Module 5 Review Questions Flashcards
Renin inhibitors MOA
- Binds tightly with renin and inhibits the cleavage of angiotensinogen to angiotensin I
- Inhibits the conversion of angiotensin I (inactive) to angiotensin II (highly active)
ACE inhibitors MOA
- Reduce levels of angiotensin II through inhibition of ACE
- Increasing levels of bradykinin through inhibition of Kinase II
- Dilate blood vessels and reduce blood volume
- Reverse pathologic changes in the heart and blood vessels mediated by angiotensinII and aldosterone
ARBs MOA
- Block access of angiotensin II
- Cause dilation of arterioles and veins
- Prevent angiotensin II from inducing pathologic changes in cardiac structure
- Reduce excretion of K+
- Decrease release of aldosterone
- Increase renal excretion of Na+ and H2O
- Do not inhibit Kinase II
- Do not increase levels of bradykinin
Aldosterone antagonists MOA
- Selective blockade of aldosterone receptors in the kidney
- Promotes excretion of Na+ and H2O and thereby reduces blood volume
Calcium channel blockers
A. have exact same effect on heart as beta blockers
B. Increase force of contraction of the heart
C. Speed up the heart rate
D. Increase conduction through AV node
A. Have exact same effect on the heart as Beta Blockers - they suppress calcium influx and reduce force of contraction and slow heart and suppress conduction through the AV node
Common side effects of CCBs are:
constipation, edema of lower extremities, gingival hyperplasia
Which of the following are therapeutic uses for Nifedipine? (Select all that apply) A. Post MI B. Migraines C. CHF D. Angina E. HTN
B. Migraines
D. Angina
E. HTN
Beta blockers ___ the adverse cardiac effects of Nifedipine, but can ___ the adverse cardiac effects of Verapamil and Diltiazem.
decrease, intensify
John is taking Hydralazine for elevated BP. He comes in arthralgias. What blood test might be elevated? A. Creatinine B. ANA C. RA D. ALT/AST
B. ANA (antinuclear body test) ; Hydralazine can manifest with s/sx of SLE
Untreated HTN can lead to: Check all that apply. A. Angina B. CHF C. MI D. Kidney disease E. Stroke
All of the above.
Sympatholytics are ___.
Anti-adrenergic drugs
How is stage A CHF managed? A. Beta blocker started B. Manage risks only C. Start ACE D. Start Furosemide
B. Manage risks only
True or False: Virtually all dysrhythmics can also cause dysrhythmias.
True
Which medication is used to treat Digoxin induced dysrhythmias? A. Quinidine B. Phenytoin C. Mexiletine D. Lidocaine
B. Phenytoin
Bill is taking Amiodarone for his atrial fibrillation. What diagnostics will need to be done? A. BUN/Cr yearly B. CBC yearly C. TSH and chest x-ray every 6 months D. Electrolytes every 3 months
C. TSH and chest x-ray every 6 months.
Recommended cholesterol screening is:
Every 5 years after age 20.
Lucy is taking gemfibrozil and warfarin. You know to check INR and expect that: A. INR might be elevated B. INR will be subtherapeutic C. INR will be unchanged D. None of the above.
A. INR might be elevated (Gemfibrozil displaces Warfarin from plasma protein)
Bill has Prinzmetal's angina and it is wakening him at night. What will the NP prescribe? A. Beta blocker B. CCB C. Digoxin D. ASA
B. CCB
How do you prevent nitrate intolerance. Check all that apply.
A. Give smallest dose possible.
B. Give largest dose possible.
C. Keep patches on at all times.
D. Have 8 free hours per day with long acting nitrates.
E. Do not use spray
A. Give smallest dose possible.
D. Have 8 free hours per day with LA nitrates.
Mary has been admitted with unstable angina. You know she will be treated with:
ASA Plavix (Clopidogrel) Beta blocker Statin ACE
What happens when clopidogrel is given with a PPI?
The anti-platelet effect is decreased.
What role does O2 play in STEMI? ASA? Morphine? Nitro? BB?
O2: Although oxygen is recommended, and using it seems to make sense, the practice is not evidence-based.
ASA: A study by ISIS-2, aspirin caused substantial reduction in mortality.
Morphine: In addition to relieving pain, morphine can improve hemodynamics. By promoting venodilation, the drug reduces cardiac preload
Nitro: (1) reduce preload and thereby reduce O2 demand; (2) increase collateral blood flow in the ischemic region of the heart; (3) control HTN caused by STEMI-associated anxiety; and (4) limit infarct size and improve LV function. However, Nitro does not reduce mortality
BB: Decreases myocardial O2 demand, reduce cardiac pain, infarct size, and short-term mortality; recurrent ischemia and re-infarction are also decreased
Which must Heparin bind to in order to exert its anticoagulant effect?
Antithrombin III (Heparin binds to antithrombin III then activates thrombin and Factor Xa)
Which one of the following drugs binds bile acids in the intestine, thus preventing their return to the liver via the enterohepatic circulation? A. Niacin B. Fenofibrate C. Cholestyramine D. Lovastatin
C. Cholestyramine
A 58 year old female reports that she recently stopped taking her blood
pressure meds because of swelling in her feet that began shortly after she
started treatment. Which of the following is most likely to cause peripheral
edema?
A. Atenolol
B. Clonidine
C. Felodipine
D. Hydralazine
C. Felodipine (calcium channel blocker)
Jack is taking Colesevelam. The NP tells him to:
A. Beware of flushing
B. He might have muscle aches
C. He needs to increase fluids and fiber for constipation
D. He might have itching a few days after starting
C. He needs to increase fluids and fiber for constipation.
Colesevelam is a bile acid-binding resin used to lower cholesterol.
A 54 year old male is noted to have hyperlipidemia, and is prescribed
atorvastatin. This drug reduces plasma cholesterol by which of the following
processes?
A. inhibiting ApoB synthesis
B. Inhibiting cholesterol absorption
C. inhibiting cholesterol biosynthesis
D. interfering with bile acid reabsorption
C. Inhibiting cholesterol biosynthesis
A 42 year old woman is noted to have Type II diabetes. She has HTN with BP
150/94. The UA shows mild albuminuria. Which of the following drugs would
be the best choice to treat HTN?
A. Enalapril
B. Propranolol
C. HCTZ
D. Amlodipine
A. Enalapril (ACE inhibitor)
Brad has HTN and is found to have enlarged prostate on exam. His BP has
been running in the 150/90 range. Which of the following meds would offer
treatment for both?
A. Furosemide
B. Aliskiren
C. Propranolol
D. Terazosin
D. Terazosin
(Terazosin is in a class of medications called alpha-blockers. It relieves the symptoms of BPH by relaxing the muscles of the bladder and prostate)
Which best describes the action of ACE inhibitors on the failing heart? A. Increases vascular resistance B. Decreases cardiac output C. Reduces preload D. Increases aldosterone
C. Reduces preload
Which of the following is the most accurate statement regarding Digoxin?
A. Decreases mortality in patients with CHF.
B. Increases vagal tone and decreases AV node conduction
C. Lengthens the action potential and increases the refractoriness of the heart
D. Useful in treating Wolff-Parkinson-White syndrome
B. Increases vagal tone and decreases AV node conduction
Which of the following is a limiting adverse effect of ACE inhibitors? A. Hyperkalemia B. Hypokalemia C. Hyponatremia D. Hypernatremia
A. Hyperkalemia
