,NU 636 Quiz 3 Advanced Pharmacology |
1. A patient with a history of heart failure is initiated on sacubitril-valsartan. Which mechanism
contributes to its therapeutic effect?
A) Inhibition of neprilysin and angiotensin II receptor blockade
B) Inhibition of ACE and angiotensin II receptor blockade
C) Blockade of beta-adrenergic and alpha-adrenergic receptors
D) Inhibition of aldosterone synthase and renin
Correct Answer: Inhibition of neprilysin and angiotensin II receptor blockade
Rationale: Sacubitril-valsartan combines a neprilysin inhibitor with an angiotensin II receptor blocker,
enhancing natriuretic peptides while blocking harmful angiotensin effects. It does not inhibit ACE or
block adrenergic receptors. This combination reduces mortality in heart failure with reduced ejection
fraction.
2. Which medication is an aldosterone antagonist that reduces mortality in heart failure?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Metolazone
Correct Answer: Spironolactone
Rationale: Spironolactone, an aldosterone antagonist, reduces mortality in heart failure with reduced
ejection fraction. Furosemide is a loop diuretic. Hydrochlorothiazide is a thiazide diuretic. Metolazone
is a thiazide-like diuretic. None of these have the same mortality benefit.
3. Which medication is a hyperpolarization-activated cyclic nucleotide-gated channel blocker used for
heart rate reduction in heart failure?
A) Ivabradine
,B) Digoxin
C) Amiodarone
D) Adenosine
Correct Answer: Ivabradine
Rationale: Ivabradine inhibits the If current in the sinoatrial node, reducing heart rate without
affecting contractility. Digoxin increases contractility. Amiodarone is an antiarrhythmic. Adenosine
treats supraventricular tachycardia. Ivabradine is specifically indicated for heart failure with reduced
ejection fraction.
4. Which medication is a potassium channel blocker classified as a Class III antiarrhythmic?
A) Lidocaine
B) Amiodarone
C) Metoprolol
D) Verapamil
Correct Answer: Amiodarone
Rationale: Amiodarone is a Class III antiarrhythmic that primarily blocks potassium channels,
prolonging repolarization and refractory period. Lidocaine is a Class IB sodium channel blocker.
Metoprolol is a Class II beta-blocker. Verapamil is a Class IV calcium channel blocker.
5. A patient is prescribed amiodarone. Which adverse effect requires periodic monitoring of thyroid
function?
A) Hyperthyroidism and hypothyroidism
B) Hypercalcemia
C) Hypernatremia
D) Hyperglycemia
Correct Answer: Hyperthyroidism and hypothyroidism
, Rationale: Amiodarone contains iodine and can cause both hyperthyroidism and hypothyroidism,
requiring baseline and periodic thyroid function testing. It does not typically cause hypercalcemia,
hypernatremia, or hyperglycemia as primary adverse effects. Pulmonary toxicity and corneal
microdeposits are also monitored.
6. Which medication is a sodium channel blocker classified as a Class IB antiarrhythmic?
A) Lidocaine
B) Flecainide
C) Sotalol
D) Diltiazem
Correct Answer: Lidocaine
Rationale: Lidocaine is a Class IB antiarrhythmic that blocks sodium channels and is used for
ventricular arrhythmias. Flecainide is a Class IC sodium channel blocker. Sotalol is a Class III potassium
channel blocker. Diltiazem is a Class IV calcium channel blocker.
7. A patient is prescribed a medication that requires monitoring of serum potassium levels because it
can cause hyperkalemia. Which medication is most likely responsible?
A) Furosemide
B) Hydrochlorothiazide
C) Lisinopril
D) Amlodipine
Correct Answer: Lisinopril
Rationale: ACE inhibitors such as lisinopril reduce aldosterone secretion, leading to potassium
retention and hyperkalemia. Furosemide and hydrochlorothiazide cause hypokalemia. Amlodipine
does not significantly affect potassium levels. Potassium monitoring is essential with ACE inhibitor
therapy.
