APEA-PHARMACOLOGY CARDIOPVASCULAR EXAM QUESTIONS AND ACCURATE
ANSWERS WITH EXPLANATIONS //ALREADY GRADED A+
The side effect profile of angiotensin receptor blockers (ARBs) is similar to the side effects of:
angiotensin-converting enzymes (ACE) inhibitors. beta-blockers. calcium channel blockers.
pressors. - answer-angiotensin-converting enzymes (ACE) inhibitors.
Isosorbide dinitrate (Isordil) is indicated for the treatment of:
acute angina. chronic angina. myocardial
infarction. esophageal spasm. - answer-
chronic angina.
Isosorbide dinitrate (Isordil) titradose tablets are indicated for the prevention of angina pectoris due to
coronary artery disease. The onset of action of immediate-release oral isosorbide dinitrate is not
sufficiently rapid for this product to be useful in aborting an acute anginal episode. Therefore, it is not
indicated in the treatment of acute angina and myocardial infarction. The treatment of esophageal
spasms disorders is an off-label use.
Non-dihydropyridine calcium channel blockers (i.e. verapamil) may be safely used in patients with:
heart failure. bradycardia.
second-degree AV block.
chronic stable angina. - answer-chronic stable angina.
Non-dihydropyridine CCBs (non-DHP CCB; i.e. verapamil [Calan] and diltiazem [Cardizem]) have negative
chronotropic and inotropic effects. Therefore, they slow down heart rate and decrease force of
ventricular contractions. Non-DHP CCBs are contraindicated in patients with heart failure who have
reduced ejection fraction, sick sinus syndrome, and second- or third-degree atrioventricular block. Since
non-DHP CCBs increase myocardial blood flow by dilating coronary arteries, they are beneficial in
patients with chronic stable angina.
Patients who are started on olmesartan (Benicar) should be advised to report:
bladder spasms and dysuria. constipation and weakness. diarrhea
and weight loss. metallic taste and easy bruising. - answer-diarrhea
and weight loss.
,Patients should be advised to report persistent chronic diarrhea and weight loss while taking olmesartan
medoxomil (Benicar). This drug can produce a sprue-like enteropathy characterized by severe chronic
diarrhea and weight loss occurring months to years after initiation of the drug. Benicar is an angiotensin
receptor blocker (ARB). Once other etiologies have been excluded, discontinue Benicar and consider an
alternative hypertension treatment.
The medication that produces vasodilation and thus lowers blood pressure by inhibiting the formation
of angiotensin II is: amlodipine (Norvasc).
losartan (Cozaar). enalapril (Vasotec). metoprolol
(Lopressor). - answer-enalapril (Vasotec).
Amlodipine (Norvasc) is a calcium channel blocker, losartan (Cozaar) is an angiotensin II receptor
blocker, and metoprolol (Lopressor) is a beta-blocker.
Dabigatran (Pradaxa), an anticoagulant, is also classified as a:
direct factor Xa inhibitor. direct thrombin inhibitor. indirect
thrombin inhibitor. factor V inhibitor. - answer-direct
thrombin inhibitor.
Dabigatran (Pradaxa) is a direct thrombin inhibitor (DTI). Medications in this class inactivate circulating
and clotting thrombin (factor IIa). They prevent thrombin (central to the generation of a thrombus) from
attaching fibrinogen to fibrin.
Key advantages of using DTIs instead of heparin is that they: produce a more predictable anticoagulant
effect due to their lack of binding to other plasma proteins; exert an antiplatelet effect; and do not
cause immune-mediated thrombocytopenia.
Loop diuretics such as bumetanide (Bumex):
produce a large volume of diuresis even at very low doses. are more commonly used
in patients with a decreased glomerular filtration rate. reduce blood pressure as
effectively as thiazide diuretics when used as monotherapy.
can be safely administered to patients who have sulfonamide agent allergies. - answer-are more
commonly used in patients with a decreased glomerular filtration rate.
Loop diuretics are commonly used to control volume retention and are more commonly prescribed for
patients with decreased glomerular filtration rate or heart failure. Loop diuretics do not reduce blood
, pressure as effectively as thiazide diuretics when they are used as monotherapy. They possess a
sulfonamide group, which has important clinical relevance for patients with allergies to sulfonamide
agents.
It is safe to use ranolazine (Ranexa) concomitantly with:
fluconazole (Diflucan). phenytoin (Dilantin). amlodipine
(Norvasc). clarithromycin (Cleocin). - answer-amlodipine
(Norvasc).
all other 3 agents have drug drug interactions and should not be used concomitantly with ranolazine
A 3-year-old patient has a history of congenital heart disease. To reduce the afterload and decrease right
and left atrial pressures, the drug of choice should be:
lisinopril (Prinivil). captopril
(Capoten). benazepril
(Lotensin).
ramipril (Altace). - answer-captopril (Capoten).
only ACE inhibitor that is indicated for children younger than 6 years
An adverse reaction to angiotensin receptor blockers (ARBs) used in the treatment of hypertension is:
photosensitivity. hypokalemia. angioedema.
Barrett's esophagus. - answer-angioedema.
Angiotensin receptor blockers (ARBs) may cause angioedema. Angioedema is characterized by swelling
of the mouth, tongue, pharynx, and eyelids. The risk of angioedema appears to be lower with ARBs than
angiotensin-converting enzyme inhibitors. ARBs may cause hyperkalemia and hyperhidrosis. ARBs do
not produce photosensitivity.
Which beta-blocker is highly variable in bioavailability, has a shorter plasma half-life, is mostly
lipidsoluble, and is almost completely absorbed by the small intestine?
