CVS- Pharmacology and Physiology Quiz Flashcards
Which of the following is a type of plasminogen activator drug used for thrombolytic therapy?
- Aspirin
- Streptokinase
- Enoxaparin
- Warfarin
- Clopidogrel
- Streptokinase
Examples of
Direct renin inhibitor
ARBs
Thiazide diuretics
Beta blockers
Aliskiren
Losartan, Valsartan, Irbesartan
Chlorthalidone, Hydrochlorothiazide
Atenolol, Bisoprolol, Propanalol, Metaprolol
Examples of
ACE inhibitor
Dihydropyridine class of calcium channel blocker
Cardiac selective calcium channel blocker
Enalapril, Ramipril, Lisinopril
Amlodipine, Nifidipine,
Verapamil, Diltiazem
What are the Common adverse reactions associated with calcium channel blockers (CCBs) include which of the following?
Bradycardia
Peripheral oedema
Hypertension
Dry mouth
GI bleeding
Peripheral Oedema
Which of the following hormones increases the blood volume and blood pressure by restricting water loss in the kidneys?
Glucagon
Erythropoietin
Renin
Insulin
Antidiuretic hormone
Antidiuretic hormone
What is a potential adverse effect associated with the use of statin medications for cholesterol management?
Weight gain
Increased risk of bleeding disorders
Hypoglycaemia
Hypotension
Myopathy (muscle pain or weakness)
Myopathy (muscle pain or weakness)
During the cardiac cycle, which phase is characterized by the contraction of the heart’s ventricles, leading to the ejection of blood into the aorta and pulmonary arteries
Ventricilar Systole
What is the role of fibrates?
Activate peroxisome proliferator activated receptor alpha (PPAR-a) leading to decreased triglyceride production and inc HDL cholesterol levels
Role of Statins?
Inhibit the enzyme HMG-CoA reductase in the liver, which reduces cholesterol synthesis, resulting in lowered LDL cholesterol levels
Role of Ezetimibe?
Inhibits cholesterol absorption in the small intestine, reducing the amount of dietary and biliary cholesterol entering the bloodstream.
Role of Niacin?
Reduces triglycerides. LDL cholesterol and inc HDL cholesterol levels. The exact mechanisms are not fully understood.
What is the role of anionic exchange resins? (bile acid sequestrates)
Bind to bile acids in the intestines, preventing their reabsorption. This results in increased hepatic conversion of cholesterol to bile acids and decreased LDL cholesterol levels.
Which class of antihypertensive drugs primarily inhibits the sympathetic nervous system, leading to a decrease in heart rate and cardiac output, and is used to treat hypertension and other cardiovascular conditions?
Beta Blockers
Which of the following is a common adverse reaction associated with ACE inhibitors?
Thrombocytopenia
Hypertension
Hypoglycaemia
Hyperkalaemia
Bradycardia
Hyperkalaemia
(as BB can lead to inc potassium retention by the kidneys)
What is the role of an ACEi?
Inhibit the activity of angiotensin-converting enzyme, reducing the production of angiotensin II. This results in vasodilation, decreased aldosterone secretion, and lowered blood pressure
What is the role of a Calcium Channel blocker?
Inhibit calcium entry into smooth muscle cells, resulting in relaxation of arterial walls and reduced peripheral vascular resistance, ultimately lowering blood pressure
What is the role of an Angiotensin II Receptor Blocker (ARB)?
Blocks the receptors for angiotensin II, preventing angiotensin II from exerting its vasoconstrictive effects. This leads to vasodilation, reduced aldosterone secretion, and lower blood pressure.
What is the role of a Direct Renin Inhibitor?
Inhibit the action of renin, an enzyme involved in the renin-angiotensin-aldosterone system (RAAS), ultimately reducing the production of angiotensin I and angiotensin II
What is the role of a Beta-adrenergic blocker?
Blocks the effects of adrenaline and related hormones on beta-adrenergic receptors. This leads to a decrease in heart rate, reduced cardiac output, and lower blood pressure
What is the role of a Thiazide-like diuretic?
Increase the excretion of sodium and water by the kidneys, reducing blood volume and subsequently lowering blood pressure. They are often the first-line treatment for hypertension
Which of the following food and drug interactions can exacerbate the adverse effects of statin medications, particularly increasing the risk of myopathy (muscle pain or weakness)?
- Consuming grapefruit or grapefruit juice
- Drinking green tea
- Using ibuprofen for pain relief
- Eating high-fiber foods
- Taking vitamin C supplements
Consuming grapefruit or grapefruit juice
Can interact with statin medications, particularly simvastatin and atorvastatin, leading to an inc risk of adverse affects inc myopathy
What is the primary role of reverse cholesterol transport in the body?
To transport cholesterol from arterial walls to the liver for excretion
Which of the following drugs is primarily used to inhibit cholesterol absorption in the small intestine?
Fibrates
Bile acid sequestrant
Ezetimibe
PCSK9 inhibitors
Statins
Ezetimibe
Which of the following statements is true regarding ST-elevation myocardial infarction (STEMI)?
- It is caused by vasospasm of the coronary arteries.
- STEMI is not considered a medical emergency.
- Fibrinolytic therapy is the primary treatment of choice for STEMI.
- STEMI is characterized by chest pain relieved with rest or nitroglycerin
- The ECG in STEMI typically shows ST-segment elevation and Q-waves
The ECG in STEMI typically shows ST-segment elevation and Q-waves
ST-elevation myocardial infarction (STEMI) is defined by the presence of significant ST-segment elevation on the ECG. Q-waves may develop in the hours to days following the event
What is the primary mechanism of action of statins in the management of hypercholesterolemia?
