Antianginal Drugs: Pharmacology, Mechanisms, and Clinical Applications

Question 1

What is the predominant mechanism of action of nitrates?

Accepted Answer

Vasodilation of coronary arteries

Answer

Reduction of preload

Answer

Elevation of afterload

Answer

Negative chronotropy

Question 2

Which factor significantly influences the effectiveness of beta-blockers?

Accepted Answer

Thyroid function

Answer

Age

Answer

Weight

Answer

Liver function

Question 3

Which adverse effect is most commonly associated with calcium channel blockers?

Accepted Answer

Headache

Answer

Nausea

Answer

Hypotension

Answer

Bradycardia

Question 4

Which of the following is NOT an indication for nicorandil?

Accepted Answer

Heart failure

Answer

Angina pectoris

Answer

Hypertension

Answer

Migraine prevention

Question 5

Which parameter should be routinely monitored in patients taking ivabradine?

Accepted Answer

Heart rate

Answer

Blood pressure

Answer

Potassium levels

Answer

Blood glucose

Question 6

Which nursing intervention is important for patients taking trimetazidine?

Accepted Answer

Education about potential gastrointestinal upset

Answer

Monitoring for rash

Answer

Assessment for dizziness

Answer

Encouragement of regular exercise

Question 7

Which of the following is the primary mechanism of action of nitrates in managing angina?

Accepted Answer

Increasing coronary artery vasodilation

Answer

Decreasing preload and afterload

Answer

Increasing myocardial contractility

Answer

Blocking calcium channels

Question 8

What is a common adverse effect associated with nitroglycerin?

Accepted Answer

Headache

Answer

Constipation

Answer

Arrhythmias

Answer

Edema

Question 9

Which of the following antianginal drugs belongs to the calcium channel blocker class?

Accepted Answer

Verapamil

Answer

Nitroglycerin

Answer

Atorvastatin

Answer

Metoprolol

Question 10

What is a key nursing consideration when administering sublingual nitroglycerin tablets?

Accepted Answer

Allow the patient to sit or lie down before administration

Answer

Instruct the patient to swallow the tablet whole

Answer

Administer the drug with food or milk

Answer

Monitor the patient for signs of hypertension

Question 11

Which of the following drugs is contraindicated for patients with asthma?

Accepted Answer

Beta-blockers

Answer

Calcium channel blockers

Answer

Nitrates

Answer

Statins

Question 12

What is the main therapeutic goal of antianginal therapy?

Accepted Answer

Reduce myocardial oxygen demand

Answer

Increase myocardial oxygen supply

Answer

Dilate coronary arteries

Answer

Decrease heart rate

Question 13

Which of the following is a potential drug interaction with beta-blockers?

Accepted Answer

Cimetidine

Answer

Warfarin

Answer

Aspirin

Answer

Metformin

Question 14

What is the primary mechanism of action by which nitrates alleviate angina?

Accepted Answer

Reducing arterial resistance and dilating coronary blood vessels

Answer

Increasing cardiac contractility and reducing heart rate

Answer

Inhibiting the renin-angiotensin-aldosterone system and promoting diuresis

Answer

Suppressing sympathetic nervous system activity and decreasing blood pressure

Question 15

Which of the following is a common adverse effect of beta-blockers used in angina treatment?

Accepted Answer

Bradycardia (slow heart rate)

Answer

Tachycardia (rapid heart rate)

Answer

Hypertension (high blood pressure)

Answer

Increased angina severity

Question 16

How does isosorbide dinitrate differ from isosorbide mononitrate in terms of clinical use?

Accepted Answer

It has a longer duration of action and is typically taken once daily

Answer

It is more effective in reducing the frequency and severity of angina attacks

Answer

It is less likely to cause dizziness and headache as side effects

Answer

It is not metabolized by the liver and has a more predictable effect

Question 17

Which class of antianginal drugs is most likely to cause a significant drop in blood pressure?

Accepted Answer

Nitrates

Answer

Beta-blockers

Answer

Calcium channel blockers

Answer

ACE inhibitors

Question 18

Which nursing intervention is crucial when administering diltiazem to a patient with angina?

Accepted Answer

Monitoring for signs and symptoms of heart failure, such as shortness of breath and edema

Answer

Encouraging regular caffeine consumption to enhance its effectiveness

Answer

Administering the medication with grapefruit juice to increase its absorption

Answer

Teaching the patient to take the medication at bedtime to minimize daytime drowsiness

Question 19

How does ranolazine differ from other antianginal drugs in its mechanism of action?

