High Yield Systems Pharmacology - Bisphosphonates and cardiovascular drugs (part 1) Flashcards
1
Q
What are bisphosphonates commonly used for in medicine?
A
Bisphosphonates are commonly used to treat osteoporosis and other bone diseases.
2
Q
True or False: Bisphosphonates can cause osteonecrosis of the jaw (ONJ).
A
True
3
Q
Fill in the blank: Patients on bisphosphonates should inform their dentist about their _____.
A
medication use
4
Q
What is the mechanism of action of bisphosphonates?
A
They inhibit osteoclast-mediated bone resorption.
5
Q
Multiple Choice: Which of the following is a potential side effect of bisphosphonates? A) Nausea B) Osteonecrosis of the jaw C) Kidney damage D) All of the above
A
D) All of the above
6
Q
What dental procedure is particularly concerning for patients taking bisphosphonates?
A
Tooth extraction
7
Q
True or False: It is safe to perform dental implants on patients taking bisphosphonates without additional precautions.
A
False
8
Q
What is the recommended dental management strategy for patients on bisphosphonates?
A
Conduct thorough risk assessments and provide preventive care.
9
Q
Fill in the blank: The risk of ONJ increases with the duration and ____ of bisphosphonate therapy.
A
potency
10
Q
What should be done before performing invasive dental procedures on bisphosphonate patients?
A
Consult with the patient’s physician.
11
Q
Multiple Choice: Which type of bisphosphonate is most associated with ONJ? A) Alendronate B) Risedronate C) Zoledronic acid D) Ibandronate
A
C) Zoledronic acid
12
Q
True or False: Patients taking bisphosphonates should have regular dental check-ups.
A
True
13
Q
What is one of the most important factors to consider when treating a patient on bisphosphonates?
A
The duration of bisphosphonate therapy.
14
Q
Fill in the blank: The primary route of administration for bisphosphonates is _____.
A
oral or intravenous
15
Q
What is the role of dental professionals in managing patients on bisphosphonates?
A
To assess risk and provide appropriate dental care.
16
Q
Multiple Choice: Which of the following is NOT a bisphosphonate? A) Pamidronate B) Denosumab C) Etidronate D) Zoledronic acid
A
B) Denosumab
17
Q
What is the recommended action if a patient on bisphosphonates presents with jaw pain?
A
Evaluate for signs of osteonecrosis and refer to a specialist if needed.
18
Q
True or False: Bisphosphonates can lead to increased bone density in the jaw.
A
True
19
Q
What should dentists be aware of regarding the timing of bisphosphonate therapy and dental procedures?
A
The timing of dental procedures in relation to the administration of bisphosphonates can influence the risk of ONJ.
20
Q
Fill in the blank: Patients should have a complete _____ before starting bisphosphonate therapy.
A
dental examination
21
Q
What is the significance of a patient’s dental history for those taking bisphosphonates?
A
It helps assess the risk for ONJ and plan appropriate care.
22
Q
Multiple Choice: Which of the following conditions necessitates caution when prescribing bisphosphonates? A) Chronic kidney disease B) Hypertension C) Diabetes D) Asthma
A
A) Chronic kidney disease
23
Q
True or False: All patients on bisphosphonates will experience side effects.
A
False
24
Q
What are the most common diseases treated with bisphosphonates?
A
- Osteoporosis: alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva), help increase bone density and reduce the risk of fractures
Paget’s disease: Zoledronic acid (Reclast) is often used to regulate the abnormal bone remodeling in Paget’s disease, reducing pain and preventing complications.
- Bone metastases: Bisphosphonates like zoledronic acid (Zometa) and pamidronate (Aredia) are used to manage bone metastases by decreasing the activity of osteoclasts (cells that break down bone)
Hypercalcemia of malignancy: Hypercalcemia (high calcium levels in the blood) is a common complication of advanced cancer. Bisphosphonates such as pamidronate and zoledronic acid lower calcium levels by inhibiting bone resorption, which helps reduce the risk of kidney damage, dehydration, and other life-threatening effects of hypercalcemia.
- Certain genetic bone disorders like osteogenesis imperfecta.
25
List the order of least potent to most potent bisphosphonate drugs
**EPRAZ**
Etidronate
Pamidronate
Risedronate
Alendronate
Zoledronate/Minodronate
26
What is the least potent bisphosphonate drug?
Etidronate
27
True or False: Alendronate is more potent than Risedronate.
True
28
Fill in the blank: The order of bisphosphonates from least potent to most potent is Etidronate, ________, Risedronate, Alendronate, and Zoledronic acid.
