Cardiovascular Pharmacology Quiz
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Questions and Answers

Which enzyme can react with nitrate to get converted into nitric oxide (NO)?

  • Nitrate reductase
  • Cytochrome oxidase (correct)
  • Nitric oxide synthase
  • Xanthine oxidase (correct)
  • What is the outcome of the conversion of nitric oxide (NO) in the body?

  • Decreased blood flow
  • Relaxation of smooth muscle (correct)
  • Formation of excessive cGMP
  • Increased platelet aggregation
  • What role does cGMP play in the cardiovascular system?

  • It relaxes smooth muscle (correct)
  • It promotes platelet aggregation
  • It inhibits the relaxation of blood vessels
  • It converts nitrate to nitric oxide
  • At high doses, what effect does nitric oxide (NO) have on platelet aggregation?

    <p>It inhibits platelet aggregation (D)</p> Signup and view all the answers

    In what form is nitric oxide (NO) converted in the body?

    <p>cGMP (D)</p> Signup and view all the answers

    What is the primary function of endothelin receptor antagonists?

    <p>To treat pulmonary hypertension (D)</p> Signup and view all the answers

    What class of medications do -sartans belong to, and what is their main action?

    <p>AT1 receptor antagonists; they decrease plasma volume (C)</p> Signup and view all the answers

    What is the mechanism of action of aliskiren?

    <p>It inhibits renin release (A)</p> Signup and view all the answers

    Which medication is classified as a carbonic anhydrase inhibitor?

    <p>Acetazolamide (B)</p> Signup and view all the answers

    How does amlodipine affect the cardiovascular system?

    <p>It decreases rate and force of contraction (C)</p> Signup and view all the answers

    What is the role of alirocumab in the treatment of hyperlipidemia?

    <p>It is a PCSK9 inhibitor (D)</p> Signup and view all the answers

    What does an increased vascular radius primarily result in?

    <p>Decreased blood pressure (B)</p> Signup and view all the answers

    What function do statins primarily serve in cardiovascular health?

    <p>They affect LDL cholesterol levels (C)</p> Signup and view all the answers

    Which of the following accurately describes amiloride?

    <p>It is a potassium-sparing diuretic (B)</p> Signup and view all the answers

    What is the method through which pril medications primarily work?

    <p>Inhibiting angiotensin II and aldosterone generation (D)</p> Signup and view all the answers

    What is angiotensin I converted to?

    <p>Angiotensin II (B)</p> Signup and view all the answers

    Which receptor does angiotensin II predominantly act on to induce vasoconstriction?

    <p>AT1 (D)</p> Signup and view all the answers

    What effect does angiotensin II have on the adrenal gland?

    <p>It stimulates aldosterone release. (A)</p> Signup and view all the answers

    What happens when aldosterone acts on its receptors?

    <p>It promotes sodium and water reabsorption. (A)</p> Signup and view all the answers

    At high doses, dopamine primarily acts on which receptors to induce vasoconstriction?

    <p>Alpha and beta receptors (D)</p> Signup and view all the answers

    How does dopamine function at low doses?

    <p>Induces cAMP release (C)</p> Signup and view all the answers

    What is the role of high potency nitrates at low doses?

    <p>They are bioactivated by aldehyde dehydrogenase in mitochondria. (D)</p> Signup and view all the answers

    What effect does angiotensin II have on blood pressure?

    <p>It raises blood pressure. (A)</p> Signup and view all the answers

    What does the stimulation of MR receptors by aldosterone promote?

    <p>Sodium reabsorption (B)</p> Signup and view all the answers

    Which effect is NOT associated with angiotensin II?

    <p>Vasodilation (A)</p> Signup and view all the answers

    What is the primary mechanism of action for high potency nitrates at low doses?

    <p>Bioactivation by aldehyde dehydrogenase (B)</p> Signup and view all the answers

    At moderate doses of dopamine, which receptor is primarily affected to increase cardiac contractility?

    <p>Beta 1 receptors (D)</p> Signup and view all the answers

    What does NO get converted into that helps in relaxing smooth muscle?

    <p>cGMP (B)</p> Signup and view all the answers

    What happens to high potency nitrates at high doses?

    <p>They are bioactivated by cytochrome P450 (D)</p> Signup and view all the answers

    Which of the following enzymes are involved in the conversion of nitrates to NO?

    <p>Aldehyde dehydrogenase (B), Xanthine oxidase (D)</p> Signup and view all the answers

    What is the effect of cGMP in the vascular system?

