ORGANOTROPIC AGENTS

PART I Drugs acting on respiratory system

001. Following drugs directly activate the respiratory center EXCEPT:

a) Bemegride

b) Caffeine

c) Aethymizole

d) Cytiton

002. The mechanism of Cytiton action is:

a) Direct activation of the respiratory center

b) The reflex mechanism

c) The mixed mechanism

d) None of the above

003. Indicate the drug belonging to antitussives of narcotic type of action:

a) Glaucine hydrochloride

b) Aethylmorphine hydrochloride

c) Tusuprex

d) Libexine

004. Tick out the drug belonging to non-narcotic antitussives:

a) Libexine

b) Tusuprex

c) Codeine

d) Aethylmorphine hydrochloride

005. Indicate the expectorant with the reflex mechanism:

a) Sodium benzoate

b) Derivatives of Ipecacucnha and Thermopsis

c) Trypsin

d) Ambroxol

006. Tick the antitussive agent with a peripheral effect:

a) Codeine

b) Tusuprex

c) Libexine

d) Glaucine hydrochloride

007. Chymotrypsin is an agent containing free sulfhydryl groups. It’s:

a) True

b) False

008. All of these drugs contain free sulfhydryl groups EXCEPT:

a) Acetylcysteine

b) Ambroxol

c) Bromhexin

d) Trypsin

009. Which of the following drugs is proteolytic enzyme?

a) Potassium iodide

b) Desoxiribonuclease

c) Carbocysteine

d) Acetylcysteine

010. All of the following drugs destroy disulfide bonds of proteoglycans, which causes depolymerization and reduction of viscosity of sputum, EXCEPT:

