D

Question 19

Question
CCB improve anginal symptoms by causing coronary and [blank_start]peripheral[blank_end] vasodilatation and [blank_start]reducing[blank_end] contractility
Answer
  • peripheral
  • central
  • reducing
  • increasing

Question 20

Question
Select the non-dihydropyridine CCB:
Answer
  • Diltiazem
  • Verapamil
  • Amlodipine
  • Felodipine
  • Nifedipine

Question 21

Question
Which types of CCB are preferred for angina
Answer
  • Long-acting non-dihydropyridine CCB - Verapamil & Diltiazem
  • Second generation CCB - Amlodipine or Felodipine
  • 1st generation CCB - Nifidepine

Question 22

Question
What is the most concerning adverse effect of dihyrdropyridine (amlodipine, felodipine, nifedipine
Answer
  • Peripheral edema
  • Lightheadedness
  • Flushing

Question 23

Question
What are potential adverse effects of Dihydropyridines
Answer
  • Constipation
  • Bradycardia
  • Peripheral edema
  • Lightheadness
  • Flushing
  • Headache

Question 24

Question
What are potential adverse effects of non-dihydropyridines
Answer
  • Bradycardia
  • Constipation
  • Peripheral edema
  • Headache
  • Lightheadedness
  • Flushing

Question 25

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

Question 26

Question
MOA for nitrate used for stable angina is
Answer
  • 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

Question 27

Question
Select the cardioselective beta blockers
Answer
  • Atenolol
  • Metoprolol
  • Propranolol

Question 28

Question
Select the non-cardioselective beta blockers
Answer
  • Meoprolol
  • Atenolol
  • Propranolol

Question 29

Question
Nitrates are used as
Answer
  • First‐line therapy for the treatment of acute anginal
  • Prophylactically for activities known to elicit angina
  • Ongoing management of stable angina

Question 30

Question
Usually in the form of a sublingual preparation, nitrates onset of action is within [blank_start]2‐5 minutes[blank_end] and duration of action [blank_start]15‐30 minutes[blank_end]
Answer
  • 2‐5 minutes
  • 5 - 10 minutes
  • 1 - 2 minutes
  • 15 ‐ 30 minutes
  • 5 - 10 minutes
  • 10 - 20 minutes
  • 15 - 20 minutes

Question 31

Question
Select the potential adverse effects of nitrates
Answer
  • Hypotension
  • Flushing
  • Bradycardia
  • Headache
  • N/V/D
  • LIghtheadedness

Question 32

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

Question 33

Question
Nitroglycerin tablets are both [blank_start]heat[blank_end] and [blank_start]light[blank_end] sensitive
Answer
  • heat
  • light

Question 34

Question
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
Answer
  • True
  • False

Question 35

Question
The following are longer-acting nitrate therapies
Answer
  • Nitroglycerin table
  • Isosorbide dinitrate
  • Isosorbide mononitrate
  • Transdermal nitroglycerin patch

Question 36

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

Question 37

Question
What is a REALLY IMPORTANT nitrate contraindication drug
Answer
  • 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

Question 38

Question
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
Answer
  • Pre-existing QT interval
  • Hepatic disease
  • Renal disease
  • Tachycardia

Question 39

Question
The following are angina PREVENTIVE therapies
Answer
  • ASA
  • Clopidogrel (Plavix) if allergic to aspirin
  • Verapamil if allergic to aspirin
  • Propranolol if allergic to aspiring
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