1. A patient with a history of heart failure is initiated on sacubitril-valsartan. Which mechanism
contributes to its therapeutic effect?
A) Inhibition of neprilysin and angiotensin II receptor blockade
B) Inhibition of ACE and angiotensin II receptor blockade
C) Blockade of beta-adrenergic and alpha-adrenergic receptors
D) Inhibition of aldosterone synthase and renin
Correct Answer: Inhibition of neprilysin and angiotensin II receptor blockade
Rationale: Sacubitril-valsartan combines a neprilysin inhibitor with an angiotensin II receptor blocker,
enhancing natriuretic peptides while blocking harmful angiotensin effects. It does not inhibit ACE or
block adrenergic receptors. This combination reduces mortality in heart failure with reduced ejection
fraction.
2. Which medication is an aldosterone antagonist that reduces mortality in heart failure?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Metolazone
Correct Answer: Spironolactone
Rationale: Spironolactone, an aldosterone antagonist, reduces mortality in heart failure with reduced
ejection fraction. Furosemide is a loop diuretic. Hydrochlorothiazide is a thiazide diuretic. Metolazone
is a thiazide-like diuretic. None of these have the same mortality benefit.
3. Which medication is a hyperpolarization-activated cyclic nucleotide-gated channel blocker used for
heart rate reduction in heart failure?
A) Ivabradine
,B) Digoxin
C) Amiodarone
D) Adenosine
Correct Answer: Ivabradine
Rationale: Ivabradine inhibits the If current in the sinoatrial node, reducing heart rate without
affecting contractility. Digoxin increases contractility. Amiodarone is an antiarrhythmic. Adenosine
treats supraventricular tachycardia. Ivabradine is specifically indicated for heart failure with reduced
ejection fraction.
4. Which medication is a potassium channel blocker classified as a Class III antiarrhythmic?
A) Lidocaine
B) Amiodarone
C) Metoprolol
D) Verapamil
Correct Answer: Amiodarone
Rationale: Amiodarone is a Class III antiarrhythmic that primarily blocks potassium channels,
prolonging repolarization and refractory period. Lidocaine is a Class IB sodium channel blocker.
Metoprolol is a Class II beta-blocker. Verapamil is a Class IV calcium channel blocker.
5. A patient is prescribed amiodarone. Which adverse effect requires periodic monitoring of thyroid
function?
A) Hyperthyroidism and hypothyroidism
B) Hypercalcemia
C) Hypernatremia
D) Hyperglycemia
Correct Answer: Hyperthyroidism and hypothyroidism
, Rationale: Amiodarone contains iodine and can cause both hyperthyroidism and hypothyroidism,
requiring baseline and periodic thyroid function testing. It does not typically cause hypercalcemia,
hypernatremia, or hyperglycemia as primary adverse effects. Pulmonary toxicity and corneal
microdeposits are also monitored.
6. Which medication is a sodium channel blocker classified as a Class IB antiarrhythmic?
A) Lidocaine
B) Flecainide
C) Sotalol
D) Diltiazem
Correct Answer: Lidocaine
Rationale: Lidocaine is a Class IB antiarrhythmic that blocks sodium channels and is used for
ventricular arrhythmias. Flecainide is a Class IC sodium channel blocker. Sotalol is a Class III potassium
channel blocker. Diltiazem is a Class IV calcium channel blocker.
7. A patient is prescribed a medication that requires monitoring of serum potassium levels because it
can cause hyperkalemia. Which medication is most likely responsible?
A) Furosemide
B) Hydrochlorothiazide
C) Lisinopril
D) Amlodipine
Correct Answer: Lisinopril
Rationale: ACE inhibitors such as lisinopril reduce aldosterone secretion, leading to potassium
retention and hyperkalemia. Furosemide and hydrochlorothiazide cause hypokalemia. Amlodipine
does not significantly affect potassium levels. Potassium monitoring is essential with ACE inhibitor
therapy.
