Cardiovascular Pharmacology Quiz

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Questions and Answers

What can occur as a serious effect of acute withdrawal from beta blockers?

Reduced risk of myocardial infarction

Enhanced muscle contraction

Improved blood sugar levels

Increased blood pressure (correct)

Which of the following calcium channel blockers is categorized as a dihydropyridine?

Verapamil

Nicardipine

Amlodipine (correct)

Diltiazem

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

Increasing calcium influx into cells

Stimulating adrenaline release

Enhancing muscle contraction in the heart

Preventing calcium entry into heart and vascular smooth muscle cells (correct)

Which condition is most commonly associated with the use of calcium channel blockers?

Hypertension Signup and view all the answers

Which beta blocker has a secondary effect of delaying recovery from hypoglycemia in type 1 diabetes patients?

Propranolol Signup and view all the answers

What is the primary effect of Angiotensin II Receptor Blockers (ARBs) on the vascular system?

Block vasoconstriction Signup and view all the answers

For which condition are ARBs NOT typically indicated?

Pregnancy Signup and view all the answers

Which of the following adverse effects is less likely to occur with ARBs compared to ACE inhibitors?

Cough Signup and view all the answers

What is a known contraindication for the use of ARBs?

Kidney disease Signup and view all the answers

Which of the following statements is true regarding the mechanism of action of eplerenone?

It acts as a selective aldosterone blocker Signup and view all the answers

What beneficial hemodynamic effect is associated with ARBs?

Decreased systemic vascular resistance Signup and view all the answers

Which of the following ARBs is listed as an example?

Irbesartan Signup and view all the answers

What is the main therapeutic effect of ARBs?

Potent vasodilation Signup and view all the answers

What is the primary indication for the use of nimodipine?

Cerebral artery spasms associated with aneurysm rupture Signup and view all the answers

Which condition is NOT a contraindication for nimodipine usage?

Mild allergic reaction Signup and view all the answers

Which of the following is an adverse effect commonly associated with nimodipine?

Flushing Signup and view all the answers

Which of the following drugs is classified as a centrally acting adrenergic?

Clonidine Signup and view all the answers

What effect do centrally acting adrenergic drugs have on the sympathetic nervous system (SNS)?

Increase renin release Signup and view all the answers

Which subcategory of adrenergic drugs involves the stimulation of alpha2-adrenergic receptors?

Alpha2 receptor agonists Signup and view all the answers

Which of the following actions is NOT attributed to the stimulation of the sympathetic nervous system (SNS)?

Enhancing digestion Signup and view all the answers

Which of the following drugs is likely NOT included on the quiz regarding dihydropyridine CCBs?

Isradipine Signup and view all the answers

What primarily causes chronic stable angina?

Coronary artery disease Signup and view all the answers

Which of the following best describes myocardial infarction?

Necrosis of the myocardium due to oxygen deprivation Signup and view all the answers

What is the main therapeutic objective of antianginal drug therapy?

Minimize the frequency and intensity of anginal attacks Signup and view all the answers

Which class of drugs is NOT typically used in the treatment of angina?

Diuretics Signup and view all the answers

What condition is defined as damaged tissue resulting from inadequate oxygen supply?

Ischemia Signup and view all the answers

In the context of angina, what triggers reflex tachycardia?

Changes in blood pressure or emotional stress Signup and view all the answers

Which of these types of angina is caused by spasms of the coronary arteries?

Vasospastic angina Signup and view all the answers

What could be considered a worst-case outcome of untreated coronary artery disease?

Myocardial infarction Signup and view all the answers

What is considered a normal therapeutic level for digoxin?

0.5 to 2 ng/mL Signup and view all the answers

Which condition does NOT generally require monitoring of digoxin levels?

First starting the drug Signup and view all the answers

What is a common sign of digoxin toxicity?

Bradycardia Signup and view all the answers

When is digoxin immune Fab indicated?

Hyperkalemia in a patient with digoxin toxicity Signup and view all the answers

Which condition does NOT predispose a patient to digoxin toxicity?

High potassium levels Signup and view all the answers

What should be monitored due to potentially increasing digoxin toxicity?

Serum electrolytes Signup and view all the answers

After administration of digoxin immune Fab, how will serum digoxin levels appear?

They will appear elevated for days to weeks. Signup and view all the answers

What is a contraindication to using digoxin immune Fab?

