APEA PHARM CARDIOVASCULAR EXAM 68
QUESTIONS & CORRECT ANSWERS
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.
QUESTIONS & CORRECT ANSWERS
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.