Pamidronate
29
Which bisphosphonate is considered the most potent?
Zoledronic acid
30
Multiple choice: Which of the following is in the middle of the potency spectrum of bisphosphonates? A) Etidronate B) Pamidronate C) Zoledronic acid D) Alendronate
B) Pamidronate
31
What is the primary disease treated with bisphosphonates?
Osteoporosis
32
True or False: Bisphosphonates are used to treat Paget's disease.
True
33
Fill in the blank: Bisphosphonates are commonly prescribed to prevent __________ in patients undergoing cancer treatment.
bone loss
34
Which of the following conditions is NOT typically treated with bisphosphonates?
A) Osteoporosis
B) Osteosarcoma
C) Paget's disease
D) Hypercalcemia of malignancy
B) Osteosarcoma
35
Name one condition associated with increased bone resorption that bisphosphonates can help manage.
Hypercalcemia of malignancy
36
What is the most common class of diuretics?
Thiazide diuretics (hydrochlorothiazide and chlorthalidone)
37
What is the primary mechanism of action of thiazide diuretics (hydrochlorothiazide and chlorthalidone)?
Inhibition of Na/Cl reabsorption in the distal convoluted tubule
38
True or False: Loop diuretics (Furosemide) are more potent than thiazide diuretics (Hydrochlorothiazide).
True
39
Fill in the blank: The main site of action for loop diuretics (Furosemide) is the __________.
thick ascending limb of the **loop of Henle**
40
Which diuretic is commonly used to treat hypertension?
Hydrochlorothiazide (thiazide diuretic)
41
Name the side effects of thiazide diuretics (hydrochlorothiazide and chlorthalidone).
Hypokalemia
Headaches
Dizziness
Xerostomia
Arrhythmias
42
What is the mechanism of action of potassium-sparing diuretics (Spironolactone)?
Inhibition of aldosterone in the collecting ducts
43
Which class of diuretics can cause ototoxicity (when a person develops hearing or balance problems due to a medicine)?
Loop diuretics (Furosemide)
44
True or False: Thiazide diuretics can cause hyperuricemia (a condition where there is too much uric acid in the blood).
True ( hydrochlorothiazide and chlorthalidone)
45
What is the primary indication for the use of loop diuretics?
Heart failure and edema
46
Fill in the blank: The most common potassium-sparing diuretic is __________.
Spironolactone
47
What electrolyte imbalance is commonly associated with loop diuretics?
Hypokalemia
48
Which diuretic is often used in patients with renal impairment?
Loop diuretics (Furosemide)
49
What is one contraindication for thiazide diuretics?
Severe renal impairment
50
Name a thiazide diuretic other than hydrochlorothiazide.
Chlorthalidone
51
True or False: Diuretics are used to treat fluid overload conditions.
True
52
What is the effect of diuretics on blood pressure?
They lower blood pressure
53
Fill in the blank: Thiazide diuretics can increase the risk of __________.
Diabetes mellitus
54
Which diuretic is effective in treating hyperaldosteronism?
Spironolactone
55
What is the role of carbonic anhydrase inhibitors in diuretics?
They inhibit bicarbonate reabsorption in the proximal tubule
56
True or False: All diuretics are effective at the same dose regardless of the patient's renal function.
False
57
What is a common side effect of potassium-sparing diuretics (Spironolactone)?
Hyperkalemia
58
Fill in the blank: The class of diuretics that includes Furosemide is called __________.
Loop diuretics
59
What is the primary action of osmotic diuretics?
Increase osmotic pressure in the renal tubules
60
Name one osmotic diuretic.
Mannitol
61
True or False: Diuretics can be used to manage edema in liver cirrhosis.
True
62
What is the primary therapeutic use of hydralazine?
Hypertension management
63
True or False: Hydralazine is a potassium channel opener.
False
64
Fill in the blank: Hydralazine primarily acts as a ________ vasodilator.
arterial
65
What is the mechanism of action of hydralazine?
It relaxes vascular smooth muscle by increasing intracellular cGMP.
66
Name one common side effect of hydralazine.
Headache
67
Which of the following is a common vasodilator? A) Lisinopril B) Hydralazine C) Metoprolol
B) Hydralazine
68
What class of drugs does hydralazine belong to?
Vasodilators
69
True or False: Hydralazine can cause reflex tachycardia.
True
70
What is a serious potential side effect of long-term hydralazine use?
Lupus-like syndrome
71
Fill in the blank: Hydralazine is often combined with ________ to prevent reflex tachycardia.
beta-blockers
72
What is the route of administration for hydralazine?