Inhibition of HMG-CoA reductase, a key enzyme in cholesterol biosynthesis in the liver. By reducing cholesterol synthesis, they lower blood cholesterol levels.
Warfarin (Coumadin)
Suppresses the synthesis of vitamin K-dependent clotting factors (II, VII, IX, and X) by inhibiting the vitamin K epoxide reductase enzyme
Role of Direct Oral Anticoagulants (DOACs) (e.g.,Rivaroxaban, Apixaban, Edoxaban?
Directly inhibit specific clotting factors, Factor Xa, to prevent the formation of blood clots
Role of Heparin?(unfractionated)
Enhances the activity of antithrombin III, which inactivates various clotting factors, including thrombin (factor IIa) and factor Xa
Role of Low Molecular Weight Heparins? (LMWHs) (e.g., Enoxaparin, Dalteparin)
Primarily target factor Xa indirectly through antithrombin III, resulting in decreased thrombin formation and inhibition of coagulation
Role of Direct Thrombin Inhibitors? (e.g., Argatroban, Bivalirudin, Dabigatran)
These drugs directly inhibit thrombin, a critical clotting factor in the coagulation cascade
Common adverse reactions associated with thiazide-like diuretics includes what?
Hypokalaemia
Which of the following statements is true regarding familial hyperlipidaemia?
It is characterized by elevated levels of high-density lipoprotein (HDL) cholesterol.
It is most commonly associated with a sedentary lifestyle.
It is an acquired condition caused by poor dietary choices.
It is primarily caused by genetic mutations affecting lipid metabolism
It is a temporary condition that can be easily reversed.
It is primarily caused by genetic mutations affecting lipid metabolism
What is the primary role of endothelial cells in regulating platelet function and preventing abnormal clot formation in blood vessels?
- Endothelial cells activate thrombin to facilitate clot formation.
- Endothelial cells release von Willebrand factor (vWF) to activate platelets.
- Endothelial cells secrete platelet activators to initiate clot formation.
- Endothelial cells release nitric oxide (NO) and prostacyclin (PGI2) to inhibit platelet activation and adhesion
- Endothelial cells produce fibrin to stabilize clots.
Endothelial cells release nitric oxide (NO) and prostacyclin (PGI2) to inhibit platelet activation and adhesion
What classes of drugs commonly used for the treatment of angina (chest pain) and ischemic heart disease?
Nitrates and beta-blockers
What is a potential adverse reaction associated with ACE inhibitors that can affect the respiratory system?
Persistent dry cough
Which of the following is responsible for the primary regulation of cholesterol absorption in the small intestine?
Cholesterol ester transfer protein
Niemann-Pick C1-Like 1 (NPC1L1) transporter
Lipoprotein lipase
Bile acid sequestrants
Chylomicron synthesis
Niemann-Pick C1-Like 1 (NPC1L1) transporter
In which of the following cases are ACE inhibitors typically not recommended or avoided as the initial choice of treatment? (4)
Pregnant
Patients with bilateral renal artery stenosis
Carribean or black African ethnic origin (less response to renin-dependent BP regulation)
55 or above years (natural ageing of renal function)
Which class of antihypertensive drugs primarily works by inhibiting the renin-angiotensin-aldosterone system? (RAAS)
ACEi
Overproduction of ___________ will increase the blood viscosity (thickening of blood), resistance, and pressure, and decrease flow in addition to its contribution as a vasoconstrictor.
erythropoietin
In cardiac myocytes, excitation-contraction coupling refers to:
The mechanism by which calcium ions are released and initiate muscle contraction
Antiplatelets:
Abciximab, Eptifibatide , Tirofiban
Explain their role
These are glycoprotein IIb/IIIa receptor antagonists that block the final common pathway of platelet aggregation by inhibiting the binding of fibrinogen to the glycoprotein IIb/IIIa receptor on platelet surfaces
Antiplatelets:
Aspirin (Acetylsalicylic Acid)
Explain their role:
Irreversibly inhibits cyclooxygenase (COX), reducing the production of thromboxane A2, which is a platelet activator. As a result, platelet aggregation is decreased
Antiplatelets:
Clopidogrel and Prasugrel
Explain their role:
Irreversibly inhibits the platelet P2Y12 ADP receptor, which is involved in platelet activation and aggregation
Antiplatelets:
Ticagrelor
Explain their role:
Reversibly inhibits the P2Y12 ADP receptor on platelets, preventing ADP-induced platelet activation and aggregation
Which molecules, released by endothelial cells, lead to the constriction of capillary sphincters?
Endothelin
NO2= Vasodilatation (opposite)
What describes the pharmacological mechanism of the drug ‘valsartan’?
ARB
Blocking of angiotensin II receptors
What is the primary function of fibrinolysis in the body’s physiological processes?
To dissolve and break down blood clots.
Which hormone is released from the heart and promotes diuresis by inhibiting renin, aldosterone and ADH?
Atrial natriuretic peptide (ANP)
Which of the following statements about the baroreceptor reflex is correct?
It is primarily regulated by the sympathetic nervous system
It functions to regulate blood pressure by sensing changes in stretch of blood vessels.
Baroreceptors are located in the walls of the heart
Baroreceptors are not involved in the regulation of heart rate
The reflex leads to vasodilation in response to high blood pressure
It functions to regulate blood pressure by sensing changes in stretch of blood vessels.
Which enzyme is a key regulatory step in the de novo cholesterol synthesis pathway within the liver
HMG-CoA reductase
……….arteries perfuse blood to myocardium with the high arterial pressure (90-120 mmHg) during both systole and diastole
Coronary
