Pharmacology(5) Hypertension, Angina And Heart Failure

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  • 1/11 Questions

    Stable angina is characterized by

    • Attacks which occur at rest
    • Is relieved by glyceryl trinitrate
    • Is often a prelude to myocardial infarction
    • Attacks that occur with increasing frequency and intensity
    • Attacks that occur on less and less exertion
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Heart Failure Quizzes & Trivia
About This Quiz

This quiz titled 'Pharmacology(5) Hypertension, Angina and heart failure' assesses knowledge on managing stable angina, factors contributing to cardiac ischemia, and urgent therapies for unstable angina using glyceryl trinitrate. It's crucial for healthcare professionals focusing on cardiovascular treatments.

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  • 2. 

    Besides atheroma other factors which can contribute to cardiac ischemia are:

    • White thrombus (platelet/fibrinogen/fibrin aggregates)

    • Spasm of the smooth muscle of the coronary arteries

    • A presence of endothelium-derived vasodilators

    • Smoking

    • A relative deficiency of endothelium-derived vasodilators

    Correct Answer(s)
    A. White thrombus (platelet/fibrinogen/fibrin aggregates)
    A. Spasm of the smooth muscle of the coronary arteries
    A. Smoking
    A. A relative deficiency of endothelium-derived vasodilators
    Explanation
    The correct answer includes several factors that can contribute to cardiac ischemia. White thrombus, which consists of platelet/fibrinogen/fibrin aggregates, can block the coronary arteries and restrict blood flow to the heart. Spasm of the smooth muscle of the coronary arteries can also narrow the blood vessels and reduce blood flow. Smoking is known to damage the endothelium and promote atherosclerosis, leading to reduced vasodilation and increased risk of ischemia. Additionally, a relative deficiency of endothelium-derived vasodilators can further impair blood flow regulation and contribute to cardiac ischemia.

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  • 3. 

    Patients with unstable angina:

    • Need not stop smoking

    • Require urgent antiplatelet therapy

    • If treated with glyceryl trinitrate then a constant i.v. infusion should be used

    • Pain should be easily relieved by glyceryl trinitrate sublingually

    • Are treated by i.v. heparin and beta-blockers

    Correct Answer(s)
    A. Require urgent antiplatelet therapy
    A. If treated with glyceryl trinitrate then a constant i.v. infusion should be used
    A. Are treated by i.v. heparin and beta-blockers
    Explanation
    Patients with unstable angina require urgent antiplatelet therapy to prevent further clot formation and reduce the risk of heart attack or stroke. If treated with glyceryl trinitrate, a constant intravenous infusion should be used to maintain a steady level of the medication and provide continuous relief of symptoms. They are also treated with intravenous heparin to prevent blood clot formation and beta-blockers to reduce heart rate and blood pressure. Stopping smoking is always recommended for patients with any form of cardiovascular disease, including unstable angina.

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  • 4. 

    Glyceryl trinitrate (nitroglycerin) A. is used for..B. is

    • A... acute prophylaxis

    • A... longer prophylaxis

    • B... volatile

    • B... not volatile

    • B... to be stored in a cool place in a tightly capped dark container

    Correct Answer(s)
    A. A... acute prophylaxis
    A. A... longer prophylaxis
    A. B... volatile
    A. B... to be stored in a cool place in a tightly capped dark container
  • 5. 

    For acute prophylaxis glyceryl trinitrate can be administered

    • Orally

    • Sublingually

    • Transdermally

    • In a spray

    • Immediately before undertaking strenuous activity

    Correct Answer(s)
    A. Sublingually
    A. In a spray
    A. Immediately before undertaking strenuous activity
    Explanation
    Glyceryl trinitrate is commonly used for acute prophylaxis, which means it is used to prevent the occurrence of certain medical conditions. In this case, it is administered sublingually, which means it is placed under the tongue for absorption into the bloodstream. It can also be administered in a spray form, which allows for easy and quick absorption. The medication should be taken immediately before undertaking strenuous activity, as it helps to relax and widen blood vessels, reducing the risk of certain conditions like angina or heart attack during physical exertion.

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  • 6. 

    Stable angina is managed using:

    • Glyceryl trinitrate for pain relief

    • Acute prophylaxis by sublingual buccal administration of organic nitrates

    • Longer prophylaxis by oral organic nitrates

    • Beta-adrenoceptor blockers

    • Calcium channel blockers

    Correct Answer(s)
    A. Glyceryl trinitrate for pain relief
    A. Acute prophylaxis by sublingual buccal administration of organic nitrates
    A. Longer prophylaxis by oral organic nitrates
    A. Beta-adrenoceptor blockers
    A. Calcium channel blockers
    Explanation
    Stable angina is a condition characterized by chest pain or discomfort that occurs when the heart muscle doesn't receive enough blood and oxygen. The management of stable angina involves various approaches. Glyceryl trinitrate is used for pain relief as it helps to relax and widen the blood vessels, improving blood flow to the heart. Acute prophylaxis is achieved by using organic nitrates administered sublingually or buccally, which quickly relieve symptoms by dilating the blood vessels. Longer prophylaxis is achieved by taking oral organic nitrates, which help prevent angina attacks over a longer period of time. Beta-adrenoceptor blockers are also used as they reduce the heart's workload and oxygen demand. Calcium channel blockers are another option as they relax and widen the blood vessels, improving blood flow and reducing chest pain.

