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BCR 1 > Pharmacology - Calcium channel blockers and nitrates > Flashcards

Pharmacology - Calcium channel blockers and nitrates Flashcards

1
Q

which of these is a vasoconstrictor?

a. endothelin
b. EDRF
c. NO

A

a. endothelin

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2
Q

which of these is a vasodilator?

a. endothelin
b. ERDF
c. thromboxane A2
d. Xa

A

b.ERDF

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3
Q

what is the role of endothelin?

a. vasoconstriction
b. vasodilation
c. endothelial repair

A

a.vasoconstriction

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4
Q

contraction velocity is …………. than in smooth muscle than skeletal muscle

a. higher
b. lower
c. the same

A

b.lower

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5
Q

calmodulin is found in which type of muscle?

a. skeletal
b. smooth
c. cardiac

A

b.smooth

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6
Q

what does calcium act on in the smooth muscle?

a. calmodulin
b. MLCK
c. myosin-P
d. actin

A

a.calmodulin

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7
Q

troponin is not found in which of these muscle types?

a. smooth
b. skeletal
c. cardiac

A

a.smooth

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8
Q

which of these drugs is not an anti hypotensive?

a. Nitrates
b. calcium channel antagonists
c. ACEi /ARBS
d. heparin
e. a adrenoceptor anatagonists

A

a. Nitrates

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9
Q

-nitrate

A

nitrates

GTN
ISDN

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10
Q

where is the receptor for nitrates found?

a. skeletal muscle
b. vascular smooth muscle
c. cardiac muscle
d. smooth muscle

A

b.vascular smooth muscle

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11
Q

The NO group formed when nitrates bind to vascular smooth muscle cells what do they stimulate in order to produce cyclic GMP?

a. COX 1
b. cyclic GMP
c. COX 2
d. phosphodiesterase

A

b. cyclic GMP

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12
Q

what effect does increased GMP have on the cell?

a. allows for calcium entry
b. inhibits calcium entry
c. inhibits sodium entry
d. allows for sodium entry

A

b. inhibits calcium entry

// enhanced calcium exit

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13
Q

Tolerance to nitrates is due to a depletion of which groups ?

a. SH
b. NO
c. Fe
d. Ca

A

a.SH

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14
Q

smooth muscle relaxation =

a. vasoconstriction
b. vasodilation

A

b.vasodilation

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15
Q

which vessel is more dilated by nitrates?

a. veins
b. arteries

A

a.veins

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16
Q

what is reduced by venous dilation?

a. after load
b. pre load
c. heart rate

A

b.pre load

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17
Q

symptoms of heart failure and cardiac are reduced by which drug group?

a. nitrates
b. fibrates
c. ccb
d. thiazide like diuretics

A

a.nitrates

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18
Q

dilation of which arteries by nitrates reduce coronary spasm

a. pulmonary
b. coronary
c. cardiac
d. peripheral

A

b.coronary

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19
Q

how is blood redistributed after taking nitrates?

a. endocardial to epicardial
b. epicardial to endocardial

A

b.epicardial to endocardial

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20
Q

what happens to venous return when taking nitrates?

a. reduced
b. increased
c. no difference

A

a.reduced

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21
Q

how long does it take for sublingual nitrates to start having n effect?

a. 2 mins
b. 10 mins
c. 5 days
d. 3 hrs

A

a.2 mins

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22
Q

what is the main drawback of nitrates?