a) Acetylcysteine

b) Ambroxol

c) Desoxiribonuclease

d) Bromhexin

011. Which of these groups of drugs is used for asthma treatment?

a) Methylxanthines

b) M-cholinoblocking agents

c) Beta2 - stimulants

d) All of above

012. Tick the drug belonging to non-selective beta2-adrenomimics:

a) Salbutamol

b) Isoprenaline

c) Salmeterol

d) Terbutaline

013. Select the side-effect characteristic for non-selective beta2-adrenomimics:

a) Depression of the breathing centre

b) Tachycardia

c) Peripheral vasoconstriction

d) Dry mouth

014. Pick out the bronchodilator drug related to xanthine:

a) Atropine

b) Orciprenaline

c) Adrenaline

d) Theophylline

015. Pick out the bronchodilator drug belonging to sympathomimics:

a) Isoprenaline

b) Ephedrine

c) Atropine

d) Salbutamol

016. The property of prolonged theophyllines is the prevention of night asthmatic attacks. It’s:

a) True

b) False

017. The mechanism of methylxanthines action is:

a) Inhibition of the enzyme phosphodiesterase

b) Beta2 -adrenoreceptor stimulation

c) Inhibition of the production of inflammatory cytokines

d) Inhibition of M-cholinoreceptors

018. Which of the following M-cholinoblocking agents is used especially as an anti-asthmatic?

a) Atropine

b) Ipratropium

c) Platiphylline

d) Metacin

019. Indicate the side effect of Theophylline:

a) Bradycardia

b) Increased myocardial demands for oxygen

c) Depression of respiratory centre

d) Elevation of the arterial blood pressure

020. All of the following drugs are inhaled glucocorticoids EXCEPT:

a) Triamcinolone

b) Beclometazone

c) Sodium cromoglycate

d) Budesonide

021. Choose the drug belonging to membranestabilizing agents:

a) Zileutin

b) Sodium cromoglycate

c) Zafirlucast

d) Montelucast

022. Tick the drug which is a 5-lipoxygenase inhibitor:

a) Budesonide

b) Sodium cromoglycate

c) Zileutin

d) Beclometazone

023. Zileutin prevents the production of leukotrienes. This statement is:

a) True

b) False

024. Indicate the drug which is a leucotriene receptor antagonist:

a) Sodium cromoglycate

b) Zafirlucast

c) Zileutin

d) Triamcinolone

025. Zafirlucast prevents aspirin-sensitive asthma. This consideration is:

a) True

b) False

PART II Drugs used in gastrointestinal diseases

001. Tick the main approach of peptic ulcer treatment:

a) Neutralization of gastric acid

b) Eradication of Helicobacter pylori

c) Inhibition of gastric acid secretion

d) All the above

002. Gastric acid secretion is under the control of the following agents EXCEPT:

a) Histamine

b) Acetylcholine

c) Serotonin

d) Gastrin

003. Indicate the drug belonging to proton pump inhibitors:

a) Pirenzepine

b) Ranitidine

c) Omeprazole

d) Trimethaphan

004. All of the following agents intensify the secretion of gastric glands EXCEPT:

a) Pepsin

b) Gastrin

c) Histamine

d) Carbonate mineral waters

005. Which of the following drugs is an agent of substitution therapy?

a) Gastrin

b) Hydrochloric acid

c) Hystamine

d) Carbonate mineral waters

006. Choose the drug which is a H2-receptor antagonist:

a) Omeprazole

b) Pirenzepine

c) Carbenoxolone

d) Ranitidine

007. All of the following drugs are proton pump inhibitors EXCEPT:

a) Pantoprozole

b) Omeprazole

c) Famotidine

d) Rabeprazole

008. Indicate the drug belonging to M1-cholinoblockers:

a) Cimetidine

b) Ranitidine

c) Pirenzepin

d) Omeprazole

009. Which of the following drugs may cause reversible gynecomastia?

a) Omeprazole

b) Pirenzepine

c) Cimetidine

d) Sucralfate

010. Cimetidine has no effect on hepatic drug metabolism. It’s

a) True

b) False

011. Tick the drug forming a physical barrier to HCL and Pepsin:

a) Ranitidine

b) Sucralfate

c) Omeprazole

d) Pirenzepine

012. Which drug is an analog of prostaglandin E1?

a) Misoprostole

b) De-nol

c) Sucralfate

d) Omeprazole

013. Select the drug stimulating the protective function of the mucous barrier and the stability of the mucous membrane against damaging factors:

a) De-nol

b) Sucralfate

c) Misoprostol

d) Omeprazole

014. Antacids are weak bases that react with gastric hydrochloric acid to form salt and water. It’s

a) True

b) False

015. Most of drugs are antacids EXCEPT:

a) Misoprostol

b) Maalox

c) Mylanta

d) Almagel

016. Indicate the drug that cause metabolic alkalosis:

a) Sodium bicarbonate

b) Cimetidine

c) Pepto-Bismol

d) Carbenoxolone

017. Choose the drug that causes constipation:

a) Sodium bicarbonate

b) Aluminium hydroxide

c) Calcium carbonate

d) Magnesium oxide

018. All of the following drugs stimulate appetite EXCEPT:

a) Vitamins

b) Bitters

c) Fepranone

d) Insulin

019. Ethyl alcohol is an agent decreasing appetite. It’s:

a) True

b) False

020. Select an anorexigenic agent affecting serotoninergic system:

a) Fenfluramine

b) Fepranone

c) Desopimone

d) Masindole

021. All of the following drugs intensify gastrointestinal motility EXCEPT:

a) Papaverine

b) Metoclopramide

c) Domperidone

d) Cisapride

022. Metoclopramide is a potent dopamine antagonist.It’s

a) True

b) False

023. Choose an emetic drug of central action:

a) Ipecacuanha derivatives

b) Promethazine

c) Tropisetron

d) Apomorphine hydrochloride

024. Tick the mechanism of Metoclopramide antiemetic action:

a) H1 and H2-receptor blocking effect

b) M-cholinoreceptor stimulating effect

c) D2-dopamine and 5-HT3-serotonin receptor blocking effect

d) M-cholinoblocking effect

025. Select the emetic agent having a reflex action:

a) Ipecacuanha derivatives

b) Apomorphine hydroclorid

c) Chlorpromazine

d) Metoclopramide

026. All of the following drugs are antiemetics EXCEPT:

a) Metoclopramide

b) Ondansetron

c) Chlorpromazine

d) Apomorphine hydrochloride

027. Indicate an antiemetic agent which is related to neuroleptics:

a) Metoclopramide

b) Nabilone

c) Tropisetron

d) Prochlorperazine

028. All of these drugs reduce intestinal peristalsis EXCEPT:

a) Loperamide

b) Cisapride

c) Methyl cellulose

d) Magnesium aluminium silicate

029. Indicate the laxative drug belonging to osmotic laxatives:

a) Docusate sodium

b) Bisacodyl

c) Phenolphthalein

d) Sodium phosphate

030. The mechanism of stimulant purgatives is:

a) Increasing the volume of non-absorbable solid residue

b) Increasing motility and secretion

c) Altering the consistency of the feces

d) Increasing the water content

031. Choose the drug irritating the gut and causing increased peristalsis:

a) Phenolphthalein

b) Methyl cellulose

c) Proserine

d) Mineral oil

032. All of the following drugs stimulate bile production and bile secretion EXCEPT:

a) Chenodiol

b) Cholenszyme

c) Oxaphenamide

d) Cholosas

033. Tick the stimulant of bile production of vegetable origin:

a) Oxaphenamide

b) Papaverine

c) Cholenzyme

d) Cholosas

034. Select the drug which inhibits peristalsis:

a) Castor oil

b) Bisacodyl

c) Loperamide

d) Sorbitol

035. Choose the drug affecting the biliary system and relaxing Oddy sphincter:

a) Cholosas

b) Oxaphenamide

c) No-spa

d) Cholenzyme

PART III Drugs acting on hematopoietic system

001. Following drugs stimulate erythrogenesis EXCEPT:

a) Iron dextran

b) Vitamine B12

c) Methotrexate

d) Folic acid

002. Choose the drug depressing erythrogenesis:

a) Radioactive phosphorus 32

b) Ferrous sulfate

c) Molgramostim

d) Folic acid

003. Which drug does not influence leucopoiesis?

a) Filgrastim

b) Erythropoetin

c) Doxorubicin

d) Methotrexate

004. Iron deficiency anemia leads to pallor, fatigue, dizziness, exertional dyspnea and other symptoms of tissue ischemia. It’s:

