Anesthesia Pharmacology: Physiological Factors Predisposing to Anginal Symptoms

Prinzmetal's angina --
1. exertional
2. rest
Causes of myocardial ischemia
1. arterial thrombus
2. coronary vasospasm
3. coronary vessel atherosclerosis
4. B & C
5. A, B & C
In the absence of atherosclerotic disease, intramyocardial resistance arterioles can significantly dilate
1. true
2. false
Factors that increase myocardial oxygen requirements:
1. enhanced contractility
2. reduced wall tension
3. increased heart rate
4. B & C
5. A & C
Drug effects that may prevent/terminate angina:
1. coronary vasodilators
2. negative inotropic drugs
3. peripheral vasodilators
4. negative chronotropic drugs
5. all of the above
More important for coronary blood flow control:
1. local metabolic factors
2. nervous system regulation
Possible vasodilatory substances responsible for local coronary blood flow regulation:
1. prostaglandins
2. hydrogen ions
3. adenosine
4. B & C
5. A, B & C
Coronary blood flow and sympathetic activation:
1. associated with more coronary vasoconstriction
2. associated with more coronary vasodilation
Preferred for acute management of angina:
1. nitroprusside sodium (Nipride)
2. hydralazine (Apresoline)
3. sublingual nitroglycerin
4. propranolol (Inderal)
5. minoxidil (Loniten)
Principal mechanism by which sublingual nitroglycerin terminates anginal episodes in patients with advanced atherosclerotic coronary vessel disease:
1. coronary vasodilation
2. decreased afterload
3. decreased preload
4. decreased heart rate
5. decreased contractility
Drugs clinically used for management of angina --
1. atenolol (Tenormin)
2. propranolol (Inderal)l
3. nadolol (Corgard)
4. metoprolol (Lopressor)
5. all of the above
Management of variant (Prinzmetal's) angina:
1. propranolol (Inderal)
2. verapamil (Isoptin, Calan)
3. both
4. neither
Substrate for nitric oxide synthase for production of endogenous nitrates:
1. phenylalanine
2. arginine
3. proline
4. tranylcypromine (Parnate)
5. tryptophan
Organic nitrate/nitrates following denitration to produce NO, cause these effects on second messenger systems:
1. decrease cGMP
2. activation guanylate cyclase
3. both
4. neither
More likely associated with low-dose nitrates
1. reduced and-diastolic left and right ventricular chamber size and pressures
2. reflex-mediated tachycardia along with substantial venous pooling and arteriolar dilation