Pharmacology: Cardiac Exam
Questions with Accurate Answers
What is the drug-name ending of angiotensin converting enzyme inhibitors (ACE
inhibitors)? - ANSWERS--PRIL
What are ACE inhibitors indicated for? - ANSWERS1. Congestive heart failure with low
ejection fraction (prevents left ventricular remodeling/hypertrophy)
2. Hypertension/Hypertensive crisis (especially diabetics)
3. Proteinuria (protects the kidney of diabetics)
4. Acute MCI (prevents vicious cycle of cardiac decline)
What is the mechanism of action of ACE inhibitors? - ANSWERS1. ACE inhibitors block
the function of ACE--an enzyme that resides in the lungs and converts Angiotensin I to
Angiotensin II
2. Angiotensin II is a potent vasoconstrictor which also stimulates the release of
aldosterone from the zona glomerulosa of the adrenal gland
What are the common adverse effects of ACE inhibitors? - ANSWERS1. Dry cough due
to increased bradykinin
2. Angioedema and hyperkalemia may also occur
What are the drug-names and drug-name endings of Calcium Channel Blockers? -
ANSWERS1. Ditiazem, Verapamil
2. --PINE
When are calcium channel blockers indicated? - ANSWERSThey are indicated in
patients who require immediate vasodilation or correction of conduction abnormalities:
1. Hypertension (high risk coronary disease)
2. Atrial arrhythmias
3. Pulmonary Hypertension
4. Hypertrophic cardiomyopathy
5. Raynaud's Phenomenon (spontaneous vasospasm)
,6. Subarrachnoid Hemorrhage
7. Vasospastic angina
What is the mechanism of action of calcium channel blockers? - ANSWERS1. Calcium
channel blockers block calcium channels in smooth muscle, leading to POTENT
VASODILATION
2. Calcium Channel Blockers also limit conduction at the AV node of the heart (can help
arrhythmia)
What are the side-effects of calcium channel blockers? - ANSWERS1. Postural
hypotension, flushing, constipation, edema
2. Ditiazem and Verapamil cause AV BLOCK***
3. --PINE Calcium Channel inhibitors cause TACHYCARDIA***
What are spironolactone and eperenone? - ANSWERSAldosterone antagonists
When are spironolactone and eperenone indicated? - ANSWERS1. Congestive heart
failure (decreases the cardiac work load)
2. Ascites (best initial diuretic therapy)
3. Adrenal hyperplasia or small cell carcinoma of the lung (aldosterone producing
neoplasias)
-Acne (can be anti-androgenic in women)
-Hypertension (rarely)
-Amnorrhea
What are the medications that are KNOWN to lower mortality in congestive heart
failure? - ANSWERSHIGH YIELD, KNOW IN YOUR SLEEP
1. ACE Inhibitors
2. Angiotensin Receptor Blockers
3. Spironolactone and eperenone
4. Beta Blockers
5. Hydralazine AND Nitrates in combination
All of these decrease the progression of heart disease by decreasing the stress on the
heart. Compensation for heart failure is good, but it will eventually lead to a vicious cycle
of progressive decompensation.
What are the mechanism of action of spironolactone and eperenone? - ANSWERS1.
Both of these are aldosterone antagonists
2. Spironolactone is also anti-andronergic
What are the side-effects of spironolactone and eperenone? - ANSWERS1.
Spironolactone can cause hyperkalemia (due to decreased aldosterone), or
gynecomastia due to it's anti-andronergic effects.
, 2. Eperenone only causes hyperkalemia, because it does not cross inhibit the
testosterone receptor.
What is the mechanism of action of Propranolol? - ANSWERSA nonspecific blocker of
both the Beta-1 and Beta-2 receptors
When is Propranolol indicated? - ANSWERS1. Migraine headaches
2. Portral hypertension (decreases esophageal varices bleeding)
3. Thyroid storm
4. Essential tremor
5. Pheochromocytoma (adrenal tumor)
What are the side-effects of propranolol? - ANSWERSMANY side-effects compared to
selective Beta-1 blockers.
1. Bronchospasm, depression, bradycardia, hypotension, erectile dysfunction.
2. Hyperkalemia by inhibiting Sodium/Potassium ATPase
3. Adverse effects on glucose and peripheral arterial disease.
What is indicated for usage to treat supra ventricular tachycardia that does not respond
to sinus massage? - ANSWERSAdenosine
How does adenosine relieve supra ventricular tachycardia? - ANSWERS1. Reduces
calcium currents and is anti arrhythmic by increasing AV nodal refractoriness
2. Transiently slows the sinus rate and AV nodal conduction velocity
3. Opens potassium channels, hyperpolarizing nodal tissue and making them less likely
to fire.
What mechanism of aspirin has an impact on cardiovascular disease? -
ANSWERSAspirin IRREVERSIBLY inhibits COX, which will decrease the production of
TXA2. TXA2 is necessary for hemostasis--therefore aspirin prevents clot formation and
thins the blood.