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  • 7. 

    After organic nitrates administration:

    • Nitric oxide is generated

    • The vascular smooth muscle is contracted

    • Platelet function is inhibited

    • Chest pain is relieved

    • Non-vascular smooth muscles are not influenced

    Correct Answer(s)
    A. Nitric oxide is generated
    A. Platelet function is inhibited
    A. Chest pain is relieved
    Explanation
    After organic nitrates administration, nitric oxide is generated, which leads to the relaxation and dilation of blood vessels. This helps in relieving chest pain by improving blood flow to the heart. Additionally, organic nitrates inhibit platelet function, preventing the formation of blood clots. However, organic nitrates do not have a direct effect on non-vascular smooth muscles.

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  • 8. 

    Organic nitrates A. are selective for... B. can...

    • A...arteriolar rather than venous smooth muscle

    • A...venous rather than arteriolar smooth muscle

    • B...reduce cardiac preload

    • B...increase cardiac work and oxygen demand

    • B...improve coronary blood flow

    Correct Answer(s)
    A. A...venous rather than arteriolar smooth muscle
    A. B...reduce cardiac preload
    A. B...improve coronary blood flow
    Explanation
    Organic nitrates are substances that are selective for venous rather than arteriolar smooth muscle. This means that they primarily affect the veins, causing them to dilate and reduce the amount of blood returning to the heart (cardiac preload). By reducing preload, organic nitrates decrease the workload on the heart and improve coronary blood flow. These effects can be beneficial in conditions such as angina, where there is a reduced blood supply to the heart muscle. However, organic nitrates do not have a significant effect on arteriolar smooth muscle, which is responsible for regulating blood flow to various organs and tissues.

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  • 9. 

    Tolerance to organic nitrates A. is... B. can be avoided

    • A...loss of efficacy of the drugs

    • A...due to exhaustion of sulfydryl-containing intermediary

    • A...a long-term event

    • B...by intermittent dosage

    • B...by omitting the evening dose in patients who do not experience angina at night

    Correct Answer(s)
    A. A...loss of efficacy of the drugs
    A. A...due to exhaustion of sulfydryl-containing intermediary
    A. B...by intermittent dosage
    A. B...by omitting the evening dose in patients who do not experience angina at night
    Explanation
    Tolerance to organic nitrates refers to a decrease in the effectiveness of the drugs over time. This loss of efficacy is believed to occur due to the exhaustion of sulfydryl-containing intermediary, which is a long-term event. To counteract this tolerance, intermittent dosage can be used, where the drug is not taken continuously but rather in a scheduled manner. Additionally, in patients who do not experience angina at night, the evening dose can be omitted to further prevent tolerance.

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  • 10. 

    Nitrovasodilators A. provide NO... B.can be active...

    • A...as an endothelium-derived relaxing factor

    • A...in an endothelium-independent manner

    • B...only if endothelial function is normal

    • B...also if endothelial function is severely impaired

    • B...in many patients with coronary artery disease

    Correct Answer(s)
    A. A...in an endothelium-independent manner
    A. B...also if endothelial function is severely impaired
    A. B...in many patients with coronary artery disease
    Explanation
    Nitrovasodilators provide nitric oxide (NO) in an endothelium-independent manner, meaning they can relax blood vessels even if endothelial function is impaired. This makes them effective in many patients with coronary artery disease, where endothelial function may be compromised.

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  • 11. 

    Systemic bioavailability of glyceryl trinitrate from the gut

    • Is determined by presystemic drug biotransformation

    • Is higher as opposed to that from the sublingual space

    • Is higher as opposed to that from the buccal mucosa

    • Is useful for minimizing adverse effects of the sublingual tablets if they are swallowed

    • Can be influenced by molecule modification

    Correct Answer(s)
    A. Is determined by presystemic drug biotransformation
    A. Is useful for minimizing adverse effects of the sublingual tablets if they are swallowed
    A. Can be influenced by molecule modification
    Explanation
    The systemic bioavailability of glyceryl trinitrate from the gut is determined by presystemic drug biotransformation, which means that the drug undergoes biotransformation before reaching the systemic circulation. This process can affect the amount of drug that is available for absorption and distribution in the body. Additionally, the systemic bioavailability of glyceryl trinitrate can be influenced by molecule modification, which refers to changes made to the chemical structure of the drug. Lastly, it is useful for minimizing adverse effects of the sublingual tablets if they are swallowed, suggesting that swallowing the tablets can help reduce potential side effects.

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Quiz Review Timeline (Updated): Mar 22, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 01, 2015
    Quiz Created by
    Ferna

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