Cardovascular Pharm
Which of the following physiological processes is associated with thiazide intake? A. Activation of the rennin-angiotensin-aldosterone system. B. Activation of the NaCl co-transporter in the distal tubule. C. Activation of the organophosphate excretion system in the proximal tubule. D. Contraction of arteriolar smooth muscle. E. Decreased exchange of sodium for potassium in the distal tubule.
A. Activation of the rennin-angiotensin-aldosterone system.
A 70-year-old man is brought to the emergency department because of left-sided weakness for one hour. The patient reports that he suddenly could not move his left leg at home. The patient denies any history of a bleeding disorder, active bleeding, or recent surgery. His past medical history is significant for hypercholesterolemia, hypertension, atrial fibrillation, and tobacco abuse. Physical examination shows 5/5 strength in the left upper extremity and 1/5 strength in the left lower extremity. There is decreased sensation in the left leg and foot. A computed tomography scan of the brain shows no hemorrhages. Which of the following is the next best step in management? A. Alteplase B. Aspirin C. Clopidogrel D. Unfractionated heparin E. Warfarin
A. Alteplase
Which one of the following is a TRUE significant unwanted effect of the drug named? A. Constipation with verapamil B. Heart failure with hydralazine C. Hemolytic anemia with atenolol D. Hypokalemia with aliskiren E. Lupus-like syndrome with hydrochlorothiazide
A. Constipation with verapamil
Which of the following electrolytes derangement is associated with loop diuretics intake? A. Hypokalemia. B. Hypernatremia. C. Hypercalcemia. D. Hypophosphatemia.
A. Hypokalemia.
A 60-year-old man comes to the clinic because of shortness of breath, fever, and weight gain over the past week. He received a heart transplant six weeks prior and has had no complications in the post operative period. He is due for another routine heart biopsy and the sample is taken to pathology. Which of the following findings is most likely to be described in the pathology report? A. Mostly eosinophils, with some evidence of complement fragments on staining. B. Fibroblasts and myofibroblasts. C. Infiltrating T cells, with some eosinophils, plasma cells, and neutrophils, as well as injury to blood vessels and altered tissue structure. D. Diffuse infiltration with numerous giant cells, lymphocytes, neutrophils, and eosinophils with myocyte damage. Complement fragments and macrophages, consistent with cell-related rejection
A. Infiltrating T cells, with some eosinophils, plasma cells, and neutrophils, as well as injury to blood vessels and altered tissue structure.
A 56-year-old male comes to the office with a complaint of a dry cough for 2 months. His past medical history includes a recent myocardial infarction (MI), after which he was placed on several medications. He is currently on lisinopril, clopidogrel, digoxin, lovastatin, and nitroglycerin. He does not smoke cigarettes and does not drink alcohol. He denies a history of bronchial asthma. Examination of the chest is within normal limits. Which of the following medications may have caused his symptom? A. Lisinopril B. Clopidogrel C. Nitroglycerin D. Lovastatin E. Digoxin
A. Lisinopril
PJ is a 17-year-old young patient. At his checkup, the pediatrician notices cutaneous xanthomas and orders a lipid panel. Repeated measures confirm that the patient's serum cholesterol levels are high (936 mg/dL). Further testing confirms a diagnosis of familial hypercholesterolemia. Which of the following interventions will be appropriate and effective in this patient? A. PCSK9 inhibitors and statin B. Ezetimibe C. Fibrate D. Pravastatin E. Niacin
A. PCSK9 inhibitors and statin
A 67-year-old woman is brought to the emergency department because of heart palpitations and dizziness. A diagnosis of atrial fibrillation is made and she is started on warfarin to prevent embolic events. Four days after the initiation of warfarin treatment, she starts developing well defined, purpuric and bullous lesions on her thighs, as shown in the image below. The inhibition of which of the following components of the coagulation cascade is likely responsible for this woman's lesions? A. Protein C B. Protein S C. Factor II D. Factor IX E. Factor VII
A. Protein C
Which one of the following is a K+ sparing diuretic? A. Spironolactone B. Frusemide C. Acetazolamide D. Torasemide E. Clopamide
A. Spironolactone
After being counseled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of which of the following? A. Blood urea nitrogen B. Alanine and aspartate aminotransferase C. Platelets D. Red blood cells E. Uric acid
B. Alanine and aspartate aminotransferase
29-year-old farm hand is brought into the emergency department by his friends because he chest pain, delirium, confusion, and visual changes. His friends state they just tried a new drug like cocaine. On exam, the patient's vitals are: T: 36 deg C, HR: 120 bpm, BP: 180/110 mmHg, RR: 12, SaO2: 99%. Which of the following agent should be avoided for the treatment of HTN? A. Non-selective Alpha blocker B. Beta blocker C. Alpha -1 blocker D. Hydralazine
B. Beta blocker
A patient was placed on triamterene for hypertension control developed right upper flank pain and mild hematuria. What is the most likely diagnosis? A. Struvite nephrolithiassis B. Calcium oxalate nephrolithiasis C. Uric acid nephrolithiasis D. Cysteine nephrolithiasis
B. Calcium oxalate nephrolithiasis
An 82 year old female was diagnosed with hypertension 6 months ago in January. She is taking Lisinopril (an ACEI vasodilator) and HCTZ with excellent control of her blood pressure. She lives here in Tucson in the dry desert all year. Recently on July 5th she tells you that she nearly passed out when getting out of bed in the morning. The same thing happened again later in the morning when she went shopping. What should be done with her medicines? A. Ask your friends what medicines they are taking and try some. B. Check her blood pressure, it may be low secondary to dehydration and use of medication. You may need to reduce or discontinue HCTZ. C. Take two aspirin tablets every day. Nothing, everyone faints once in a while.
