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36 Cards in this Set
- Front
- Back
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"-olol"
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beta blockers (decrease oxygen demand)
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"-dipine"
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DHP calcium channel blockers (mainly act on peripheral blood vessels)
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Angina is pain due to ______ .
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ischemia of nerves innervating organ
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characteristic sudden, severe, pressing chest pain radiating to neck, jaw, back and arms
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angina pectoris
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Which of the following can angina NOT occur in?
a. heart b. abdominal organs c. brain d. extremities (skeletal muscles) |
C. nerves in brain are NOT innervated
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The most common type of angina is:
a. stable angina b. unstable angina c. prinzmetal angina d. none of the above |
A.
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Nitroglycerin is useful for:
a. stable angina b. unstable angina c. prinzmetal angina d. A and C |
D.
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Plaque has ruptured within:
a. stable angina b. unstable angina c. prinzmetal angina d. none of the above |
B.
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This type of angina responds to vasodilators such as NTG and CCB:
a. stable angina b. unstable angina c. prinzmetal angina d. none of the above |
C
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T or F. you should give NTG to a pt with unstable angina.
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F.
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Which of the following is NOT a hemodynamic change in angina?
a. acute LV failure b. increase in LV volume c. redistribution of blood flow from subendocardium to subepicardium d. decrease in sympathetic activity |
D. bc there's not enough blood that's being pumped, so more NOREPI is released.
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Which of the following will not help with angina:
a. decrease HR b. use NTG to divert blood to subendocardium c. increase collateral flow to ischemic areas with NTG d. increase preload to LV with venodilators |
D. you actually decrease LVEDP preload with venodilators bc there's less blood flow back from periphery
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Which of the following has a mechanism of activating myosin-LC phosphatase in order to dephosphorylate Myosin-LC and cause relaxation of vascular smooth muscle cells?
a. Nitric oxide b. CCBs c. cAMP agonists (ie. albuterol) d. A and C |
D.
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which is NOT a true mechanism of nitrates to cause relaxation and dilation of blood vessels?
a. increase NO b. increase cGMP c. decrease myosin phosphatase d. cause hyperpolarizaiton of cells by opening K channels |
C. they actually INCREASE myosin phosphatase
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Nitrates work more in the:
a. arteries b. veins c. both equally |
B. if you dilate veins, that's less blood in LV (less preload) and that reduces wall stress and less oxygen demand
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Who would NOT give beta-blockers to?
a. asthmatic patient b. pt with conduction problems c. pt with hypotension d. all the above |
D.
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Which of these CCBs do you want to decrease peripheral vascular resistance ONLY:
a. nifedipine b. diltiazem c. verapamil |
A.
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Which of these CCBs are useful if you want more of an effect on the heart (automaticity/decrease HR)
a. nifedipine b. diltiazem c. verapamil |
C.
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Which CCB will act equally on both the heart and blood vessels?
a. nifedipine b. diltiazem c. verapamil |
B.
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name the drug class that is contraindicated when giving a patient nitrates for angina.
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phosphodiesterase inhibitors (eg. sildenafil or Viagra)
If someone is on phosphodiesterase inhibitors and take nitrates at the same time, they will have too much vasodilation going on (so if someone is on Viagra, they can’t go onto nitrates) |
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Which is NOT commonly used nitrate:
a. nitroglycerin b. isosorbide dinitrate c. sodium nitroprusside d. none of the above |
D. they're all commonly used
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which of the following nitrates requires close monitoring because of potential cyanide poisoning?
a. nitroglycerin b. isosorbide dinitrate c. sodium nitroprusside d. none of the above |
C.
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in which of the following nitrates is the occurrence of nitrate tolerance not an issue?
a. nitroglycerin b. isosorbide dinitrate c. sodium nitroprusside d. none of the above |
C.
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which of the following is NOT a contraindication for NTG usage?
a. severe anemia b. constrictive pericarditis/pericardial tamponade c. chronic rheumatic disease d. acute MI |
C.
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Would you give NTG to a patient with hypotension? Why or why not?
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No bc NTG would further lower BP and pt may go into hypotensive shock.
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NTG causes which two paradoxical adverse conditions in the cardiovascular system?
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paradoxical angina
paradoxical hypertension |
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what 2 adverse conditions are caused by NTG in the CNS?
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headache and flushing
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name 3 hematological adverse effects of NTG
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hemodilution
methmoglobinemia (NO will bind to Hb, leading to this) prolonged bleeding time cyanide poisoning (with nitroprusside) |
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Which of the following is NOT a correct mechanism of beta blocker therapy?
a. decrease HR b. increase Norepinephrine release to increase sympathetic effect c. decrease renin/AGII to dilate blood vessels d. increase diastolic perfusion time |
B. beta blockers actually decrease NOREPI release to have a sympatholytic effect
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which of the following is NOT an example of an adverse effect by beta blockers?
a. bronchoconstriction due to beta-2 blockade b. tachycardia due to beta-1 blockade c. hypotension d. B and C |
B. beta blockers at on beta-1 and can give you bradycardia. so this is bad for patients with conduction problems.
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Which of the following is NOT a site of action by calcium channel blockers?
a. SA node b. AV node c. coronary blood vessels d. peripheral blood vessels e. none of the above |
E. CCBs work at all these sites!
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"-dil"
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potassium channel openers
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what is the main mechanisms of action and uses for K channel openers?
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open ATP-mediated K+ channels,
hyperpolarize cells and close Ca2+ channels in arterioles (to cause relaxation) used for severe/refractory hypertension (SECOND LINE DRUG DUE TO NUMEROUS SIDE EFFECTS) |
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name some SEs of K channel openers
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Flushing, headache, hypotension, reflex tachycardia
angina pain. Hirsutism (promotes hair growth) |
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hydrazyline is a:
a. direct arterial vasoconstrictor b. direct venous vasoconstrictor c. direct arterial vasodilator d. direct venous vasodilator |
C. hydralazine is a direct arterial vasodilator (also not a first line drug bc leads to reflex tachycardia).
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This drug is a endothelin antagonist and is useful for severe pulmonary HTN:
a. hydralazine b. nitroglycerin c. bosentan d. viagra |
C. endothelin is a peptide made by endothelial cells that constricts smooth muscle cells. therefore any antagonist is going to decrease the constriction of SMCs. bosentan has so many SEs that it's only used in hopsital settings.
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