Angina Pectoris: Causes and Determinants of Myocardial Oxygen Demand

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What is the bioavailability of Isosorbide Mononitrate?

100% (correct)
50%
75%
80%

What is the main side effect of Amyl nitrate?

Orthostatic hypotension (correct)
Orthostatic hypertension
Tachycardia
Throbbing headache

What is the way to avoid tolerance to nitrates?

Use of Nicorandil
Continuous i.v infusions
Provision of daily nitrate-free period (correct)
Use of isosorbide dinitrate

What is the action of Nicorandil?

Vasodilator with K+ channel-opening action (A) Signup and view all the answers

What is the indication of nitrates in hypertensive emergencies?

Hypertensive emergencies (B) Signup and view all the answers

What is the contraindication of nitrates in patients taking?

Sildenafil (A) Signup and view all the answers

What is the primary cause of angina pectoris?

Coronary atheroma (C) Signup and view all the answers

Which of the following factors affects myocardial oxygen demand?

Heart rate (B) Signup and view all the answers

What is the mechanism of action of organic nitrates in angina treatment?

Releasing free nitrite ion to activate guanylyl cyclase (B) Signup and view all the answers

Which type of angina is associated with coronary artery spasm?

Angiospastic or variant angina (C) Signup and view all the answers

What is the primary treatment for unstable angina?

Anticoagulants plus the three groups of drugs (A) Signup and view all the answers

What is the name of the prototype of organic nitrates?

Nitroglycerin (C) Signup and view all the answers

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 (C) Signup and view all the answers

Why is the sublingual route preferred for achieving therapeutic blood levels of organic nitrates?

It avoids the first pass effect in the liver (B) Signup and view all the answers

What is the primary route of excretion of organic nitrate metabolites?

Kidney (D) Signup and view all the answers

What is the duration of action of sublingual nitroglycerin?

10-30 minutes (D) Signup and view all the answers

Which of the following is NOT a preparation of nitroglycerin?

Intravenous Injection (B) Signup and view all the answers

What is the primary use of isosorbide dinitrate?

Prophylaxis and maintenance therapy of angina (A) Signup and view all the answers

What is the primary mechanism of action of calcium channel blockers?

Noncompetitive blockade of voltage-activated L-type calcium channels (B) Signup and view all the answers

Which of the following calcium channel blockers has a greater ratio of vascular smooth muscle effects?

Dihydropyridines (B) Signup and view all the answers

What is the effect of calcium channel blockers on cardiac muscle?

Decreased contractility and sinus node rate (D) Signup and view all the answers

Which of the following is a pharmacokinetic characteristic of calcium channel blockers?

High first pass effect (A) Signup and view all the answers

What is the effect of calcium channel blockers on smooth muscle?

Long-standing relaxation (A) Signup and view all the answers

Which of the following calcium channel blockers can be administered by the i.v. route?

Verapamil and diltiazem (B) Signup and view all the answers

What is the effect of verapamil and diltiazem on AV conduction?

They decrease AV conduction (D) Signup and view all the answers

What is the primary mechanism by which Ca+ channel blockers reduce angina pectoris?

By reducing oxygen demand of the myocardium (C) Signup and view all the answers

What is the effect of nifedipine on cardiac conduction and heart rate?

It has no effect on cardiac conduction and heart rate (D) Signup and view all the answers

What is the benefit of using nifedipine with beta blockers in the treatment of angina?

It prevents reflex tachycardia (C) Signup and view all the answers

What is the effect of verapamil on heart rate and myocardial contractility?

It slows heart rate and reduces myocardial contractility (C) Signup and view all the answers

What is the primary effect of Ca+ channel blockers on arterioles?

They dilate arterioles (D) Signup and view all the answers