B. Check her blood pressure, it may be low secondary to dehydration and use of medication. You may need to reduce or discontinue HCTZ
Which of the following is a major toxicity associated with gemfibrozil therapy? A. Bloating and constipation B. Cholelithiasis C. Hyperuricemia D. Kidney failure E. Severe cardiac arrhythmia
B. Cholelithiasis
A 35-year-old woman appears to have familial combined hyperlipidemia. Her serum concentrations of total cholesterol, LDL cholesterol, and triglyceride are elevated. Her serum concentration of HDL cholesterol is somewhat reduced. Which of the following drugs is most likely to increase this patient's triglyceride and VLDL cholesterol concentrations when used as monotherapy? A. Atorvastatin B. Cholestyramine C. Ezetimibe D. Gemfibrozil E. Niacin
B. Cholestyramine
What part of the nephron does Indapamide act on? A. Thin ascending loop of Henle B. Distal convoluted tubule C. Thick ascending loop of Henle D. Proximal convoluted tubule E. Collecting duct
B. Distal convoluted tubule
A 70-year-old man undergoes elective hip replacement. He tolerates the surgery without difficulties and remains in the hospital for rehabilitation. As prophylaxis, he receives daily subcutaneous injections of a medication that functions by indirectly inhibiting thrombin and activated factor X. He notices small bruises at the site of the injection. The effects of this medication on the patient's PT and aPTT are most similar to those seen in which of the following diseases? A. Factor VII deficiency B. Hemophilia A C. Factor V Leiden mutation D. Vitamin K deficiency E. Thrombotic thrombocytopenic purpura
B. Hemophilia A
A 59-year-old man is brought to the emergency department because of severe headache and confusion for 2 hours. His blood pressure is 215/135 mm Hg. Ophthalmologic examination shows papilledema. Therapy with intravenous nitroprusside is begun. Which of the following events is most likely to occur within vascular smooth muscle cells as a result of this drug? A. Inactivation of protein kinase G B. Increased activity of myosin light-chain phosphatase C. Prevention of cyclic guanosine monophosphate degradation D. Decreased activity of guanylate cyclase E. Inhibition of voltage-dependent slow ion channels F. Inactivation of protein kinase C
B. Increased activity of myosin light-chain phosphatase
A 65-year-old man with atrial fibrillation, has been using warfarin for the past 12 months after he presented to the emergency department with signs of ischaemic stroke. This morning he called an ambulance when he developed a nose bleed that could not be stopped. The registrar then stops the patient's warfarin and finds that this patient's INR is 6 (range of 2.0 to 3.0 is ideal). He thinks that he needs to reverse the effects of warfarin to effectively stop the bleeding. What is the quickest way to reverse the anticoagulant effects of warfarin? A. IV vitamin K B. Intravenous factors II, VII, IX and X C. Oral vitamin K D. There are no antidote to warfarin, so can only stop warfarin and wait for its levels to come down
B. Intravenous factors II, VII, IX and X
A 32-year-old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy? A. Atenolol -BB B. Losartan- ARB C. Methyldopa- like clonidine D. Nifedipine-CCB E. Propranolol -BB
B. Losartan- ARB
Anti-lipid drug that usually causes cutaneous vasodilation after each dose when the drug is started? A. Gemfibrozil B. Niacin (vitamin B3) C. Cholestyramine D. Clofibrate
B. Niacin (vitamin B3)
A 35-year old male is to undergo heart surgery and will be placed on cardiac bypass. He is anticoagulated with unfractionated heparin prior to and during bypass. At the end of the procedure, the patient is weaned off the cardiopulmonary bypass by warming, lung ventilation, and heart defibrillation. The venous return of the bypass machine will be slowed down, allowing the heart to fill and the external pump to be decelerated. While this is occurring, global cardiac function and hemodynamics must be monitored. Finally, anticoagulation must be reversed and hemostasis achieved. What should be used to achieve this? A. NaHCO3 B. Protamine sulfate C. Fresh frozen plasma (FFP) D. IV vitamin K
B. Protamine sulfate
Which of the following drug-side effect combinations are correct? A. Spironolactone - Hypokalemia B. Spironolactone - Hyperkalemia C. Eplerenone - Ototoxicity D. Spironolactone + ACE inhibitors - Hypokalemia E. Spironolactone - Hyperchloremic metabolic alkalosis
B. Spironolactone - Hyperkalemia