a) True

b) False

005. All of the following drugs used for iron deficiency anemia EXCEPT: a) Ferrous sulfate

b) Folic acid

c) Ferrous gluconate

d) Ferrous fumarate

006. Tick the drug for parenteral iron therapy:

a) Ferrous sulfate

b) Fercoven

c) Ferrous lactate

d) Ferrous fumarate

007. Indicate the drug which increases absorption of iron from intestine:

a) Cyanocobalamin

b) Folic acid

c) Ascorbic acid

d) Erythropoetin

008. The drugs used for oral administration EXCLUDE:

a) Ferrous sulfate

b) Fercoven

c) Ferrous lactate

d) Ferrous fumarate

009. Pernicious anemia is developed due to deficiency of:

a) Erythropoetin

b) Vitamin B12

c) Iron

d) Vitamin B6

010. Select the drug used for pernicious anemia:

a) Ferrous lactate

b) Cyanocobalamin

c) Iron dextran

d) Ferrous gluconate

011. An adverse effect of oral iron therapy is:

a) Anemia

b) Thrombocytopenia

c) Headache

d) Constipation

012. Choose the drug which contains cobalt atom:

a) Folic acid

b) Iron dextran

c) Cyanocobalamine

d) Ferrous gluconate

013. Tick the drug used in aplastic anemia:

a) Fercoven

b) Cyanocobalamine

c) Epoetin alpha

d) Folic acid

014. Folic acid is recommended for treatment of megaloblastic anemia. This statement is:

a) True

b) False

015. Select the drug of granulocyte colony-stimulating factor:

a) Filgrastim

b) Methotrexate

c) Erythropoetin

d) Doxorubicin

PART IV Drugs used in disorders of coagulation

001. All of the following physiologic reactions are involved in the control of bleeding EXCEPT:

a) Platelet adhesion reaction

b) Platelet release reaction

c) Activation of the antifibrinolytic system

d) Triggering of the coagulation process

002. Which of the following substances is synthesized within vessel walls and inhibits thrombogenesis?

a) Thromboxane A2 (TXA2)

b) Prostacyclin (PGI2)

c) Prostaglandin ((PGE)

d) None of the above

003. All of the following groups of drugs are for thrombosis treatment EXCEPT:

a) Anticoagulant drugs

b) Antifibrinolitic drugs

c) Fibrinolitic drugs

d) Antiplatelet drugs

004. Pick out the drug belonging to anticoagulants of direct action:

a) Aspirin

b) Heparin

c) Dicumarol

d) Phenprocoumon

005. Which of the following drugs has low-molecular weight?

a) Dicumarol

b) Enoxaparin

c) Phenprocoumon

d) Heparin

006. Indicate the drug belonging to antagonists of heparin:

a) Aspirin

b) Dicumarol

c) Dalteparin

d) Protamine sulfate

007. Tick the drug used as an oral anticoagulant:

a) Heparin

b) Daltreparin

c) Dicumarol

d) Enoxaparin

008. All of the following drugs are indirect acting anticoagulants EXCEPT:

a) Dicumarol

b) Warfarin

c) Dalteparin

d) Phenindione

009. Which of the following drugs belongs to coumarin derivatives?

a) Heparin

b) Enoxaparin

c) Dalteparin

d) Warfarin

010. Heparin is effective when administred orally. This consideration is:

a) True

b) False

011. All of these drugs are antiplatelet agents EXCEPT:

a) Aspirin

b) Urokinase

c) Ticlopidine

d) Clopidogrel

012. The use of heparin is recommended for treatment of deep venous thrombosis. This statement is:

a) True

b) False

013. Mechanism of aspirin action is:

a) Converts inactive plasminogen into active plasmin

b) Inhibits COX and thus thromboxane synthesis

c) Enhances the interaction between antitrombin III and both thrombin and the factors involved in the intrinsic clotting cascade

d) Inhibits the glycoprotein IIb/IIIa complex

014. Which doses of Aspirin may be more effective in inhibiting Tromboxane A2?

a) Low

b) High

015. Which of the following drugs is an inhibitor of platelet glycoprotein IIb/IIIa receptors?

a) Aspirin

b) Clopidogrel

c) Ticlopidine

d) Abciximab

016. Ticlopidine is an inhibitor of ADP-induced platelet aggregation. It’s: a) True

b) False

017. Which of the following drugs is fiibrinolytic?

a) Ticlopidine

b) Streptokinase

c) Aspirin

d) Warfarin

018. Mechanism of urokinase action is an inhibition of Thromboxane A2. This statement is:

a) True

b) False

019. Fibrinolytic drugs are used for following EXCEPT:

a) Central deep venous thrombosis

b) Multiple pulmonary emboli

c) Heart failure

d) Acute myocardial infarction

020. Indicate the drug belonging to fibrinoliytic inhibitors:

a) Aminocapronic acid

b) Ticlopidine

c) Streptokinase

d) Vitamin K

021. Aminocapronic acid is a drug of choice for treatment of:

a) Acute myocardial infarction

b) Bleeding from fibrinolytic therapy

c) Heart failure

d) Multiple pulmonary emboli

022. Tranexamic acid is an analog of aminocapronic acid. It’s:

a) True

b) False

PART V Drugs used for treatment of heart failure

001. All of the following are normally involved in the pathogenesis of heart failure EXCEPT:

a) A cardiac lesion that impairs cardiac output

b) An increase in peripheral vascular resistance

c) A decrease in preload

d) An increase in sodium and water retention

002. All of the following are compensatory mechanisms that occur during the pathogenesis of congestive heart failure EXCEPT:

