Agents used in insufficiency of coronary circulation

1. Determine an antianginal agent by its pharmacological effect. It insignificantly improves coronary circulation (especially in subendocardial layers), but the main cause of elimination of stenocardia is dilation of peripheral veins and arteries, that leads to decrease of cardiac work and myocardial oxygen demand. Besides, it oppresses the central links of cardiostimulating reflexes.

A. * Nitroglycerine

B. Phenihydinum

С Amiodaronum

D. Validolum

E. Anaplilinum

2. A patient who had been suffering from stenocardia accompanied by cardiac arrhythmia (paroxysmal tachycardia) and arterial hypertension was admitted to the hospital. Specify antianginal drug and the group which it belongs to, which should be admin­istered taking into account the patient's diseases.

A. *β-adrenoblocker - anaprilinum

B. Organic nitrate - nitroglycerinum

C. Myotropic spasmolytic agent – No-spa

D. Calcium antagonist - nifedipin

E. Potassium channel activator nicorandil

3. Indicate the nitroglycerin's drug with prolonged action

A. *Sustac

B. Validolum

С. Amylnitrite

D. Natrium nitroprussid

E. Dipiridamolum

4. Indicate the drug which exerts antianginal action because of decrease of oxygen demand and increase of oxygen delivery to the myocardium.

A. *Nitroglycerinum

B. Anaprilinum

C. Dipiridamolum

D. Talinololum

E. Carbocromenum

5. Indicate the state which requires administration of nitroglycerine

A. *An attack of stenocardia

B. Acute cardiac failure

С Hypertensive crisis

D. Chronic cardiac insufficiency

E. Endarteritis obliterans

6. Indicate the mechanism of action of nitroglycerine

A. * Release of NO groups which activate guanylyl cyclase

B. Blockade of calcium channels

C. Blockade of adenosine receptors

D. Activation ol adenylyl cyclase

E. Inhibition of phosphodiesterase

7. А patient with ischemic heart disease complaints of worsening of his state that is caused by overdosage of antianginal agent. What group of drugs can cause this state it it is known that concentration of methemoglobin in patient’s blood is increased?

A. *Organic nitrates

B. Beta-adrenoblockers

С. Blockators of calcium channels

D. Activators of potassium channels

E. Myotropic coronary dilators

8. After sublingual introduction of nitroglycerine its maximal concentra­tion in blood is developed in:

A. * 4-5minutes

B. 15minutes

С. 1 minute

D. 30 minutes

E. 1 hour

9. Why are the tablets of nitroglycerine introduced sublingually only?

A. *The substance is being considerably destroyed during its first passage through the liver

B. The substance is badly absorbed in the gastrointestinal tract

С The 'substance operates reflexly from oral cavity receptors

D. The substance is destroyed under the action of gastric Juice

E. It causes less side-effects in such way of introduction

10. Determine an antianginal agent according to its pharmacological effects: dilating coronary arteries it increases myocardial blood supply, dilating peripheral veins it decreases myocardial preload, dilating perypheral arteries it decrease myocardial postload, besides it oppresses the central links of coronaroconstrictive and cardiostimulatory reflexes:

A. *Nitroglycerine

B. Fenigidinum

С. Amiodarone

D. Validolum

E. Anaprilinum

11. Introduction of an antianginal drug to a patient with stenocardia caused improvement of patient's state and also arterial hypotension, tachycardia and throbbing headache. Indicate this drug.

A. *Nitroglycerine

B. Carbocromen

С. Dipyridamole

D. Mildronate

E. Verapamil

12. A 50 years old patient has suffered from angina pectoris for several months. As a rule he has successfully used a tablet of validolum during the attack but last 2 weeks this remedy hasn’t been effective. What drug should be administered to the patient for elimination of the attack?

A. * Nitroglycerine

B. Nifedipine

С Verapamil

D. Anaprilinum (propranolol)

E. Isosorbide mononitrate

13. The calcium channels of cardiomyocytes have been blocked on an isolated rabbit's heart. What changes in the heart's activity can happen as a result?

A. *Decrease rate and force of heart beat

B. Heart stops in systole

C. Decrease of heart beat rate

D. Decrease force of the contraction

E. Heart stops in diastole

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