Oral and intravenous
73
Name one condition, other than hypertension, that hydralazine can be used to treat.
Heart failure
74
What effect does hydralazine have on blood pressure?
Decreases blood pressure
75
True or False: Hydralazine is effective in treating pulmonary hypertension.
False
76
Which of the following is NOT a mechanism of action for vasodilators? A) Nitric oxide release B) Calcium channel blockade C) Beta-agonism
C) Beta-agonism
77
What is the recommended starting dose of hydralazine for adults?
10 mg orally 2-3 times a day
78
Fill in the blank: Hydralazine is often used in combination with ________ for optimal blood pressure control.
diuretics
79
What type of drug interaction should be monitored when using hydralazine?
Interactions with other antihypertensives
80
True or False: Hydralazine is safe for use during pregnancy.
True
81
What is the primary effect of hydralazine on cardiac output?
Increases cardiac output due to reduced afterload
82
What is the primary mechanism of action (MOA) of calcium channel blockers?
Calcium channel blockers inhibit the influx of calcium ions through L-type calcium channels in vascular smooth muscle and cardiac muscle.
83
Which calcium channel blocker is primarily used for hypertension and angina?
Amlodipine.
84
True or False: Diltiazem is a non-dihydropyridine calcium channel blocker.
True.
85
Fill in the blank: Verapamil is often used to treat __________.
arrhythmias.
86
What is a common side effect of calcium channel blockers?
Peripheral edema
Gingival hyperplasia
87
Which calcium channel blocker is known for having a significant effect on cardiac conduction?
Verapamil.
88
Multiple choice: Which of the following is a dihydropyridine calcium channel blocker? A) Verapamil B) Diltiazem C) Amlodipine D) None of the above
C) Amlodipine.
89
True or False: Nifedipine is effective in treating supraventricular tachycardia.
False.
90
What is the effect of calcium channel blockers on heart rate?
They can decrease heart rate, particularly non-dihydropyridines like verapamil and diltiazem.
91
Fill in the blank: Calcium channel blockers are primarily indicated for __________ and __________.
hypertension; angina.
92
Which calcium channel blocker has a longer duration of action, amlodipine or nifedipine?
Amlodipine.
93
True or False: Diltiazem can decrease myocardial oxygen demand.
True.
94
What is the primary use of nifedipine?
To treat hypertension and angina.
95
Multiple choice: Which of the following is NOT a calcium channel blocker? A) Verapamil B) Diltiazem C) Lisinopril D) Amlodipine
C) Lisinopril.
96
What is a potential adverse effect of rapid intravenous administration of verapamil?
Severe hypotension.
97
Fill in the blank: Calcium channel blockers can lead to __________ in some patients due to vasodilation.
reflex tachycardia.
98
True or False: Amlodipine is effective for both hypertension and coronary artery disease.
True.
99
Which calcium channel blocker is contraindicated in patients with heart failure?
Verapamil.
100
What is the brand name for diltiazem?
Cardizem.
101
Multiple choice: What is a common side effect of nifedipine? A) Bradycardia B) Peripheral edema C) Constipation D) Headache
B) Peripheral edema.
102
Fill in the blank: Long-acting calcium channel blockers like amlodipine are preferred for __________ management.
chronic hypertension.
103
True or False: Calcium channel blockers can be used in the treatment of Raynaud's phenomenon.
True.
104
What is the effect of calcium channel blockers on smooth muscle?
They cause relaxation of vascular smooth muscle.
105
Which calcium channel blocker is least likely to affect heart rate?
Amlodipine.
106
Multiple choice: What is the main action of calcium channel blockers on the cardiovascular system? A) Increase heart contractility B) Decrease cardiac output C) Decrease systemic vascular resistance D) Increase heart rate
C) Decrease systemic vascular resistance.
107
Fill in the blank: Calcium channel blockers are often used in conjunction with __________ for hypertension treatment.
ACE inhibitors.
108
What does ACE stand for in ACE inhibitors?
Angiotensin-Converting Enzyme
109
Which two ACE inhibitors are commonly studied for the INBDE?
Lisinopril and Captopril
110
What is the primary mechanism of action (MOA) of ACE inhibitors?
They inhibit the conversion of angiotensin I to angiotensin II.
111
True or False: ACE inhibitors can cause vasodilation.
True
112
What are common contraindications for the use of ACE inhibitors?
Pregnancy, history of angioedema, and renal artery stenosis.
113
Fill in the blank: ACE inhibitors are primarily used to treat _______.
