Pharmacology - Calcium channel blockers and nitrates Flashcards
which of these is a vasoconstrictor?
a. endothelin
b. EDRF
c. NO
a. endothelin
which of these is a vasodilator?
a. endothelin
b. ERDF
c. thromboxane A2
d. Xa
b.ERDF
what is the role of endothelin?
a. vasoconstriction
b. vasodilation
c. endothelial repair
a.vasoconstriction
contraction velocity is …………. than in smooth muscle than skeletal muscle
a. higher
b. lower
c. the same
b.lower
calmodulin is found in which type of muscle?
a. skeletal
b. smooth
c. cardiac
b.smooth
what does calcium act on in the smooth muscle?
a. calmodulin
b. MLCK
c. myosin-P
d. actin
a.calmodulin
troponin is not found in which of these muscle types?
a. smooth
b. skeletal
c. cardiac
a.smooth
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. Nitrates
-nitrate
nitrates
GTN
ISDN
where is the receptor for nitrates found?
a. skeletal muscle
b. vascular smooth muscle
c. cardiac muscle
d. smooth muscle
b.vascular smooth muscle
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
b. cyclic GMP
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
b. inhibits calcium entry
// enhanced calcium exit
Tolerance to nitrates is due to a depletion of which groups ?
a. SH
b. NO
c. Fe
d. Ca
a.SH
smooth muscle relaxation =
a. vasoconstriction
b. vasodilation
b.vasodilation
which vessel is more dilated by nitrates?
a. veins
b. arteries
a.veins
what is reduced by venous dilation?
a. after load
b. pre load
c. heart rate
b.pre load
symptoms of heart failure and cardiac are reduced by which drug group?
a. nitrates
b. fibrates
c. ccb
d. thiazide like diuretics
a.nitrates
dilation of which arteries by nitrates reduce coronary spasm
a. pulmonary
b. coronary
c. cardiac
d. peripheral
b.coronary
how is blood redistributed after taking nitrates?
a. endocardial to epicardial
b. epicardial to endocardial
b.epicardial to endocardial
what happens to venous return when taking nitrates?
a. reduced
b. increased
c. no difference
a.reduced
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.2 mins
what is the main drawback of nitrates?
a. side effects
b. inconvenience
c. poor oral bioavailability
c. poor oral bioavailability
which of these is a use of nitrates
a. acute angina symptom treatment
b. NSTEMI
c. acute angina prophylaxis
d. STEMI
c. acute angina prophylaxis
What is the main downfall of nitrate patches
a. side effects
b. first pass effect
c. tolerance
c.tolerance
what is the duration of action of isosorbide dinitrate/ isosorbide mononitrate
a. 14 mins
b. 24 hr
c. 5 hr
c.5 hr
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
which form of nitrate is used in acute effort angina?
a. GTN
b. ISMN
c. ISDN
a.GTN
which form of nitrate is used in angina prophylaxis?
a. GTN
b. ISMN
c. ISDN
b. ISMN
which form of nitrate is used in angina at rest?
a. GTN
b. ISMN
c. ISDN
a.GTN
which form of nitrate is used in angina at rest and as IV in an emergency ?
a. GTN
b. ISMN
c. ISDN
a.GTN
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
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
what line of hypertension treatment are nitrates?
a. 1
b. 2
c. 3
d. 4
c. 3
after BB / CCB / thiazide like diuretics
which of these do nitrates interact with?
a. anti coagulants
b. anti platelets
c. alcohol
d. CCB
c. alcohol
increases vasodilator effects
which of these effects is not an adverse effect of vasodilators?
a. headache
b. flushing
c. hypotension
d. tachycardia
e. hypertension
e. hypertension
-dipine
dihydropyridines
form of CCB
which of these is not a rate limiting CCB?
a. diltiazem
b. verapamil
c. felodipine
c. felodipine
- ipine = dihydropyridines
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
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
which of these is the strongest anti arrhythmic?
a. verapamil
b. diltiazem
c. amlodipine
a. verapamil
which of these is the strongest anti anginal (negative inotropic effect)?
a. verapamil
b. diltiazem
c. amlodipine
a. verapamil
which of these is the strongest anti hypertensive?
a. verapamil
b. diltiazem
c. amlodipine
c.amlodipine
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
patient has sick sinus syndrome which CCB is most appropriate?
a. amlodipine
b. verapamil
a.amlodipine
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
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
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
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
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
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
what effect does nicorandil have on potassium channels?
a. inhibitor
b. activator
b.activator
what effect does the opening of K+ channels by nicorandil have on intracellular Ca2+?
a. increase
b. decrease
b.decrease
opening of k+ channels leads to
a. depolarisation
b. hyperpolarisation
of smooth muscle cells
b.hyperpolarisation
causing closure of ca2+ channels
skin /mucosal ulceration is a side effect of which drug/
a. amlodipine
b. verapamil
c. isosorbide mononitrate
d. nicorandil
d. nicorandil
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
patient with heart failure / angina unable to tolerate BB what should be given?
a. ivabradine
b. nicrandil
c. verapamil
a. ivabradine
ivabradine is ineffective in which case?
a. sinus rhythm
b. non sinus rhythm
b. non sinus rhythm
eg . AF
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