    <p>Relaxation of smooth muscle (B)</p> Signup and view all the answers

    What role does the mitochondria play in the bioactivation of nitrates?

    <p>Environment for aldehyde dehydrogenase (A)</p> Signup and view all the answers

    What is one of the outcomes of nitric oxide in the cardiovascular system?

    <p>Prevention of platelet aggregation (B)</p> Signup and view all the answers

    What type of drug is Atenolol classified as?

    <p>Cardioselective beta blocker (B)</p> Signup and view all the answers

    Which process converts nitrates into their active form in the body?

    <p>Bioactivation through enzymatic reactions (C)</p> Signup and view all the answers

    What is the role of bempedoic acid in the body?

    <p>It inhibits ATP citrate lyase. (B)</p> Signup and view all the answers

    What effect do beta blockers have on contraction?

    <p>They decrease the rate and force of contraction. (A)</p> Signup and view all the answers

    How do bile acid binding resins affect LDL uptake?

    <p>They increase LDL uptake due to complex formation. (D)</p> Signup and view all the answers

    Where is carbonic anhydrase type II primarily located?

    <p>In the cytoplasm. (C)</p> Signup and view all the answers

    What does the action of carbonic anhydrase inhibitors prevent?

    <p>Formation of H2CO3. (A)</p> Signup and view all the answers

    What is the recommended action regarding beta blockers for patients with myocardial conduction defects?

    <p>They should be avoided. (A)</p> Signup and view all the answers

    What happens to LDL levels when bile acid binding resins are used?

    <p>LDL levels decrease. (B)</p> Signup and view all the answers

    Which type of carbonic anhydrase is specifically mentioned as being present in the luminal brush border?

    <p>Type IV. (B)</p> Signup and view all the answers

    What is a consequence of bumetanide usage as a loop diuretic?

    <p>Increased excretion of sodium and chloride. (A)</p> Signup and view all the answers

    What effect do carbonic anhydrase inhibitors have on CO2 levels?

    <p>They increase CO2 levels in the blood. (B)</p> Signup and view all the answers

    What effect does carvedilol have on patients with decompensated heart failure?

    <p>It is contraindicated. (A)</p> Signup and view all the answers

    Which drug is classified as a bile acid binding resin?

    <p>Cholestyramine (B)</p> Signup and view all the answers

    What mechanism does clonidine utilize to treat hypertension?

    <p>Decreases heart rate and relaxes blood vessels. (B)</p> Signup and view all the answers

    What is a common drug interaction for gemfibrozil?

    <p>Increases the risk of myopathy with statins. (B)</p> Signup and view all the answers

    How does empagliflozin function as an SGLT2 inhibitor?

    <p>It increases glucose excretion in urine. (B)</p> Signup and view all the answers

    Which drug acts as a loop diuretic?

    <p>Furosemide (B)</p> Signup and view all the answers

    Which drug is designed to inhibit cholesterol absorption?

    <p>Ezetimibe (A)</p> Signup and view all the answers

    What role do bile acid binding resins play in cholesterol management?

    <p>They bind bile acids and reduce reabsorption. (B)</p> Signup and view all the answers

    What is the primary action of guanadrel?

    <p>It acts as a norepinephrine (NE) replacement. (C)</p> Signup and view all the answers

    Which of the following statements about furosemide is true?

    <p>It is a loop diuretic that increases urine output. (D)</p> Signup and view all the answers

    What is the mechanism of action for diltiazem?

    <p>It is a calcium channel blocker that relaxes blood vessels. (D)</p> Signup and view all the answers

    Which drug is a direct vasodilator?

    <p>Clevidipine (A)</p> Signup and view all the answers

    Which of the following is a primary action of fenofibrate?

    <p>It promotes the breakdown of triglycerides. (A)</p> Signup and view all the answers

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    Flashcards

    What are endothelin receptor antagonists used to treat?

    Endothelin receptor antagonists are used to treat pulmonary hypertension by blocking the effects of endothelin, a potent vasoconstrictor.

    How do angiotensin II receptor blockers (ARBs) affect blood pressure?

    Angiotensin II receptor blockers (ARBs) like sartans inhibit the AT1 receptor, reducing blood pressure by decreasing plasma volume.

    What do statins do to lower cholesterol?

    Statins are HMG-CoA reductase inhibitors, responsible for lowering cholesterol levels by inhibiting an enzyme in the cholesterol synthesis pathway.