a) An increase in ventricular end-diastolic volume

b) An increase in the concentration of plasma catecholamines

c) An increase in vagal tone

d) Increased activity of the renin-angiotensin-aldosterone system

003. All of the following are recommended at the initial stages of treating patients with heart failure EXCEPT:

a) Reduced salt intake

b) Verapamil

c) ACE inhibitors

d) Diuretics

004. All of the following agents belong to cardiac glycosides EXCEPT:

a) Digoxin

b) Strophantin K

c) Amrinone

d) Digitoxin

005. The non-glycoside positive inotropic drug is:

a) Digoxin

b) Strophantin K

c) Dobutamine

d) Digitoxin

006. Sugar molecules in the structure of glycosides influence:

a) Cardiotonic action

b) Pharmacokinetic properties

c) Toxic properties

d) All of the above

007. Aglycone is essential for:

a) Plasma protein binding

b) Half-life

c) Cardiotonic action

d) Metabolism

008. Choose the derivative of the plant Foxglove (Digitalis):

a) Digoxin

b) Strophantin K

c) Dobutamine

d) Amrinone

009. All of the following statements regarding cardiac glycosides are true EXCEPT:

a) They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca++ in myocardial cells

b) They cause a decrease in vagal tone

c) Children tolerate higher doses of digitalis than do adults

d) The most frequent cause of digitalis intoxication is concurrent administration of diuretics that deplete K+

010. An important action of digitalis is to increase vagal tone. It’s:

a) True

b) False

011. Digoxin is thought to increase intracellular concentrations of calcium in myocardial cells by indirectly slowing the action of the sodium-calcium exchanger. This consideration is:

a) True

b) False

012. Compare the half-life of digoxin and the half-life of digitoxin:

a) Digoxin is greater than digitoxin

b) Digitoxin is greater than digoxin

013. All of the following statements regarding cardiac glycosides are true EXCEPT:

a) They inhibit the activity of the Na+/K+-ATPase

b) They decrease intracellular concentrations of calcium in myocytes

c) They increase vagal tone

d) They have a very low therapeutic index

014. All of the following statements regarding cardiac glycosides are true EXCEPT:

a) Digoxin is a mild inotrope

b) Digoxin increases vagal tone

c) Digoxin has a longer half-life than digitoxin

d) Digoxin acts by inhibiting the Na+/K+ ATPase

015. The most cardiac manifestation of glycosides intoxication is:

a) Atrioventricular junctional rhythm

b) Second-degree atrioventricular blockade

c) Ventricular tachycardia

d) All the above

016. The manifestations of glycosides intoxication are:

a) Visual changes

b) Ventricular tachyarrhythmias

c) Gastrointestinal disturbances

d) All the above

017. For digitalis-induced arrhythmias the following drug is favored:

a) Verapamil

b) Amiodarone

c) Lidocaine

d) Propanolol

018. In very severe digitalis intoxication the best choice is to use:

a) Lidocaine

b) Digibind (Digoxin immune fab)

c) Oral potassium supplementation

d) Reducing the dose of the drug

019. All of the following statements regarding cardiac glycoside-induced ventricular tachyarrhythmias are true EXCEPT:

a) Lidocaine is a drug of choice in treatment

b) Digibind should be used in life-threatening cases

c) They occur more frequently in patients with hyperkalemia than in those with hypokalemia

d) They are more likely to occur in patients with a severely damaged heart

020. This drug is a selective beta-1 agonist:

a) Digoxin

b) Dobutamine

c) Amrinone

d) Dopamine

021. Tolerance to this inotropic drug develops after a few days:

a) Amrinone

b) Amiodarone

c) Dobutamine

d) Adenosine

022. This drug inhibits breakdown of cAMP in vascular smooth muscle:

a) Digoxin

b) Dobutamine

c) Amrinone

d) Dopamine

023. This drug is useful for treating heart failure because it increases the inotropic state and reduces afterload:

a) Amiodarone

b) Amrinone

c) Propanolol

d) Enalapril

024. This drug acts by inhibiting type III cyclic nucleotide phosphodiesterase:

a) Amiodarone

b) Milrinone

c) Propanolol

d) Enalapril

025. All of the following statements regarding inhibitors of type III phosphodiesterase are true EXCEPT:

a) They raise cAMP concentrations in cardiac myocytes

b) They reduce afterload

c) They show significant cross-tolerance with beta-receptor agonists

d) They are associated with a significant risk for cardiac arrhythmias

026. All of the following drugs are used in the treatment of severe congestive heart failure EXCEPT:

a) Verapamil

b) Digoxin

c) Dobutamine

d) Dopamine

027. Drugs most commonly used in chronic heart failure are:

a) Cardiac glycosides

b) Diuretics

c) Angiotensin-converting enzyme inhibitors

d) All the above

028. All of the following statements concerning angiotensin converting enzyme (ACE) inhibitors are true EXCEPT:

a) They act by inhibiting the ability of renin to convert angiotensinogen to angiotensin I.

b) Enalapril is a prodrug that is converted to an active metabolite

c) They reduce secretion of aldosterone

d) They can produce hyperkalemia in combination with a potassium-sparing diuretic