a. side effects
b. inconvenience
c. poor oral bioavailability

A

c. poor oral bioavailability

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23
Q

which of these is a use of nitrates

a. acute angina symptom treatment
b. NSTEMI
c. acute angina prophylaxis
d. STEMI

A

c. acute angina prophylaxis

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24
Q

What is the main downfall of nitrate patches

a. side effects
b. first pass effect
c. tolerance

A

c.tolerance

25
what is the duration of action of isosorbide dinitrate/ isosorbide mononitrate a. 14 mins b. 24 hr c. 5 hr
c.5 hr
26
oral bioavailibility of isosorbide mononitrate is better due to reduced metabolism by which organ during the first pass a. kidney b. liver c. gut
b.liver
27
which form of nitrate is used in acute effort angina? a. GTN b. ISMN c. ISDN
a.GTN
28
which form of nitrate is used in angina prophylaxis? a. GTN b. ISMN c. ISDN
b. ISMN
29
which form of nitrate is used in angina at rest? a. GTN b. ISMN c. ISDN
a.GTN
30
which form of nitrate is used in angina at rest and as IV in an emergency ? a. GTN b. ISMN c. ISDN
a.GTN
31
patient has severe acute congestive right sided failure (good BP) . Which drug should be given? a.nitrate b.CCB c. anticoagulant D. anti platelet
a.nitrate
32
patient ha emergency severe hypertension with progressive organ damage. Which drug should be given? a.nitrate b.CCB c. anticoagulant D. anti platelet
a.nitrate
33
what line of hypertension treatment are nitrates? a. 1 b. 2 c. 3 d. 4
c. 3 after BB / CCB / thiazide like diuretics
34
which of these do nitrates interact with? a. anti coagulants b. anti platelets c. alcohol d. CCB
c. alcohol | increases vasodilator effects
35
which of these effects is not an adverse effect of vasodilators? a. headache b. flushing c. hypotension d. tachycardia e. hypertension
e. hypertension
36
-dipine
dihydropyridines | form of CCB
37
which of these is not a rate limiting CCB? a. diltiazem b. verapamil c. felodipine
c. felodipine | - ipine = dihydropyridines
38
what do dihydropyridines bind to? a. ryanodine b. depolarised L type Ca channel c. hyperpolarised L type Ca channel
b.depolarised L type Ca channel
39
what receptors do rate limiting CCBs bind to? a. ryanodine b. depolarised L type Ca channel c. hyperpolarised L type Ca channel
c.hyperpolarised L type Ca channel
40
which of these is the strongest anti arrhythmic? a. verapamil b. diltiazem c. amlodipine
a. verapamil
41
which of these is the strongest anti anginal (negative inotropic effect)? a. verapamil b. diltiazem c. amlodipine
a. verapamil
42
which of these is the strongest anti hypertensive? a. verapamil b. diltiazem c. amlodipine
c.amlodipine
43
which of these is contraindicated with rate limiting CCBs only ? a. impaired cardiac conduction b. severe myocardial depression c. mod - severe aortic stenosis / LVOT obstruction d. heart failure
a.impaired cardiac conduction
44
patient has sick sinus syndrome which CCB is most appropriate? a. amlodipine b. verapamil
a.amlodipine
45
patient on large doses of BB for arrhythmias in severe myocardial depression what should be given? a. rate limiting CCB b. non rate limiiting CCB c. nitrate
b.non rate limiiting CCB
46
what is the main adverse effects of CCBs? a. vasodilatory eg headache/flushing b. diarrhoea c. constiptation d. excacerbation of heart failure e. heart block
a. vasodilatory eg headache/flushing
47
which of these side effects is specific to rate limiting CCB a. heart block b. diarrhoea c. excacerbation of heart failure d. vasodilator effects
a. heart block
48
which of these side effects is specific to Dihydropyridines ? a. heart block b. diarrhoea c. excacerbation of heart failure d. vasodilator effects e. constipated
e.constipated
49
which of these side effects is specific to verapamil ? a. heart block b. diarrhoea c. excacerbation of heart failure d. steal effect e. constipated
d.steal effect
50
what channel does nicorandil work on? a. ryanodine b. depolarised L type Ca channel c. hyperpolarised L type Ca channel d. ATP sensitive K+ channels
d. ATP sensitive K+ channels
51
what effect does nicorandil have on potassium channels? a. inhibitor b. activator
b.activator
52
what effect does the opening of K+ channels by nicorandil have on intracellular Ca2+? a. increase b. decrease
b.decrease
53
opening of k+ channels leads to a. depolarisation b. hyperpolarisation of smooth muscle cells
b.hyperpolarisation causing closure of ca2+ channels
54
skin /mucosal ulceration is a side effect of which drug/ a. amlodipine b. verapamil c. isosorbide mononitrate d. nicorandil
d. nicorandil
55
what channel is is inhibited by ivabradine? a. hyperpolarisation activated , cyclic nucleotide gated (HCN) Na+/K+ channels b. hyperpolarised L type ca channel c. depolarised L type channels d. ATP sensitive K+ channels
a. hyperpolarisation activated , cyclic nucleotide gated (HCN) Na+/K+ channels and therefore the SAN
56
patient with heart failure / angina unable to tolerate BB what should be given? a. ivabradine b. nicrandil c. verapamil
a. ivabradine
57
ivabradine is ineffective in which case? a. sinus rhythm b. non sinus rhythm
b. non sinus rhythm | eg . AF
58
which of these is ivabradine contraindicated in? a. impaired cardiac conduction b. severe myocardial depression c. mod - severe aortic stenosis / LVOT obstruction d. heart failure e. acute MI
e. acute MI

BCR 1 (60 decks)

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