When is aspirin indicated? - ANSWERS1. Acute coronary syndromes (MI, unstable
angina)
2. Stroke or TIA
3. Peripheral artery disease
4. Kawasaki's Disease (despite the fact that it affects children!)
5. Essential Thrombocythemia
-Fever
-RA
-Gout
What are the adverse effects of aspirin? - ANSWERS1. Bleeding
2. Peptic ulcers, asthma, renal insufficiency, rash
Questions with Accurate Answers
What is the drug-name ending of angiotensin converting enzyme inhibitors (ACE
inhibitors)? - ANSWERS--PRIL
What are ACE inhibitors indicated for? - ANSWERS1. Congestive heart failure with low
ejection fraction (prevents left ventricular remodeling/hypertrophy)
2. Hypertension/Hypertensive crisis (especially diabetics)
3. Proteinuria (protects the kidney of diabetics)
4. Acute MCI (prevents vicious cycle of cardiac decline)
What is the mechanism of action of ACE inhibitors? - ANSWERS1. ACE inhibitors block
the function of ACE--an enzyme that resides in the lungs and converts Angiotensin I to
Angiotensin II
2. Angiotensin II is a potent vasoconstrictor which also stimulates the release of
aldosterone from the zona glomerulosa of the adrenal gland
What are the common adverse effects of ACE inhibitors? - ANSWERS1. Dry cough due
to increased bradykinin
2. Angioedema and hyperkalemia may also occur
What are the drug-names and drug-name endings of Calcium Channel Blockers? -
ANSWERS1. Ditiazem, Verapamil
2. --PINE
When are calcium channel blockers indicated? - ANSWERSThey are indicated in
patients who require immediate vasodilation or correction of conduction abnormalities:
1. Hypertension (high risk coronary disease)
2. Atrial arrhythmias
3. Pulmonary Hypertension
4. Hypertrophic cardiomyopathy
5. Raynaud's Phenomenon (spontaneous vasospasm)
,6. Subarrachnoid Hemorrhage
7. Vasospastic angina
What is the mechanism of action of calcium channel blockers? - ANSWERS1. Calcium
channel blockers block calcium channels in smooth muscle, leading to POTENT
VASODILATION
2. Calcium Channel Blockers also limit conduction at the AV node of the heart (can help
arrhythmia)
What are the side-effects of calcium channel blockers? - ANSWERS1. Postural
hypotension, flushing, constipation, edema
2. Ditiazem and Verapamil cause AV BLOCK***
3. --PINE Calcium Channel inhibitors cause TACHYCARDIA***
What are spironolactone and eperenone? - ANSWERSAldosterone antagonists
When are spironolactone and eperenone indicated? - ANSWERS1. Congestive heart
failure (decreases the cardiac work load)
2. Ascites (best initial diuretic therapy)
3. Adrenal hyperplasia or small cell carcinoma of the lung (aldosterone producing
neoplasias)
-Acne (can be anti-androgenic in women)
-Hypertension (rarely)
-Amnorrhea
What are the medications that are KNOWN to lower mortality in congestive heart
failure? - ANSWERSHIGH YIELD, KNOW IN YOUR SLEEP
1. ACE Inhibitors
2. Angiotensin Receptor Blockers
3. Spironolactone and eperenone
4. Beta Blockers
5. Hydralazine AND Nitrates in combination
All of these decrease the progression of heart disease by decreasing the stress on the
heart. Compensation for heart failure is good, but it will eventually lead to a vicious cycle
of progressive decompensation.
What are the mechanism of action of spironolactone and eperenone? - ANSWERS1.
Both of these are aldosterone antagonists
2. Spironolactone is also anti-andronergic
What are the side-effects of spironolactone and eperenone? - ANSWERS1.
Spironolactone can cause hyperkalemia (due to decreased aldosterone), or
gynecomastia due to it's anti-andronergic effects.
, 2. Eperenone only causes hyperkalemia, because it does not cross inhibit the
testosterone receptor.
What is the mechanism of action of Propranolol? - ANSWERSA nonspecific blocker of
both the Beta-1 and Beta-2 receptors
When is Propranolol indicated? - ANSWERS1. Migraine headaches
2. Portral hypertension (decreases esophageal varices bleeding)
3. Thyroid storm
4. Essential tremor
5. Pheochromocytoma (adrenal tumor)
What are the side-effects of propranolol? - ANSWERSMANY side-effects compared to
selective Beta-1 blockers.
1. Bronchospasm, depression, bradycardia, hypotension, erectile dysfunction.
2. Hyperkalemia by inhibiting Sodium/Potassium ATPase
3. Adverse effects on glucose and peripheral arterial disease.
What is indicated for usage to treat supra ventricular tachycardia that does not respond
to sinus massage? - ANSWERSAdenosine
How does adenosine relieve supra ventricular tachycardia? - ANSWERS1. Reduces
calcium currents and is anti arrhythmic by increasing AV nodal refractoriness
2. Transiently slows the sinus rate and AV nodal conduction velocity
3. Opens potassium channels, hyperpolarizing nodal tissue and making them less likely
to fire.
What mechanism of aspirin has an impact on cardiovascular disease? -
ANSWERSAspirin IRREVERSIBLY inhibits COX, which will decrease the production of
TXA2. TXA2 is necessary for hemostasis--therefore aspirin prevents clot formation and
thins the blood.
When is aspirin indicated? - ANSWERS1. Acute coronary syndromes (MI, unstable
angina)
2. Stroke or TIA
3. Peripheral artery disease
4. Kawasaki's Disease (despite the fact that it affects children!)
5. Essential Thrombocythemia
-Fever
-RA
-Gout
What are the adverse effects of aspirin? - ANSWERS1. Bleeding
2. Peptic ulcers, asthma, renal insufficiency, rash