Accepted Answer

It is a novel antianginal agent with a unique mechanism of action

Answer

It is not effective in treating Prinzmetal's angina, a variant form of angina

Answer

It has no effect on heart rate, unlike other antianginal drugs

Answer

It is primarily used to treat hypertension, rather than angina

Question 20

What potential interaction should be considered when administering isosorbide dinitrate with sildenafil (Viagra)?

Accepted Answer

Hypotension

Answer

Hypertension

Answer

Tachycardia

Answer

Bronchospasm

Question 21

How does tolerance development affect the clinical use of nitrates in managing angina?

Accepted Answer

Reduces effectiveness over time, potentially requiring dosage adjustments or alternative medications.

Answer

Increases effectiveness over time, allowing for lower doses to achieve the same effect.

Answer

Has no clinically significant impact and can be disregarded in patient management.

Question 22

Which type of drug from the following list is commonly used as a beta-blocker in the treatment of angina?

Accepted Answer

Propranolol

Answer

Diltiazem

Answer

Nitroglycerin

Answer

Verapamil

Question 23

Constipation is a common side effect associated with which class of antianginal drugs?

Accepted Answer

Calcium channel blockers

Answer

Nitrates

Answer

Beta-blockers

Answer

Potassium channel activators

Question 24

Which of the following conditions is NOT considered a contraindication for the use of nitrates in angina treatment?

Accepted Answer

Stable angina

Answer

Severe aortic stenosis

Answer

Hypotension

Answer

Pregnancy

Question 25

When administering sublingual nitroglycerin, which nursing action is of utmost importance?

Accepted Answer

Instructing the patient to hold the tablet under the tongue for 30 seconds before swallowing

Answer

Monitoring for signs of hypotension

Answer

Assessing the patient for potential headache

Answer

Administering the medication only as needed

Question 26

Which substance has the potential to interact with calcium channel blockers, affecting their metabolism and efficacy?

Accepted Answer

Grapefruit juice

Answer

Warfarin

Answer

Aspirin

Answer

Digoxin

Question 27

Which clinical manifestation is indicative of nitrate tolerance?

Accepted Answer

Decreased effectiveness of the medication

Answer

Increased frequency and severity of angina attacks

Answer

Withdrawal symptoms upon cessation of therapy

Answer

Severe hypotension

Question 28

Which adverse effect is most commonly associated with beta-blockers used to treat angina?

Accepted Answer

Bradycardia

Answer

Tachycardia

Answer

Hypotension

Answer

Hypertension

Question 29

What is the primary mechanism of action of nitrates in mitigating angina?

Accepted Answer

Vasodilation of coronary arteries, increasing blood supply to the heart

Answer

Reduction of preload, decreasing cardiac workload

Answer

Blockade of calcium channels, reducing myocardial contractility

Answer

Constriction of peripheral arteries, increasing afterload

Question 30

Which drug class is specifically indicated for the treatment of Prinzmetal's angina, a variant angina caused by coronary artery spasms?

Accepted Answer

Calcium channel blockers, which inhibit calcium influx into vascular smooth muscle, reducing vasospasm

Answer

Beta-blockers, which reduce heart rate and myocardial oxygen demand

Answer

Nitrates, which primarily dilate large coronary arteries

Answer

Antiplatelets, which prevent platelet aggregation

Question 31

Among beta-blockers used in angina management, which side effect is most commonly observed?

Accepted Answer

Bradycardia, a decrease in heart rate, which reduces myocardial oxygen demand

Answer

Tachycardia, an increase in heart rate, which increases myocardial oxygen demand

Answer

Vasodilation, a widening of blood vessels, which can lower blood pressure

Question 32

Which condition is a contraindication for the use of nitrates in the treatment of angina?

Accepted Answer

Hypotension, dangerously low blood pressure, which can be exacerbated by the vasodilatory effects of nitrates

Answer

Tachycardia, a rapid heart rate, which can be offset by the bradycardic effects of nitrates

Answer

Bradycardia, a slow heart rate, which can be further reduced by nitrates

Question 33

What is the typical sublingual dose range for nitroglycerin, a fast-acting nitrate used to relieve acute angina attacks?

Accepted Answer

0.3-0.6 mg, administered under the tongue for rapid absorption and onset of action

Answer

1-2 mg, a dose that may be too low to provide effective relief

Answer

15-20 mg, a dose typically used for intravenous administration in severe angina

Answer

5-10 mg, a dose that may increase the risk of side effects

Question 34

Which class of antianginal drugs exerts its therapeutic effect primarily by decreasing myocardial oxygen demand?

