Pharmacology(5) Hypertension, Angina And Heart Failure
- 1.
Stable angina is characterized by
- A.
Attacks which occur at rest
- B.
Is relieved by glyceryl trinitrate
- C.
Is often a prelude to myocardial infarction
- D.
Attacks that occur with increasing frequency and intensity
- E.
Attacks that occur on less and less exertion
Correct Answer
B. Is relieved by glyceryl trinitrateExplanation
Stable angina is a type of chest pain that occurs when the heart muscle doesn't receive enough blood and oxygen. It is typically triggered by physical exertion or emotional stress. The fact that it is relieved by glyceryl trinitrate (also known as nitroglycerin) is a key characteristic of stable angina. Glyceryl trinitrate helps to relax and widen the blood vessels, improving blood flow to the heart and relieving the chest pain. This medication is commonly prescribed to people with stable angina to alleviate their symptoms and prevent further complications.Rate this question:
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- 2.
Besides atheroma other factors which can contribute to cardiac ischemia are:
- A.
White thrombus (platelet/fibrinogen/fibrin aggregates)
- B.
Spasm of the smooth muscle of the coronary arteries
- C.
A presence of endothelium-derived vasodilators
- D.
Smoking
- E.
A relative deficiency of endothelium-derived vasodilators
Correct Answer(s)
A. White thrombus (platelet/fibrinogen/fibrin aggregates)
B. Spasm of the smooth muscle of the coronary arteries
D. Smoking
E. A relative deficiency of endothelium-derived vasodilatorsExplanation
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.Rate this question:
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- 3.
Patients with unstable angina:
- A.
Need not stop smoking
- B.
Require urgent antiplatelet therapy
- C.
If treated with glyceryl trinitrate then a constant i.v. infusion should be used
- D.
Pain should be easily relieved by glyceryl trinitrate sublingually
- E.
Are treated by i.v. heparin and beta-blockers
Correct Answer(s)
B. Require urgent antiplatelet therapy
C. If treated with glyceryl trinitrate then a constant i.v. infusion should be used
E. Are treated by i.v. heparin and beta-blockersExplanation
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.Rate this question:
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- 4.
Glyceryl trinitrate (nitroglycerin) A. is used for..B. is
- A.
A... acute prophylaxis
- B.
A... longer prophylaxis
- C.
B... volatile
- D.
B... not volatile
- E.
B... to be stored in a cool place in a tightly capped dark container
Correct Answer(s)
A. A... acute prophylaxis
B. A... longer prophylaxis
C. B... volatile
E. B... to be stored in a cool place in a tightly capped dark container -
- 5.
For acute prophylaxis glyceryl trinitrate can be administered
- A.
Orally
- B.
Sublingually
- C.
Transdermally
- D.
In a spray
- E.
Immediately before undertaking strenuous activity
Correct Answer(s)
B. Sublingually
D. In a spray
E. Immediately before undertaking strenuous activityExplanation
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.Rate this question:
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- 6.
Stable angina is managed using:
- A.
Glyceryl trinitrate for pain relief
- B.
Acute prophylaxis by sublingual buccal administration of organic nitrates
- C.
Longer prophylaxis by oral organic nitrates
- D.
Beta-adrenoceptor blockers
- E.
Calcium channel blockers
Correct Answer(s)
A. Glyceryl trinitrate for pain relief
B. Acute prophylaxis by sublingual buccal administration of organic nitrates
C. Longer prophylaxis by oral organic nitrates
D. Beta-adrenoceptor blockers
E. Calcium channel blockersExplanation
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.Rate this question:
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- 7.
After organic nitrates administration:
- A.
Nitric oxide is generated
- B.
The vascular smooth muscle is contracted
- C.
Platelet function is inhibited
- D.
Chest pain is relieved
- E.
Non-vascular smooth muscles are not influenced
Correct Answer(s)
A. Nitric oxide is generated
C. Platelet function is inhibited
D. Chest pain is relievedExplanation
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.Rate this question:
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- 8.
Organic nitrates A. are selective for... B. can...
- A.
A...arteriolar rather than venous smooth muscle
- B.
A...venous rather than arteriolar smooth muscle
- C.
B...reduce cardiac preload
- D.
B...increase cardiac work and oxygen demand
- E.
B...improve coronary blood flow
Correct Answer(s)
B. A...venous rather than arteriolar smooth muscle
C. B...reduce cardiac preload
E. B...improve coronary blood flowExplanation
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.Rate this question:
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- 9.
Tolerance to organic nitrates A. is... B. can be avoided
- A.
A...loss of efficacy of the drugs
- B.
A...due to exhaustion of sulfydryl-containing intermediary
- C.
A...a long-term event
- D.
B...by intermittent dosage
- E.
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
B. A...due to exhaustion of sulfydryl-containing intermediary
D. B...by intermittent dosage
E. B...by omitting the evening dose in patients who do not experience angina at nightExplanation
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.Rate this question:
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- 10.
Nitrovasodilators A. provide NO... B.can be active...
- A.
A...as an endothelium-derived relaxing factor
- B.
A...in an endothelium-independent manner
- C.
B...only if endothelial function is normal
- D.
B...also if endothelial function is severely impaired
- E.
B...in many patients with coronary artery disease
Correct Answer(s)
B. A...in an endothelium-independent manner
D. B...also if endothelial function is severely impaired
E. B...in many patients with coronary artery diseaseExplanation
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.Rate this question:
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- 11.
Systemic bioavailability of glyceryl trinitrate from the gut
- A.
Is determined by presystemic drug biotransformation
- B.
Is higher as opposed to that from the sublingual space
- C.
Is higher as opposed to that from the buccal mucosa
- D.
Is useful for minimizing adverse effects of the sublingual tablets if they are swallowed
- E.
Can be influenced by molecule modification
Correct Answer(s)
A. Is determined by presystemic drug biotransformation
D. Is useful for minimizing adverse effects of the sublingual tablets if they are swallowed
E. Can be influenced by molecule modificationExplanation
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.Rate this question:
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