    What does acetazolamide target?',

    Acetazolamide is a carbonic anhydrase inhibitor that reduces fluid buildup by interfering with its production.

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    What is alirocumab and what does it do?

    Alirocumab is a PCSK9 inhibitor that helps reduce LDL cholesterol levels by increasing the number of LDL receptors on liver cells.

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    How does aliskiren affect blood pressure?

    Aliskiren is a renin release inhibitor, used to lower blood pressure by preventing the production of angiotensin.

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    What is amiloride and how does it affect blood pressure?

    Amiloride is an ENaC inhibiting potassium-sparing diuretic, removing sodium while conserving potassium to lower blood pressure.

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    How does amlodipine affect the heart and blood vessels?

    Amlodipine is a vascular L-type calcium channel blocker, decreasing heart rate and force, relaxing blood vessels, and lowering blood pressure.

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    What is the role of angiotensinogen in blood pressure regulation?

    Angiotensinogen, a precursor protein, is converted to angiotensin I, and then angiotensin II, a potent vasoconstrictor, increasing blood pressure.

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    How does vascular radius affect blood pressure?

    A smaller vascular radius leads to increased resistance and higher blood pressure, making it harder for blood to flow.

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    Angiotensin II formation

    Angiotensin I is converted to angiotensin II by angiotensin-converting enzyme (ACE).

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    Nitric Oxide (NO)

    Nitric oxide (NO) is a signaling molecule produced in the body. It helps regulate blood pressure, blood flow, and inflammation.

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    Angiotensin II's effect on blood vessels

    Angiotensin II binds to angiotensin type 1 (AT1) receptors on blood vessels, leading to vasoconstriction.

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    Nitric oxide Synthesis

    Nitric oxide (NO) is produced from the conversion of L-arginine by the enzyme nitric oxide synthase (NOS).

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    Angiotensin II's effect on aldosterone

    Angiotensin II acts on the adrenal gland to stimulate the release of aldosterone.

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    Nitric Oxide and Vasodilation

    Nitric oxide (NO) is a key signaling molecule that promotes vasodilation. It relaxes smooth muscles in blood vessels, leading to increased blood flow.

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    Nitric Oxide and Platelet Aggregation

    NO helps prevent platelet aggregation by relaxing blood vessels and inhibiting the activation of platelets.

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    Aldosterone's action

    Aldosterone binds to mineralocorticoid receptors (MR) in the kidneys, promoting sodium and water reabsorption.

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    What determines arterial pressure?

    The main factors determining arterial pressure are cardiac output, the amount of blood pumped by the heart, and peripheral resistance, the resistance to blood flow in the blood vessels.

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    cGMP and NO Signaling

    The conversion to cGMP is a key step in the NO signaling pathway.

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    Dopamine's high-dose effect

    At high doses (above 10 micrograms), dopamine acts on alpha and beta receptors, inducing vasoconstriction.

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    Dopamine's low-dose effect

    At low doses (below 2 micrograms), dopamine acts on D2 receptors, promoting vasorelaxation and inhibiting norepinephrine release.

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    Nitrates' bioactivation

    High potency nitrates are bioactivated by aldehyde dehydrogenase in the mitochondria.

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    High potency nitrates' effect

    High potency nitrates are converted to active metabolites that cause vasodilation.

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    What does Bempedoic acid inhibit?

    Bempedoic acid, a lipid-lowering medication, inhibits the enzyme ATP citrate lyase, preventing the formation of malonyl-CoA, which is a key building block in cholesterol synthesis.

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    How do beta blockers affect the heart?

    Beta blockers, used to manage high blood pressure, lower heart rate and force of contraction by blocking beta-adrenergic receptors, ultimately reducing myocardial oxygen demand and preventing HTN-induced damage.

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    How do bile acid binding resins lower cholesterol?

    Bile acid binding resins work by binding to bile acids in the gut, preventing their reabsorption and increasing fecal excretion, causing a compensatory increase in LDL uptake by the liver.

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    What's the mechanism of action of Bumetanide?

    Bumetanide, a loop diuretic, inhibits the Na+/K+/2Cl- cotransporter in the ascending limb of the loop of Henle, increasing sodium and water excretion.

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    How do carbonic anhydrase inhibitors work?

    Carbonic anhydrase inhibitors like acetazolamide work by preventing the enzyme carbonic anhydrase from converting carbon dioxide and water into bicarbonate and hydrogen ions, leading to decreased fluid formation.

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    What type of blocker is Carvedilol?

