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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
Q

what is the duration of action of isosorbide dinitrate/ isosorbide mononitrate

a. 14 mins
b. 24 hr
c. 5 hr

A

c.5 hr

26
Q

oral bioavailibility of isosorbide mononitrate is better due to reduced metabolism by which organ during the first pass

a. kidney
b. liver
c. gut

A

b.liver

27
Q

which form of nitrate is used in acute effort angina?

a. GTN
b. ISMN
c. ISDN

A

a.GTN

28
Q

which form of nitrate is used in angina prophylaxis?

a. GTN
b. ISMN
c. ISDN

A

b. ISMN

29
Q

which form of nitrate is used in angina at rest?

a. GTN
b. ISMN
c. ISDN

A

a.GTN

30
Q

which form of nitrate is used in angina at rest and as IV in an emergency ?

a. GTN
b. ISMN
c. ISDN

A

a.GTN

31
Q

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

a.nitrate

32
Q

patient ha emergency severe hypertension with progressive organ damage. Which drug should be given?

a.nitrate
b.CCB
c. anticoagulant
D. anti platelet

A

a.nitrate

33
Q

what line of hypertension treatment are nitrates?

a. 1
b. 2
c. 3
d. 4

A

c. 3

after BB / CCB / thiazide like diuretics

34
Q

which of these do nitrates interact with?

a. anti coagulants
b. anti platelets
c. alcohol
d. CCB

A

c. alcohol

increases vasodilator effects

35
Q

which of these effects is not an adverse effect of vasodilators?

a. headache
b. flushing
c. hypotension
d. tachycardia
e. hypertension

A

e. hypertension

36
Q

-dipine

A

dihydropyridines

form of CCB

37
Q

which of these is not a rate limiting CCB?

a. diltiazem
b. verapamil
c. felodipine

A

c. felodipine

- ipine = dihydropyridines

38
Q

what do dihydropyridines bind to?

a. ryanodine
b. depolarised L type Ca channel
c. hyperpolarised L type Ca channel

A

b.depolarised L type Ca channel

39
Q

what receptors do rate limiting CCBs bind to?

a. ryanodine
b. depolarised L type Ca channel
c. hyperpolarised L type Ca channel

A

c.hyperpolarised L type Ca channel

40
Q

which of these is the strongest anti arrhythmic?

a. verapamil
b. diltiazem
c. amlodipine

A

a. verapamil

41
Q

which of these is the strongest anti anginal (negative inotropic effect)?

a. verapamil
b. diltiazem
c. amlodipine

A

a. verapamil

42
Q

which of these is the strongest anti hypertensive?

a. verapamil
b. diltiazem
c. amlodipine

A

c.amlodipine

43
Q

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

a.impaired cardiac conduction

44
Q

patient has sick sinus syndrome which CCB is most appropriate?

a. amlodipine
b. verapamil

A

a.amlodipine

45
Q

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

A

b.non rate limiiting CCB

46
Q

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

a. vasodilatory eg headache/flushing

47
Q

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

a. heart block

48
Q

which of these side effects is specific to Dihydropyridines ?

a. heart block
b. diarrhoea
c. excacerbation of heart failure
d. vasodilator effects
e. constipated

A

e.constipated

49
Q

which of these side effects is specific to verapamil ?

a. heart block
b. diarrhoea
c. excacerbation of heart failure
d. steal effect
e. constipated

A

d.steal effect

50
Q

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

A

d. ATP sensitive K+ channels

51
Q

what effect does nicorandil have on potassium channels?

a. inhibitor
b. activator

A

b.activator

52
Q

what effect does the opening of K+ channels by nicorandil have on intracellular Ca2+?

a. increase
b. decrease

A

b.decrease

53
Q

opening of k+ channels leads to

a. depolarisation
b. hyperpolarisation

of smooth muscle cells

A

b.hyperpolarisation

causing closure of ca2+ channels

54
Q

skin /mucosal ulceration is a side effect of which drug/

a. amlodipine
b. verapamil
c. isosorbide mononitrate
d. nicorandil

A

d. nicorandil

55
Q

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

a. hyperpolarisation activated , cyclic nucleotide gated (HCN) Na+/K+ channels

and therefore the SAN

56
Q

patient with heart failure / angina unable to tolerate BB what should be given?

a. ivabradine
b. nicrandil
c. verapamil

A

a. ivabradine

57
Q

ivabradine is ineffective in which case?

a. sinus rhythm
b. non sinus rhythm

A

b. non sinus rhythm

eg . AF

58
Q

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

A

e. acute MI

BCR 1 (60 decks)

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