029. All of the following effects of ACE inhibitors may be useful in treating heart failure EXCEPT:

a) They decrease afterload

b) They increase circulating catecholamine levels

c) They reduce reactive myocardial hypertrophy

d) They increase myocardial beta-1 adrenergic receptor density

030. All of the following statements concerning the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of heart failure are true EXCEPT:

a) They improve hemodynamics by decreasing afterload

b) They can increase plasma cholesterol levels

c) They may slow the progression of heart failure by preventing myocardial and vascular remodeling

d) They are effective first-line agents in the treatment of chronic heart failure

PART VI Antiarrhythmic agents

001. This drug is a Class IA antiarrhythmic drug:

a) Sotalol

b) Propranolol

c) Verapamil

d) Quinidine

002. This drug is a Class IC antiarrhythmic drug:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

003. This drug is a Class IC antiarrhythmic drug:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

004. This drug is a Class II antiarrhythmic drug:

a) Flecainide

b) Propranolol

c) Lidocaine

d) Verapamil

005. This drug is a Class III antiarrhythmic drug:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

006. This drug prolongs repolarization:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

007. This drug is a Class IV antiarrhythmic drug:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

008. This drug is used in treating supraventricular tachycardias:

a) Digoxin

b) Dobutamine

c) Amrinone

d) Dopamine

009. This drug is associated with Torsades de pointes.

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

010. This drug has beta-adrenergic blocking activity:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

011. This drug is useful in terminating atrial but not ventricular tachycardias:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

012. This is a drug of choice for acute treatment of ventricular tachycardias:

a) Flecainide

b) Sotalol

c) Lidocaine

d) Verapamil

013. The calcium channel blockers have direct negative inotropic effects because they reduce the inward movement of calcium during the action potential. Thic consideration is:

a) True

b) False

014. Common unwanted effects of the dihydropyridines are due to vasodilation. It’s:

a) True

b) False

015. Verapamil is a more potent vasodilator than nifedipine. This statement is:

a) True

b) False

016. This drug is contraindicated in patients with moderate to severe heart failure:

a) Nifedipine

b) Verapamil

c) Both of the above

d) None of the above

017. This drug is an effective bronchodilator:

a) Nifedipine

b) Verapamil

c) Both of the above.

d) None of the above

018. This drug is used intravenously to terminate supraventricular tachycardias:

a) Nifedipine

b) Verapamil

c) Both of the above

d) None of the above

019. This drug has a little or no direct effect on chronotropy and dromotropy at normal doses

a) Nifedipine

b) Diltiazem

c) Verapamil

d) All of the above

020. Verapamil has a significant effect on automaticity in the SA node. It’s:

a) True

b) False

021. This drug acts by inhibiting slow calcium channels in the SA and AV nodes:

a) Quinidine

b) Adenosine

c) Flecainide

d) Diltiazem

022. All of the following statements regarding verapamil are true EXCEPT:

a) It blocks L-type calcium channels

b) It increases heart rate

c) It relaxes coronary artery smooth muscle

d) It depresses cardiac contractility

023. All of the following calcium channel blockers are useful in the treatment of cardiac arrhythmias EXCEPT:

a) Bepridil

b) Diltiazem

c) Verapamil

d) Nifedipine

024. All of the following are common adverse effects of calcium channel blockers EXCEPT:

a) Skeletal muscle weakness

b) Dizziness

c) Headache

d) Flushing

025. Tick the adverse reactions characteristic for lidocaine:

a) Agranulocytosis, leucopenia

b) Extrapyramidal disorders

c) Hypotension, paresthesias, convulsions

d) Bronchospasm, dyspepsia

PART VII Drugs for Angina Pectoris treatment

001. Angina pectoris is:

a) Severe constricting chest pain, often radiating from the precordium to the left shoulder and down the arm, due to insufficient blood supply to the heart that is usually caused by coronary disease

b) An often fatal form of arrhythmia characterized by rapid, irregular fibrillar twitching of the ventricles of the heart instead of normal contractions, resulting in a loss of pulse

c) The cardiovascular condition in which the heart ability to pump blood weakens

d) All of the above

002. All these drug groups useful in angina both decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm), EXCEPT:

a) Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)

b) Calcium channel blockers (Nifedipine, Nimodipine)

c) Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol)

d) Potassium channel openers (Minoxidil)

003. This drug group useful in angina decreases myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and does not increase myocardial oxygen delivery (by reversing coronary arterial spasm):

a) Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)

b) Myotropic coronary dilators (Dipyridamole)

c) Potassium channel openers (Minoxidil)

d) Beta-adrenoceptor-blocking drugs (Atenolol, Mtoprolol)

004. This drug group useful in angina increase myocardial oxygen delivery (by reversing coronary arterial spasm) and does not decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand):

a) Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol):

b) Myotropic coronary dilators (Dipyridamole)

c) Calcium channel blockers (Nifedipine, Nimodipine)

d) Potassium channel openers (Minoxidil)