Hypertension
114
What is a major side effect of ACE inhibitors?
Dry cough
115
Which ACE inhibitor is known for having a shorter half-life?
Captopril
116
True or False: ACE inhibitors can lead to hyperkalemia.
True
117
What is the effect of ACE inhibitors on blood pressure?
They lower blood pressure.
118
What is a serious but rare side effect associated with ACE inhibitors?
Angioedema
119
Short answer: Name one drug interaction to consider with ACE inhibitors.
Non-steroidal anti-inflammatory drugs (NSAIDs)
120
Fill in the blank: Lisinopril is often prescribed after a _______.
Heart attack
121
Which ACE inhibitor is usually preferred in patients with heart failure?
Lisinopril
122
What is the recommended monitoring parameter when starting an ACE inhibitor?
Serum creatinine and potassium levels
123
True or False: ACE inhibitors can be used in diabetic patients to protect renal function.
True
124
What is the typical initial dose of Lisinopril for hypertension?
10 mg
125
What mechanism leads to the cough associated with ACE inhibitors?
Increased bradykinin levels due to ACE inhibition.
126
Fill in the blank: ACE inhibitors are classified as _______ agents.
Antihypertensive
127
What is the effect of stopping ACE inhibitor therapy abruptly?
Rebound hypertension
128
Short answer: What is one benefit of using ACE inhibitors in heart failure?
Reduced mortality
129
True or False: ACE inhibitors are effective in reducing the risk of stroke.
True
130
Which patient population should avoid ACE inhibitors due to risk of serious side effects?
Pregnant women
131
Fill in the blank: Captopril should be taken _______ before meals.
One hour
132
What is the primary therapeutic use of ACE inhibitors?
Management of hypertension and heart failure.
133
True or False: ACE inhibitors can be used in patients with chronic kidney disease.
True
134
What is the common suffix for ACE inhibitors?
-pril
135
What is the primary mechanism of action (MOA) of angiotensin receptor blockers (ARBs) like losartan and valsartan?
They block the action of angiotensin II at the AT1 receptor.
136
True or False: Losartan is an angiotensin receptor blocker.
True
137
Fill in the blank: Valsartan is primarily used to treat ________ and ________.
hypertension; heart failure
138
What is a common side effect of angiotensin receptor blockers?
Hyperkalemia
139
Multiple Choice: Which of the following is NOT a side effect of ARBs? A) Dizziness B) Cough C) Renal impairment D) Angioedema
B) Cough
140
What is the effect of ARBs on blood pressure?
They lower blood pressure.
141
True or False: ARBs can be used in patients with heart failure.
True
142
Which ARB is known for its cardioprotective effects?
Losartan
143
Fill in the blank: ARBs are often used in patients with ________ who cannot tolerate ACE inhibitors.
cough
144
What is the primary indication for valsartan?
Hypertension and heart failure.
145
Multiple Choice: Which of the following is a contraindication for ARB use? A) Pregnancy B) Diabetes C) Hypertension D) Asthma
A) Pregnancy
146
True or False: ARBs can cause hypotension in some patients.
True
147
What is the impact of ARBs on renal function?
They can improve renal function in diabetic nephropathy.
148
Fill in the blank: Both losartan and valsartan are classified as ________.
angiotensin receptor blockers (ARBs)
149
What is a serious but rare side effect of ARBs?
Angioedema
150
Multiple Choice: Which of the following is a common dosage form of valsartan? A) Tablet B) Injection C) Patch D) Liquid
A) Tablet
151
True or False: ARBs are effective in reducing the risk of stroke.
True
152
What is the role of ARBs in post-myocardial infarction treatment?
They help to reduce the risk of further cardiovascular events.
153
Fill in the blank: The main difference between losartan and valsartan is their ________.
chemical structure and pharmacokinetics
154
What should be monitored when a patient is on ARBs?
Renal function and potassium levels.
155
Multiple Choice: Which ARB is often preferred for patients with hypertension and heart failure? A) Losartan B) Valsartan C) Both D) Neither
C) Both
156
True or False: ARBs are typically used as first-line therapy for hypertension.
True
157
What is the effect of ARBs on the sympathetic nervous system?
They reduce sympathetic outflow.
158
Fill in the blank: The onset of action for ARBs is generally ________ after oral administration.
1 to 2 hours
159
What is the primary mechanism of action (MOA) of nitroglycerin?
Nitroglycerin primarily acts as a vasodilator by converting to nitric oxide, which relaxes vascular smooth muscle.
160
True or False: Nitroglycerin is used to treat angina pectoris.
