Anesthesia Pharmacology Chapter 10: Pharmacology of
Antianginal Drugs
Click on the correct answer.
Smooth muscle relaxation by nitrates:
- coronary vasculature
- bronchioles
- biliary duct
- uterine smooth muscle
- all the above
Symptoms associated with esophageal spasm: relieved by nitrates
- true
- false
Toxicities associated with nitrates:
- headaches caused by meningeal vascular dilatation
- dizziness
- drug rash
- hypotensive reactions
- all the above
Beneficial effects of calcium channel blockers in managing angina:
- increased preload
- reduced afterload
- decreased myocardial wall tension
- B & C
- A, B & C
Antianginal action of calcium channel blockers:
- negative inotropism
- coronary artery dilatation
- both
- neither
Calcium channel blocker(s) with predominately vascular effects:
- diltiazem (Cardiazem)
- amlodipine (Norvasc)
- verapamil (Isoptin, Calan)
- B & C
- A & B
Major depolarizing current is carried by this ion in vascular smooth muscle:
- sodium
- calcium
- magnesium
In the heart, the"fast" response is mediated by this ion:
- sodium
- calcium
- magnesium
- potassium
- chloride
In the heart, the "slow" responses mediated by this ion:
- sodium
- calcium
- magnesium
- potassium
- chloride
Depolarization in the specialized conduction system, the SA. and AV nodal tissue, is mediated by this ion movement:
- sodium
- calcium
- potassium
- chloride
- magnesium
Calcium channel blockers with predominantly vascular effects
- amlodipine (Norvasc)
- nifedipine (Procardia, Adalat)
- nicardipine (Cardene)
- B & C
- A, B & C
Calcium channel blocker most likely to worsen congestive heart failure:
- nicardipine (Cardene)
- diltiazem (Cardiazem)
- amlodipine (Norvasc)
- nifedipine (Procardia, Adalat)
- all equal
Mechanism by which calcium channel blockers reduce contractility:
- inhibit cAMP production
- promote calcium binding to troponin
- reduce free intracellular calcium
- inhibit beta adrenergic receptor activity
- all of the above
Calcium channel blockers relatively slowly absorbed and long acting:
- amlodipine (Norvasc)
- isradipine (DynaCirc)
- felodipine (Plendil)
- B & C
- A, B & C
Calcium channel blocker(s) most likely to worsen myocardial ischemia:
- amlodipine
- nicardipine (Cardene)
- nitrendipine
- nimodipine (Nimotop)
- all the above
Effect of calcium channel blockers in a patient with SA or AV nodal conduction disease:
- worsen conduction
- improve conduction
Mechanisms which could worsen ischemia -- as a result of calcium channel blocker administration:
- hypotension
- increasing coronary blood flow
- increased heart rate
- A & B
- A, B & C
Calcium channel blocker approved for use in patients with CNS deficits following rupture of congenital intracranial aneurysm:
- amlodipine (Norvasc)
- verapamil (Isoptin, Calan)
- nifedipine (Procardia, Adalat)
- nimodipine (Nimotop)
- diltiazem (Cardiazem)
Mechanistic basis/bases for antianginal effects of beta-blockers:
- decreased heart rate
- decreased contractility
- decreased blood pressure during exercise
- A & C
- A, B & C
Better drug class for management of variant angina:
- beta-blockers
- calcium channel blockers
- equally appropriate