005. Which of the following statements concerning nitrate mechanism of action is True?

a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to vascular smooth muscle target tissues

b) Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly through this mechanism

c) Nitrates useful in angina decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)

d) All of the above

006. Which of the following nitrates and nitrite drugs are long-acting?

a) Nitroglycerin, sublingual

b) Isosorbide dinitrate, sublingual (Isordil, Sorbitrate)

c) Amyl nitrite, inhalant (Aspirols, Vaporole)

d) Sustac

007. Which of the following nitrates and nitrite drugs is a short-acting drug?

a) Nitroglycerin, 2% ointment (Nitrol)

b) Nitroglycerin, oral sustained-release (Nitrong)

c) Amyl nitrite, inhalant (Aspirols, Vaporole)

d) Sustac

008. Which of the following nitrates and nitrite drugs is used for prevention of angina attack?

a) Nitroglycerin, 2% ointment (Nitrol)

b) Nitroglycerin, oral sustained-release (Nitrong)

c) Isosorbide mononitrate (Ismo)

d) All of the above

009. Duration of nitroglycerin action (sublingual) is:

a) 10-30 minutes

b) 6-8 hours

c) 3-5 minutes

d) 1.5-2 hours

010. The following statements concerning mechanism of nitrate beneficial clinical effect are true, EXCEPT?

a) Decreased myocardial oxygen requirement

b) Relief of coronary artery spasm

c) Improved perfusion to ischemic myocardium

d) Increased myocardial oxygen consumption

011. Side effect of nitrates and nitrite drugs are, EXCEPT:

a) Orthostatic hypotension, tachycardia

b) GI disturbance

c) Throbbing headache

d) Tolerance

012. The following statements concerning mechanism of calcium channel blockers’ action are true, EXCEPT:

a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in vascular smooth muscle target tissues

b) Calcium channel blockers bind to L-type calcium channel sites

c) Calcium channel blockers useful in angina decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)

d) Calcium channel blockers decrease transmembrane calcium current associated in smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility

013. Which of the following antianginal agents is a calcium channel blocker?

a) Nitroglycerin

b) Dipyridamole

c) Minoxidil

d) Nifedipine

014. Which of the following cardiovascular system effects refers to a calcium channel blocker?

a) The reduction of peripheral vascular resistance

b) The reduction of cardiac contractility and, in some cases, cardiac output

c) Relief of coronary artery spasm

d) All of the above

015. Main clinical use of calcium channel blockers is:

a) Angina pectoris

b) Hypertension

c) Supraventricular tachyarrhythmias

d) All of the above

016. Which of the following antianginal agents is a myotropic coronary dilator:

a) Dipyridamole

b) Validol

c) Atenolol

d) Alinidine

017. Which of the following antianginal agents is a beta-adrenoceptor-blocking drug: a) Dipyridamole

b) Validol

c) Atenolol

d) Alinidine

018. The following agents are cardioselective beta1-adrenoceptor-blocking drugs labeled for use in angina, EXCEPT:

a) Metoprolol

b) Talinolol

c) Atenolol

d) Propranolol

019. Which of the following statements concerning beta-adrenoceptor-blocking drugs are true:

a) These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility

b) These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings

c) Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise

d) These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential

020. Which of the following antianginal agents refers to reflex coronary dilators:

a) Dipyridamole

b) Validol

c) Atenolol

d) Alinidine

021. Which of the following statements concerning Validol is true:

a) Validol has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings

b) At sublingual administration the effect is produced in five minutes and 70 % of the preparation is released in 3 minutes

c) It is used in cases of angina pectoris, motion sickness, nausea, vomiting when seasick or airsick and headaches due to taking nitrates

d) All of the above

022. Which of the following antianginal agents is the specific bradycardic drug:

a) Dipyridamole

b) Validol

c) Atenolol

d) Alinidine

023. Following statements concerning specific bradycardic agents (Falipamil, Alinidine) are true, EXCEPT:

a) Bradycardic drugs have a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings

b) The predominant effect of bradycardic drugs is a decrease in heart rate without significant changes in arterial pressure

c) The protective effect of bradycardic drugs is likely due to a reduced O2 demand

d) Specific bradycardic agents are used in the management of a wide range of cardiovascular disorders, including sinus tachyarrhythmias and angina pectoris

024. Which of the following statements concerning Dipyridamole is true?

a) Dipyridamole is an agent that blocks the reabsorption and breakdown of adenosine that results in an increase of endogenous adenosine and vasodilatation

b) The drug causes relative hypoperfusion of myocardial regions served by coronary arteries with haemodynamically significant stenoses