True
161
Fill in the blank: Nitroglycerin is classified as an __________ agent.
anti-anginal
162
What are the common routes of administration for nitroglycerin?
Sublingual, transdermal, oral, and intravenous.
163
Which type of angina is nitroglycerin most commonly used to treat?
Stable angina
164
What is a potential side effect of nitroglycerin?
Headache
165
True or False: Nitroglycerin can cause tolerance with prolonged use.
True
166
What is the mechanism by which nitroglycerin alleviates angina symptoms?
By reducing myocardial oxygen demand through vasodilation.
167
Which condition contraindicates the use of nitroglycerin?
Severe hypotension
168
What is the onset of action for sublingual nitroglycerin?
Approximately 1-3 minutes.
169
Fill in the blank: Nitroglycerin is often used in combination with __________ for better angina management.
beta-blockers
170
What is the maximum number of sublingual nitroglycerin tablets a patient can take during an angina attack?
Three tablets, with 5 minutes between doses.
171
True or False: Nitroglycerin can be used for acute myocardial infarction (MI).
True
172
What should patients do if they experience persistent chest pain after taking nitroglycerin?
Seek emergency medical help.
173
What is the shelf life of nitroglycerin tablets once opened?
Typically 3-6 months.
174
Which enzyme is involved in the conversion of nitroglycerin to nitric oxide?
Guanylate cyclase
175
What is the primary effect of nitroglycerin on coronary arteries?
Vasodilation, leading to increased blood flow.
176
What is a common adverse effect of nitroglycerin related to blood vessels?
Hypotension
177
Fill in the blank: Nitroglycerin helps to relieve angina by increasing __________ supply to the heart.
oxygen
178
True or False: Nitroglycerin is effective for all types of angina.
False
179
What should be monitored when a patient is taking nitroglycerin?
Blood pressure
180
What is the main indication for using nitroglycerin in dental procedures?
Management of angina symptoms.
181
What is the primary goal of nitroglycerin therapy?
To relieve angina and improve exercise tolerance.
182
Fill in the blank: Patients should not take nitroglycerin with __________ medications.
PDE5 inhibitors (Tadalafil)
183
In what form can nitroglycerin be administered for continuous treatment?
Transdermal patch
184
What is the effect of nitroglycerin on preload?
It decreases preload.
185
What is the primary use of digoxin?
To treat congestive heart failure and certain arrhythmias.
186
True or False: Digoxin increases the force of heart contractions.
True
187
Fill in the blank: Digoxin is classified as a __________.
cardiac glycoside
188
What is the mechanism of action (MOA) of digoxin?
It inhibits the Na+/K+ ATPase pump, increasing intracellular sodium and calcium concentrations.
189
Which ion's concentration is increased in cardiac cells by the action of digoxin?
Calcium
190
What effect does digoxin have on heart rate?
It decreases heart rate by enhancing vagal tone.
191
True or False: Digoxin has a narrow therapeutic index.
True
192
What are common side effects of digoxin?
Nausea, vomiting, diarrhea, and visual disturbances.
193
Fill in the blank: The therapeutic range for digoxin is typically __________ ng/mL.
0.5 to 2.0
194
What should be monitored regularly in patients taking digoxin?
Serum digoxin levels and renal function.
195
True or False: Digoxin is safe to use in all patients with heart failure.
False
196
Which condition is a contraindication for digoxin use?
Ventricular fibrillation
197
What is the primary route of elimination for digoxin?
Renal excretion
198
What is the impact of hypokalemia on digoxin's effects?
It increases the risk of digoxin toxicity.
199
True or False: Digoxin can be used in combination with diuretics.
True
200
What type of arrhythmias can digoxin help control?
Atrial fibrillation and atrial flutter.
201
Fill in the blank: Digoxin toxicity may present with __________ changes.
visual
202
What is the first-line treatment for digoxin toxicity?
Digoxin-specific antibody fragments (Digibind).
203
True or False: Patients should be advised to maintain a consistent potassium intake while on digoxin.
True
204
What is a common drug interaction with digoxin?
Thiazide and loop diuretics.
205
What is the effect of digoxin on the refractory period of the cardiac action potential?
It increases the refractory period.
206
Fill in the blank: Digoxin is often used in patients with __________ heart failure.
systolic
207
What should be done if a patient experiences symptoms of digoxin toxicity?
Seek immediate medical attention.
208
True or False: Digoxin has a long half-life, requiring careful dosing.
True
209
What is a key consideration for dental treatment in patients taking digoxin?
Monitoring for potential drug interactions and managing potential arrhythmias.
