Antianginal Drugs: Master Pharmacology for MPharm Students

Question 1

Which of the following statements about nitrates accurately describes their mechanism of action?

Accepted Answer

They dilate both arteries and veins, which leads to decreased preload and afterload.

Answer

They selectively dilate arteries, which leads to decreased preload and afterload.

Answer

They inhibit the renin-angiotensin-aldosterone system, which leads to decreased blood pressure.

Answer

They increase the heart rate and contractility, which leads to increased cardiac output.

Question 2

Metoprolol belongs to a class of beta-blockers known as:

Accepted Answer

Cardioselective

Answer

Non-selective

Answer

Mixed

Answer

Lipophilic

Question 3

Which of the following is a commonly experienced side effect associated with the use of nitrates?

Accepted Answer

Dizziness

Answer

Bronchospasm

Answer

Peripheral edema

Answer

Constipation

Question 4

Which adverse effect is most commonly associated with nitrates?

Accepted Answer

Headache

Answer

Angina

Answer

Bradycardia

Answer

Constipation

Question 5

Which of the following mechanisms is NOT involved in the therapeutic effects of nitrates?

Accepted Answer

Blockade of calcium channels

Answer

Vasodilation of coronary arteries

Answer

Reduction of myocardial oxygen demand

Answer

Inhibition of platelet aggregation

Question 6

Which calcium channel blocker has the most pronounced negative inotropic effect?

Accepted Answer

Verapamil

Answer

Diltiazem

Answer

Nifedipine

Answer

Amlodipine

Question 7

Which adverse effect is most commonly associated with beta-blockers?

Accepted Answer

Bradycardia

Answer

Heart failure

Answer

Bronchospasm

Answer

Peripheral edema

Question 8

Which potential interaction between nitrates and other drugs must be considered?

Accepted Answer

Potentiation of the antihypertensive effects of ACE inhibitors

Answer

Antagonism of the bronchodilatory effects of beta-agonists

Answer

Enhancement of the anticoagulant effects of warfarin

Answer

Reduction of the antiplatelet effects of aspirin

Question 9

Which antianginal drug is commonly used for prophylactic treatment of angina?

Accepted Answer

Isosorbide mononitrate transdermal patch

Answer

Nitroglycerin sublingual spray

Answer

Diltiazem extended-release tablets

Answer

Metoprolol succinate injection

Question 10

Which antianginal drug has the shortest duration of action?

Accepted Answer

Nitroglycerin sublingual spray

Answer

Amlodipine extended-release tablets

Answer

Carvedilol once-daily tablet

Answer

Isosorbide mononitrate transdermal patch

Question 11

Where is the primary site of action of nitrates?

Accepted Answer

Venous smooth muscle

Answer

Arterial smooth muscle

Answer

Cardiac muscle

Question 12

How do nitrates induce vasodilation in both arteries and veins?

Accepted Answer

Directly relaxing vascular smooth muscle by activating guanylate cyclase

Answer

Inhibiting angiotensin-converting enzyme (ACE)

Answer

Stimulating alpha-adrenergic receptors

Answer

Blocking voltage-gated calcium channels

Question 13

Which of the following is NOT a mechanism of action of nitrates?

Accepted Answer

Increase in contractility

Answer

Vasodilation of coronary arteries

Answer

Reduction of preload and afterload

Answer

Prevention of platelet aggregation

Question 14

Which dihydropyridine calcium channel blocker is highly selective for vascular smooth muscle?

Accepted Answer

Amlodipine

Answer

Nifedipine

Answer

Verapamil

Answer

Diltiazem

Question 15

Which of the following adverse effects is commonly seen with antianginal drugs?

Accepted Answer

Headache

Answer

Tachycardia

Answer

Hypertension

Answer

Bronchospasm

Question 16

Which of the following drugs is a first-line treatment for Prinzmetal's angina?

Accepted Answer

Glyceryl trinitrate

Answer

Amlodipine

Answer

Metoprolol

Answer

Diltiazem

Question 17

What is the primary mechanism of action of calcium channel blockers?

Accepted Answer

Inhibition of calcium channels

Answer

Inhibition of sodium channels

Answer

Activation of potassium channels

Answer

Inhibition of phosphodiesterase

Question 18

Which of the following beta-blockers has intrinsic sympathomimetic activity?

Accepted Answer

Pindolol

Answer

Atenolol

Answer

Propranolol

Answer

Metoprolol

Question 19

Which of the following is NOT a clinical use of beta-blockers?

Accepted Answer

Asthma

Answer

Hypertension

Answer

Arrhythmias

Answer

Angina pectoris

Question 20

When selecting an antianginal drug for a patient with diabetes, which factor should be considered?

Accepted Answer

Cardioselectivity

Answer

Lipophilicity

Answer

Half-life

Answer

Route of administration

Question 21

Which adverse effect is associated with long-term beta-blocker therapy?

Accepted Answer

Heart failure

Answer

Cardiac arrhythmias

Answer

Hypertension

Question 22

Which of the following is a stereotypical adverse effect of nitrates?

Accepted Answer

Headache

Answer

Convulsions

Answer

Hypertension

Answer

Bradycardia

Question 23

Which mechanism of action is common to both nitrates and calcium channel blockers?

Accepted Answer

Vasodilation

Answer

Blockade of the sympathetic nervous system

Answer

Inhibition of sodium channels

Answer

Reduction of heart rate

Question 24

Which of the following contraindications applies to both beta-blockers and calcium channel blockers?

Accepted Answer

Sick sinus syndrome

Answer

Pregnancy

Answer

Severe hepatic impairment

Answer

Asthma

Question 25

For a patient with both hypertension and angina, which of the following antianginal drugs would be the most suitable choice?

Accepted Answer

Amlodipine

Answer

Isosorbide mononitrate

Answer

Propranolol

Answer

Verapamil

Question 26

What is the main mechanism by which beta-blockers reduce myocardial oxygen demand?

Accepted Answer

Reduction in heart rate

Answer

Increase in stroke volume

Answer

Vasodilation of coronary arteries

Answer

Inhibition of platelet aggregation

Question 27

What is a notable advantage of using a nitrate patch over a nitrate tablet?

Accepted Answer

Sustained release

Answer

Faster onset of action

Answer

Reduced frequency of dosing

Answer

Lower risk of hypotension