c) Dipyridamole is a platelet aggregation inhibitor

d) All of the above

025. Which of the following antianginal agents is a potassium channel opener:

a) Dipyridamole

b) Validol

c) Atenolol

d) Minoxidil

026. Which of the following statements concerning potassium channel openers is true?

a) These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility

b) These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings

c) Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise

d) These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential

PART VIII Antihypertensive drugs

001. This drug reduces blood pressure by acting on vasomotor centers in the CNS:

a) Labetalol

b) Clonidine

c) Enalapril

d) Nifedipine

002. All of the following are central acting antihypertensive drugs EXCEPT:

a) Methyldopa

b) Clonidine

c) Moxonidine

d) Minoxidil

003. A ganglioblocking drug for hypertension treatment is:

a) Hydralazine

b) Tubocurarine

c) Trimethaphan

d) Metoprolol

004. Pick out the sympatholythic drug:

a) Labetalol

b) Prazosin

c) Guanethidine

d) Clonidine

005. Tick the drug with nonselective beta-adrenoblocking activity:

a) Atenolol

b) Propranolol

c) Metoprolol

d) Nebivolol

006. Choose the selective blocker of beta-1 adrenoreceptors:

a) Labetalol

b) Prazosin

c) Atenolol

d) Propranolol

007. Pick out the drug – an alpha and beta adrenoreceptors blocker:

a) Labetalol

b) Verapamil

c) Nifedipine

d) Metoprolol

008. This drug inhibits the angiotensin-converting enzyme:

a) Captopril

b) Enalapril

c) Ramipril

d) All of the above

009. This drug is a directly acting vasodilator:

a) Labetalol

b) Clonidine

c) Enalapril

d) Nifedipine

010. Pick out the diuretic agent for hypertension treatment:

a) Losartan

b) Dichlothiazide

c) Captopril

d) Prazosin

011. This drug blocks alpha-1 adrenergic receptors:

a) Prazosin

b) Clonidine

c) Enalapril

d) Nifedipine

012. This drug activates alpha-2 adrenergic receptors:

a) Labetalol

b) Phentolamine

c) Clonidine

d) Enalapril

013. This drug is an inhibitor of renin synthesis:

a) Propranolol

b) Enalapril

c) Diazoxide

d) Losartan

014. This drug is a non-peptide angiotensin II receptor antagonist:

a) Clonidine

b) Captopril

c) Losartan

d) Diazoxide

015. This drug is a potassium channel activator:

a) Nifedipine

b) Saralasin

c) Diazoxide

d) Losartan

016. All of the following statements regarding angiotensin II are true EXCEPT:

a) It is a peptide hormone

b) It stimulates the secretion of aldosterone

c) Angiotensin I is almost as potent as angiotensin II

d) It is a potent vasoconstrictor

017. This drug is contraindicated in patients with bronchial asthma:

a) Propranolol

b) Clonidine

c) Enalapril

d) Nifedipine

018. This drug is converted to an active metabolite after absorption:

a) Labetalol

b) Clonidine

c) Enalapril

d) Nifedipine

019. This drug routinely produces some tachycardia:

a) Propranolol

b) Clonidine

c) Enalapril

d) Nifedipine

020. All of the following statements regarding vasodilators are true EXCEPT:

a) Hydralazine causes tachycardia

b) Nifedipine is a dopamine receptor antagonist

c) Nitroprusside dilates both arterioles and veins

d) Minoxidil can cause hypertrichosis

021. All of the following statements regarding verapamil are true EXCEPT:

a) It blocks L-type calcium channels

b) It increases heart rate

c) It relaxes coronary artery smooth muscle

d) It depresses cardiac contractility

022. Choose the unwanted effects of clonidine:

a) Parkinson’s syndrome

b) Sedative and hypnotic effects

c) Agranulocytosis and aplastic anemia

d) Dry cough and respiratory depression

023. The reason of beta-blockers administration for hypertension treatment is:

a) Peripheral vasodilatation

b) Diminishing of blood volume

c) Decreasing of heart work

d) Depression of vasomotor center

024. An endogenous vasoconstrictor that can stimulate aldosterone release from suprarenal glands:

a) Angiotensinogen

b) Angiotensin I

c) Angiotensin II

d) Angiotensin-converting enzyme

025. Choose the group of antihypertensive drugs which diminishes the metabolism of bradykinin:

a) Ganglioblockers

b) Alfa-adrenoblockers

c) Angiotensin-converting enzyme inhibitors

d) Diuretics

026. Hydralazine (a vasodilator) can produce:

a) Seizures, extrapyramidal disturbances

b) Tachycardia, lupus erhythromatosis

c) Acute hepatitis

d) Aplastic anemia

027. Choose the vasodilator which releases NO:

a) Nifedipine

b) Hydralazine

c) Minoxidil

d) Sodium nitroprusside

028. The reason of diuretics administration for hypertension treatment is:

a) Block the adrenergic transmission

b) Diminishing of blood volume and amount of Na+ ions in the vessels endothelium

c) Depression of rennin-angiotensin-aldosterone system

d) Depression of the vasomotor center

029. Tick the diuretic agent – aldosterone antagonist:

a) Furosemide

b) Spironolactone

c) Dichlothiazide

d) Captopril

030. Tick the diuretic agent having a potent and rapid effect:

a) Furosemide

b) Spironolactone

c) Dichlothiazide

d) Indapamide

PART IX Hypertensive (anti-hypotensive) drugs. Drugs influencing cerebral blood flow. Anti-migraine agents