Nebivolol (Bystolic)
Sotalol (Betapace)
Atenolol (Tenormin)
ANSWERS WITH EXPLANATIONS //ALREADY GRADED A+
The side effect profile of angiotensin receptor blockers (ARBs) is similar to the side effects of:
angiotensin-converting enzymes (ACE) inhibitors. beta-blockers. calcium channel blockers.
pressors. - answer-angiotensin-converting enzymes (ACE) inhibitors.
Isosorbide dinitrate (Isordil) is indicated for the treatment of:
acute angina. chronic angina. myocardial
infarction. esophageal spasm. - answer-
chronic angina.
Isosorbide dinitrate (Isordil) titradose tablets are indicated for the prevention of angina pectoris due to
coronary artery disease. The onset of action of immediate-release oral isosorbide dinitrate is not
sufficiently rapid for this product to be useful in aborting an acute anginal episode. Therefore, it is not
indicated in the treatment of acute angina and myocardial infarction. The treatment of esophageal
spasms disorders is an off-label use.
Non-dihydropyridine calcium channel blockers (i.e. verapamil) may be safely used in patients with:
heart failure. bradycardia.
second-degree AV block.
chronic stable angina. - answer-chronic stable angina.
Non-dihydropyridine CCBs (non-DHP CCB; i.e. verapamil [Calan] and diltiazem [Cardizem]) have negative
chronotropic and inotropic effects. Therefore, they slow down heart rate and decrease force of
ventricular contractions. Non-DHP CCBs are contraindicated in patients with heart failure who have
reduced ejection fraction, sick sinus syndrome, and second- or third-degree atrioventricular block. Since
non-DHP CCBs increase myocardial blood flow by dilating coronary arteries, they are beneficial in
patients with chronic stable angina.
Patients who are started on olmesartan (Benicar) should be advised to report:
bladder spasms and dysuria. constipation and weakness. diarrhea
and weight loss. metallic taste and easy bruising. - answer-diarrhea
and weight loss.
,Patients should be advised to report persistent chronic diarrhea and weight loss while taking olmesartan
medoxomil (Benicar). This drug can produce a sprue-like enteropathy characterized by severe chronic
diarrhea and weight loss occurring months to years after initiation of the drug. Benicar is an angiotensin
receptor blocker (ARB). Once other etiologies have been excluded, discontinue Benicar and consider an
alternative hypertension treatment.
The medication that produces vasodilation and thus lowers blood pressure by inhibiting the formation
of angiotensin II is: amlodipine (Norvasc).
losartan (Cozaar). enalapril (Vasotec). metoprolol
(Lopressor). - answer-enalapril (Vasotec).
Amlodipine (Norvasc) is a calcium channel blocker, losartan (Cozaar) is an angiotensin II receptor
blocker, and metoprolol (Lopressor) is a beta-blocker.
Dabigatran (Pradaxa), an anticoagulant, is also classified as a:
direct factor Xa inhibitor. direct thrombin inhibitor. indirect
thrombin inhibitor. factor V inhibitor. - answer-direct
thrombin inhibitor.
Dabigatran (Pradaxa) is a direct thrombin inhibitor (DTI). Medications in this class inactivate circulating
and clotting thrombin (factor IIa). They prevent thrombin (central to the generation of a thrombus) from
attaching fibrinogen to fibrin.
Key advantages of using DTIs instead of heparin is that they: produce a more predictable anticoagulant
effect due to their lack of binding to other plasma proteins; exert an antiplatelet effect; and do not
cause immune-mediated thrombocytopenia.
Loop diuretics such as bumetanide (Bumex):
produce a large volume of diuresis even at very low doses. are more commonly used
in patients with a decreased glomerular filtration rate. reduce blood pressure as
effectively as thiazide diuretics when used as monotherapy.
can be safely administered to patients who have sulfonamide agent allergies. - answer-are more
commonly used in patients with a decreased glomerular filtration rate.
Loop diuretics are commonly used to control volume retention and are more commonly prescribed for
patients with decreased glomerular filtration rate or heart failure. Loop diuretics do not reduce blood
, pressure as effectively as thiazide diuretics when they are used as monotherapy. They possess a
sulfonamide group, which has important clinical relevance for patients with allergies to sulfonamide
agents.
It is safe to use ranolazine (Ranexa) concomitantly with:
fluconazole (Diflucan). phenytoin (Dilantin). amlodipine
(Norvasc). clarithromycin (Cleocin). - answer-amlodipine
(Norvasc).
all other 3 agents have drug drug interactions and should not be used concomitantly with ranolazine
A 3-year-old patient has a history of congenital heart disease. To reduce the afterload and decrease right
and left atrial pressures, the drug of choice should be:
lisinopril (Prinivil). captopril
(Capoten). benazepril
(Lotensin).
ramipril (Altace). - answer-captopril (Capoten).
only ACE inhibitor that is indicated for children younger than 6 years
An adverse reaction to angiotensin receptor blockers (ARBs) used in the treatment of hypertension is:
photosensitivity. hypokalemia. angioedema.
Barrett's esophagus. - answer-angioedema.
Angiotensin receptor blockers (ARBs) may cause angioedema. Angioedema is characterized by swelling
of the mouth, tongue, pharynx, and eyelids. The risk of angioedema appears to be lower with ARBs than
angiotensin-converting enzyme inhibitors. ARBs may cause hyperkalemia and hyperhidrosis. ARBs do
not produce photosensitivity.
Which beta-blocker is highly variable in bioavailability, has a shorter plasma half-life, is mostly
lipidsoluble, and is almost completely absorbed by the small intestine?
Nebivolol (Bystolic)
Sotalol (Betapace)
Atenolol (Tenormin)