    Carvedilol, a nonselective alpha and beta blocker, works by blocking both alpha and beta receptors, leading to vasodilation (relaxation of blood vessels) and reduced heart rate and force of contraction.

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    Where is carbonic anhydrase type II located?

    The enzyme carbonic anhydrase type II is found in the cytoplasm of various tissues, and plays a role in the production of bicarbonate.

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    Where is carbonic anhydrase type IV found?

    Carbonic anhydrase type IV is specifically present in the luminal brush border and basolateral membrane of the kidney, playing a crucial role in kidney function.

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    How does the drug activate at high doses?

    At high doses, the drug activates through a specific enzyme called CYP450 in the endoplasmic reticulum of cells.

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    Why should beta blockers be avoided in patients with myocardial conduction defects?

    Beta blockers should be avoided in patients with myocardial conduction defects due to their potential to worsen these conditions by slowing the heart rate and conduction.

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    Nitrate Activation at High Doses

    At high doses, the activation of nitrates occurs via the enzyme CYP450 in the endoplasmic reticulum (ER).

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    Nitrate Bioactivation at Low Doses

    At low doses, high-potency nitrates are activated by aldehyde dehydrogenase in the mitochondria.

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    Nitrate Conversion to Nitric Oxide

    The active form of nitrates reacts with either mitochondrial cytochrome oxidase or xanthine oxidase, leading to the formation of nitric oxide (NO).

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    NO Conversion to cGMP and its Effects

    Nitric oxide (NO) is converted into cyclic guanosine monophosphate (cGMP), which relaxes smooth muscles in blood vessels and prevents platelet aggregation.

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    Dopamine's Effect on Cardiac Contractility

    At moderate doses (2-5 micrograms), dopamine acts on beta1 receptors, increasing cardiac contractility.

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    Atenolol's Mechanism of Action

    Atenolol is a cardioselective beta blocker, meaning it specifically blocks beta1 receptors.

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    Renin Inhibitors and Blood Pressure

    Inhibiting the release of renin lowers blood pressure by preventing the formation of angiotensin II, a powerful vasoconstrictor.

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    Angiotensin II Receptor Blockers (ARBs)

    Angiotensin II receptor blockers (ARBs) inhibit the AT1 receptor, leading to a decrease in plasma volume and lower blood pressure.

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    Statins and Cholesterol Reduction

    Statins, by inhibiting HMG-CoA reductase, decrease cholesterol levels.

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    Alirocumab: a PCSK9 Inhibitor

    Alirocumab is a PCSK9 inhibitor, working by increasing the number of LDL receptors on liver cells, leading to lower LDL cholesterol levels.

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    What is dichlorphenamide?

    A carbonic anhydrase inhibitor that reduces fluid buildup by interfering with its production.

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    What is chlorthalidone?

    A thiazide diuretic, it increases urinary output by increasing sodium and water excretion.

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    What is clevidipine?

    An ultra short-acting L-type calcium channel blocker.

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    What is cholestyramine?

    A bile acid binding resin, it binds to bile acids in the intestines, preventing their reabsorption and reducing cholesterol levels.

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    What is furosemide?

    A loop diuretic, it blocks the reabsorption of sodium and chloride in the loop of Henle.

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    What is fenofibrate?

    A fibric acid derivative, it promotes lipid reduction by activating PPAR-a.

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    What is colesevalam?

    A bile acid binding resin, it binds to bile acids in the intestines, preventing their reabsorption.

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    What is ethacrynic acid?

    A loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle.

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    What is diltiazem?

    A cardioselective alpha-1 subunit L-type calcium channel blocker that decreases the rate and force of cardiac contraction.

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    What is dapagliflozin?

    An SGLT2 inhibitor, it works in the kidney by blocking the reabsorption of glucose into the bloodstream.

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    What is losartan?

    An angiotensin II receptor blocker (ARB), it blocks the binding of angiotensin II to its receptors in the body.

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    What is conivaptan?

    A V1a/V2 antagonist, it blocks the effects of vasopressin, a hormone that regulates blood pressure.

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    What is clonidine?

    An alpha 2 agonist, it reduces blood pressure by constricting smooth muscle and decreasing heart rate.

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    What is evolocumab?

    A PCSK9 inhibitor, it helps reduce LDL cholesterol levels by increasing the number of LDL receptors on liver cells.

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    What is ezetimibe?

    A cholesterol absorption inhibitor that works in the intestinal lumen, blocking NPC1L1 to reduce chylomicron synthesis and promote LDL receptor generation.

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