001. The main principle of shock treatment is:

a) To increase the arterial pressure

b) To increase the peripheral vascular resistance

c) To increase the cardiac output

d) To improve the peripheral blood flow

002. Pick out the drug which increases cardiac output:

a) Noradrenalin

b) Methyldopa

c) Phenylephrine

d) Angiotensinamide

003. Tick the synthetic vasoconstrictor having an adrenomimic effect:

a) Noradrenalin

b) Adrenalin

c) Phenylephrine

d) Angiotensinamide

004. Indicate the vasoconstrictor of endogenous origin:

a) Ephedrine

b) Phenylephrine

c) Xylomethazoline

d) Angiotensinamide

005. Which type of receptors can be activated by angiotensinamide:

a) Adrenergic receptors

b) Cholinergic receptors

c) Dopaminergic receptors

d) Angiotensin’s receptors

006. General unwanted effects of vasoconstrictors is:

a) Increase of arterial pressure

b) Increase of cardiac output

c) Decrease of peripheral blood flow

d) Increase of blood volume

007. For increasing blood pressure in case of low cardiac output the following agents must be used:

a) Ganglioblockers

b) Vasoconstrictors

c) Positive inotropic drugs

d) Diuretics

008. Tick the positive inotropic drug of glycoside structure:

a) Dopamine

b) Digoxin

c) Dobutamine

d) Adrenalin

009. Tick the positive inotropic drug of non-glycoside structure:

a) Digitoxin

b) Digoxin

c) Dobutamine

d) Strophanthin

010. Dopamine at low doses influences mainly:

a) Alfa-adrenoreceptors (leads to peripheral vasoconstriction)

b) Dopamine receptors (leads to vasodilation of renal and mesenterial vessels)

c) Beta-1 adrenoreceptors (leads to enhanced cardiac output)

d) All of the above

011. Dopamine at medium doses influences mainly:

a) Alfa-adrenoreceptors (leads to peripheral vasoconstriction)

b) Dopamine receptors (leads to vasodilation of renal and mesenterial vessels)

c) Beta-1 adrenoreceptors (leads to enhanced cardiac output)

d) All of the above

012. Dopamine in high doses influences mainly the:

a) Alfa-adrenoreceptors (leads to peripheral vasoconstriction)

b) Dopamine’s receptors (leads to vasodilation of renal and mesenterial vessels)

c) Beta-1 adrenoreceptors (leads to enhancing of cardiac output)

d) All of the above

013. Tick the group of drugs for treatment of shock with hypovolaemia (reduced circulating blood volume):

a) Positive inotropic drugs

b) Vasoconstrictors

c) Plasmoexpanders

d) Analeptics and tonics

014. Tick the group of drugs for chronic hypotension treatment:

a) Positive inotropic drugs

b) Vasoconstrictors

c) Plasmoexpanders

d) Analeptics and tonics

015. Indicate the group of drugs influencing the cerebral flow:

a) Ca-channel blockers

b) Derivatives of GABA

c) Derivatives of Vinca minor plant

d) All the above

016. Tick the drug influencing the blood flow which is related to antiplatelet agents:

a) Heparin

b) Aspirin

c) Pyracetam

d) Tanakan

017. Which of the following drugs is related to anticoagulants and may be useful in disorders of cerebral circulation?

a) Aspirin

b) Cinnarizine

c) Nicergoline

d) Heparin

018. Indicate the drugs which are Ca-channel blockers influencing the brain blood flow:

a) Aminalon, Picamilon

b) Nimodipine, Cinnarizine

c) Heparin, Warfarin

d) Vinpocetine, Nicergoline

019. Indicate the drugs influencing the blood flow in the brain - derivatives of GABA:

a) Aminalon, Picamilon

b) Nimodipine, Cinnarizine

c) Heparin, Warfarin

d) Vinpocetine, Nicergoline

020. Indicate the drug - Vinca minor alcaloid:

a) Nicergoline

b) Warfarin

c) Cinnarizine

d) Vinpocetine

021. Tick the drug – a derivative of Ergot:

a) Nicergoline

b) Warfarin

c) Cinnarizine

d) Vinpocetine

022. Indicate the nootropic agent useful in disorders of brain circulation: a) Aspirin

b) Pyracetam

c) Warfarin

d) All the above

023. What is the main action of GABA derivatives in disorders of brain circulation?

a) Decrease of vessel permeability

b) Stimulation of the metabolic processes in neurons

c) Brain vessel constriction

d) Intracranial pressure increase

024. Choose the appropriate mechanism of vinpocetine action:

a) It dilates cerebral vessels and improves blood supply

b) It constricts cerebral vessels and decreases blood supply

c) It stimulates GABA-receptors and thus increases cerebral metabolic processes

d) It constricts peripheral vessels and increases blood pressure

025. Antiaggregants are used in disorders of brain circulation for:

a) Stimulation of the metabolic processes in neurons

b) Dilation of cerebral vessels

c) Improving the microcirculation in cerebral tissue

d) All the above

026. Migraine is a disorder connected with:

a) Thrombosis of cerebral vessels

b) Brain hemorrhage

c) Dysfunction of regulation of cerebral vessel tonus

d) Malignant growth in brain

027. Main agents for acute migraine attack treatment are Ergot and indol derivatives and NSAID’s. The consideration is:

a) True

b) False

028. The following Indol derivative is used for treatment of acute migraine attack:

a) Paracetamol

b) Sumatriptan

c) Ergotamine

d) Metoclopramide

029. The following Ergot derivative is used for treatment of acute migraine attack:

a) Paracetamol

b) Sumatriptan

c) Ergotamine

d) Metoclopramide

030. The derivative of lysergic acid for migraine attack prevention is:

a) Metoclopramide

b) Methysergide

c) Sumatriptan

d) Ergotamine