Accepted Answer

Beta-blockers, which reduce heart rate and contractility, thereby reducing myocardial oxygen consumption

Answer

Calcium channel blockers, which inhibit calcium influx into vascular smooth muscle

Answer

Nitrates, which primarily dilate coronary arteries

Answer

Antiplatelets, which prevent platelet aggregation

Question 35

As a nurse, what is your primary objective when administering antianginal medications to a patient?

Accepted Answer

To alleviate or prevent angina symptoms, such as chest pain or discomfort

Answer

To improve overall circulation throughout the body

Answer

To increase the heart rate and cardiac output

Answer

To reduce blood pressure to prevent cardiovascular events

Question 36

Which of the following is NOT an important patient education point regarding antianginal medications?

Accepted Answer

Take the medication at bedtime, as this may interfere with its effectiveness

Answer

Report any headaches or dizziness, which can be common side effects of nitrates

Answer

Carry nitroglycerin tablets at all times in case of an angina attack

Answer

Avoid caffeine and alcohol, which can worsen angina symptoms

Question 37

Which drug is a potent vasodilator that can be administered intravenously to manage severe and refractory angina?

Accepted Answer

Sodium nitroprusside, a rapidly acting vasodilator that relaxes both arterial and venous smooth muscle

Answer

Nitroglycerin, which is typically administered sublingually

Answer

Metoprolol, a beta-blocker used for long-term angina management

Answer

Isosorbide dinitrate, a long-acting nitrate used for prophylaxis of angina

Question 38

Which of the following actions is the main mechanism of action of nitrates?

Accepted Answer

Vasodilation

Answer

Reducing heart rate

Answer

Blocking calcium channels

Answer

Increasing myocardial contractility

Question 39

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

Accepted Answer

Bradycardia

Answer

Bronchospasm

Answer

Hypotension

Question 40

Which of the following medications is the first-line treatment for acute angina attacks?

Accepted Answer

Sublingual nitroglycerin

Answer

Calcium channel blockers

Answer

Beta-blockers

Answer

Long-acting nitrates

Question 41

Which side effect is common to both nitrates and beta-blockers?

Accepted Answer

Headache

Answer

Rebound angina

Answer

Bradycardia

Answer

Bronchospasm

Question 42

Which of the following drugs should not be administered to patients with severe hypotension?

Accepted Answer

Nitroglycerin

Answer

Beta-blockers

Answer

Calcium channel blockers

Answer

Ranolazine

Question 43

What is the unique mechanism of action of ranolazine?

Accepted Answer

Inhibition of late sodium channels

Answer

Vasodilation

Answer

Blocking calcium channels

Answer

Reducing heart rate

Question 44

Which of the following is a potential serious adverse effect associated with amiodarone therapy?

Accepted Answer

Pulmonary fibrosis

Answer

Bronchospasm

Answer

Bradycardia

Answer

Headache

Question 45

Which nursing intervention is crucial when administering sublingual nitroglycerin?

Accepted Answer

Monitoring blood pressure

Answer

Storing in the refrigerator

Answer

Administering with food

Answer

Reconstituting before administration

Question 46

Which mechanism of action is NOT associated with antianginal drugs?

Accepted Answer

Diuretic effect

Answer

Vasodilation

Answer

Chronotropy

Answer

Negative inotropy

Question 47

Which antianginal drug belongs to the class of calcium channel blockers?

Accepted Answer

Verapamil

Answer

Atenolol

Answer

Nitroglycerin

Question 48

Which antianginal drug is administered sublingually for rapid onset of action?

Accepted Answer

Nitroglycerin

Answer

Metoprolol

Answer

Diltiazem

Answer

Ranolazine

Question 49

Which monitoring parameter is essential for patients taking antianginal drugs?

Accepted Answer

Blood pressure

Answer

Respiratory rate

Answer

Urine output

Answer

Temperature

Question 50

Which of the following is an indication for antianginal medications?

Accepted Answer

Stable angina

Answer

Diabetes

Answer

Heart failure

Answer

Hypertension

Question 51

Which drug listed below is classified as a nitrate?

Accepted Answer

Isosorbide mononitrate

Answer

Metoprolol

Answer

Verapamil

Answer

Diltiazem

Question 52

Which of the following is a potential drug interaction with antianginal drugs?

Accepted Answer

Phosphodiesterase inhibitors

Answer

Antibiotics

Answer

Antacids

Answer

Antihistamines