30 Questions
What is the bioavailability of Isosorbide Mononitrate?
100%
What is the main side effect of Amyl nitrate?
Orthostatic hypotension
What is the way to avoid tolerance to nitrates?
Provision of daily nitrate-free period
What is the action of Nicorandil?
Vasodilator with K+ channel-opening action
What is the indication of nitrates in hypertensive emergencies?
Hypertensive emergencies
What is the contraindication of nitrates in patients taking?
Sildenafil
What is the primary cause of angina pectoris?
Coronary atheroma
Which of the following factors affects myocardial oxygen demand?
Heart rate
What is the mechanism of action of organic nitrates in angina treatment?
Releasing free nitrite ion to activate guanylyl cyclase
Which type of angina is associated with coronary artery spasm?
Angiospastic or variant angina
What is the primary treatment for unstable angina?
Anticoagulants plus the three groups of drugs
What is the name of the prototype of organic nitrates?
Nitroglycerin
What is the effect of high capacity organic nitrate reductase in the liver on the oral bioavailability of traditional oral organic nitrates?
It decreases the oral bioavailability
Why is the sublingual route preferred for achieving therapeutic blood levels of organic nitrates?
It avoids the first pass effect in the liver
What is the primary route of excretion of organic nitrate metabolites?
Kidney
What is the duration of action of sublingual nitroglycerin?
10-30 minutes
Which of the following is NOT a preparation of nitroglycerin?
Intravenous Injection
What is the primary use of isosorbide dinitrate?
Prophylaxis and maintenance therapy of angina
What is the primary mechanism of action of calcium channel blockers?
Noncompetitive blockade of voltage-activated L-type calcium channels
Which of the following calcium channel blockers has a greater ratio of vascular smooth muscle effects?
Dihydropyridines
What is the effect of calcium channel blockers on cardiac muscle?
Decreased contractility and sinus node rate
Which of the following is a pharmacokinetic characteristic of calcium channel blockers?
High first pass effect
What is the effect of calcium channel blockers on smooth muscle?
Long-standing relaxation
Which of the following calcium channel blockers can be administered by the i.v. route?
Verapamil and diltiazem
What is the effect of verapamil and diltiazem on AV conduction?
They decrease AV conduction
What is the primary mechanism by which Ca+ channel blockers reduce angina pectoris?
By reducing oxygen demand of the myocardium
What is the effect of nifedipine on cardiac conduction and heart rate?
It has no effect on cardiac conduction and heart rate
What is the benefit of using nifedipine with beta blockers in the treatment of angina?
It prevents reflex tachycardia
What is the effect of verapamil on heart rate and myocardial contractility?
It slows heart rate and reduces myocardial contractility
What is the primary effect of Ca+ channel blockers on arterioles?
They dilate arterioles
Test your understanding of angina pectoris, its causes, and the factors that influence myocardial oxygen demand. Learn about the role of coronary atheroma and how it affects myocardial function. Assess your knowledge of the determinants of myocardial oxygen demand, including heart rate, contractility, and wall tension.
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