Hypersensitivity to digoxin immune Fab Signup and view all the answers

Study Notes

Beta Blockers

Beta blockers work by blocking the effects of epinephrine and norepinephrine on the heart and blood vessels.
Beta blockers can be caused by acute withdrawal of the drug.
Beta blockers can be used in conjunction with other antihypertensive agents.
Beta blockers can exacerbate underlying angina, precipitate an MI, or cause rebound hypertension.
Beta blockers delay the recovery from hypoglycemia in patients with type 1 diabetes.
Beta blockers are rarely used in those with type 2 diabetes.
Probably on Quiz (POQ): atenolol, carvedilol, metoprolol, propranolol
Probably not on Quiz (PNOQ): esmolol, Labetalol,, sotalol, phentolamine, tamsulosin

Calcium Channel Blockers (CCB)

Calcium plays a key role in heart and vascular smooth muscle contraction.
CCBs work by blocking calcium channels, preventing calcium from entering the cells of the heart and arteries.
CCBs cause blood vessels to relax and open.
There are three chemical classes of CCBs:
- Phenylalkylamines (e.g., verapamil)
- Benzothiazepines (e.g., diltiazem)
- Dihydropyridines (e.g. amlodipine)
Probably on Quiz (POQ): diltiazem, amlodipine, felodipine nifedipine, nimodipine, verapamil
Probably not on Quiz (PNOQ): isradipine nicardipine

Centrally Acting Adrenergics

Stimulation of the SNS leads to an increase in heart rate, force of contraction, blood vessel constriction, and renin release from the kidney, resulting in hypertension.
Centrally acting adrenergic drugs like clonidine and methyldopa work by stimulating alpha2-adrenergic receptors in the brain.
These drugs can be described as having central action (in the brain) or peripheral action (at the heart and blood vessels)

Angiotensin II Receptor Blockers (ARB)

ARBs block the binding of AII to type 1 AII receptors.
ARBs affect primarily vascular smooth muscle and the adrenal gland.
ARBs block vasoconstriction and aldosterone secretion.
ARBs are used in the treatment of hypertension or heart failure, alone or in combination with other drugs like diuretics.
ARBs decrease SVR, a measure of afterload.
Probably on Quiz (POQ): losartan (Cozaar) ,valsartan (Diovan), irbesartan (Avapro)
Probably not on Quiz (PNOQ): candesartan (Atacand), eprosartan (Teveten), telmisartan (Micardis), olmesartan (Benicar)

Miscellaneous Antihypertensive Drugs

Eplerenone (Inspra) is used for hypertension.
Eplerenone is a selective aldosterone blocker.
Eplerenone is indicated for the treatment of hypertension and post-MI heart failure.

Types of Antianginal Drugs

Three main classes of drugs treat angina:
- Nitrates
- Beta-blockers
- Calcium channel blockers (CCBs)

Objectives of Antianginal Drug Therapy

Minimize the frequency of attacks and decrease the duration and intensity of the anginal pain.
Improve the patient’s functional capacity with as few adverse effects as possible.
Prevent or delay the worst possible outcome, MI.

Digoxin

Digoxin is a cardiac glycoside used to treat heart failure and atrial fibrillation.
Therapeutic digoxin levels are 0.5 to 2 ng/mL.
Low potassium or magnesium levels may increase the potential for digoxin toxicity.
Digoxin is excreted almost exclusively by the kidneys.
Signs and symptoms of digoxin toxicity include bradycardia, headache, dizziness, confusion, nausea, and visual disturbances.
ECG findings may include heart block, atrial tachycardia with block, or ventricular dysrhythmias.

Digoxin Immune Fab (Digifab)

Digoxin immune Fab is the antidote for severe digoxin overdose.
Digoxin immune Fab is indicated for the reversal of life-threatening cardiotoxic effects.
Digoxin immune Fab is contraindicated in patients with hypersensitivity to it.
It is available only in parenteral form and dosed based on the patient’s serum digoxin level and weight.
After Digoxin immune Fab is given, all subsequent serum digoxin level measurements will be elevated for days to weeks.

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Description

Test your knowledge on Beta Blockers and Calcium Channel Blockers in this pharmacology quiz. Explore their mechanisms, uses, and contraindications. Perfect for students studying cardiovascular drugs.