What part of the nephron does Ethycrinic acid act on? A. The distal convoluted tubule B. The thick ascending loop of Henle C. The thin ascending loop of Henle D. The proximal convoluted tubule E. The collecting duct
B. The thick ascending loop of Henle
A 45-year-old male presents with a chief complaint of pain in the great toe. He has a history of gout, which is under control. He was diagnosed with diabetes 5 years ago and is currently taking metformin. He was recently diagnosed with hypertension and was placed on a hypertensive drug. He is a non-smoker and does not abuse alcohol. The family history is significant for ischemic heart disease in his father. His current blood pressure is 136/84 mm Hg and the pulse is 78/min. The physical examination did not reveal any abnormalities. He uses over-the-counter multivitamin supplements. Which of the following drugs could have resulted in these symptoms? A. Angiotensin II receptor blockers (ARBs) B. Thiazide diuretics C. Calcium channel blockers (CCBs) D. Angiotensin-converting enzyme (ACE) inhibitors E.Beta-blockers
B. Thiazide diuretics
Very large polymeric cationic exchange resins: A. niacin B. colestipol C. pravastatin D. clofibrate
B. colestipol
Which of the following medication(s) may raise potassium? A. Amiloride, hydrochlorothiazide, indapamide. B. Abciximab, acetazolamide, spironolactone. C. Amiloride, spironolactone, triamterene D. Amiloride, acetazolamide, atenolol. E. Acetazolamide, spironolactone, furosemide.
C. Amiloride, spironolactone, triamterene
A 73-year-old man with a history of a recent change in his treatment for moderately severe hypertension is brought to the emergency department because of a fall at home. Which of the following drug groups is most likely to cause postural hypotension and thus an increased risk of falls? A. ACE inhibitors B. Alpha1-selective receptor agonist C. Arteriolar dilators D. Beta1-selective receptor blockers
C. Arteriolar dilators
Which of the following is the most accurate description of ezetimibe's mechanism of an action? A. Decreased lipid synthesis in adipose tissue B. Decreased secretion of VLDL by the liver C. Decreased gastrointestinal absorption of cholesterol D. Increased endocytosis of HDL by the liver E. Increased lipid hydrolysis by lipoprotein lipase
C. Decreased gastrointestinal absorption of cholesterol
A 21 year old student is referred to you for evaluation of high blood pressure found on screening at a local mall. The blood pressure reading there was 145/90 mm Hg. What is your approach to this patient? A. No need to worry, this is a normal blood pressure for a 21 year old. B. Get two weeks of bed rest. C. Get a personal blood pressure cuff and measure your own blood pressure several times over next 10 days D. Go to the Emergency Department right now!
C. Get a personal blood pressure cuff and measure your own blood pressure several times over next 10 days
Which of the following are side effects of thiazide diuretics? A. Hypokalemia, hyperuricemia, hypoglycemia, hypermagnesemia, hypernatremia B. Hyperkalemia, hyperuricemia, hyperglycemia, hypomagnesemia, hyponatremia C. Hypokalemia, hyperuricemia, hyperglycemia, hypomagnesemia, hyponatremia D. Hypokalemia, hyperuricemia, hyperglycemia, hypermagnesemia, hyponatremia E. Hyperkalemia, hyperuricemia, hypoglycemia, hypomagnesemia, hyponatremia
C. Hypokalemia, hyperuricemia, hyperglycemia, hypomagnesemia, hyponatremia
A patient with hypertension and angina is referred for treatment. Metoprolol and verapamil are among the drugs considered. Both metoprolol and verapamil are associated with which one of the following? A. Diarrhea B. Hypoglycemia C. Increased PR interval D. Tachycardia E. Thyrotoxicosis
C. Increased PR interval
What part of the nephron does Acetazolamide act on? A. The distal convoluted tubule B. The thin ascending loop of Henle C. The proximal convoluted tubule D. The collecting duct E. The thick ascending loop of Henle
C. The proximal convoluted tubule
What is the site of action of loop diuretics at nephrons? A. Principal cells in the cortical collecting tubule. B. Proximal tubule. C. Thick ascending limbs of Henle's loop. D. Distal tubule and connecting segment. E. Bowman's capsule.
C. Thick ascending limbs of Henle's loop.
A 35-year-old, obese female is placed on anticoagulant therapy for treatment of post-surgical deep venous thrombosis of the lower leg. Four days after initiation of therapy, she develops a skin lesion on her abdomen, similar to those seen in these images. This skin finding is a classic adverse consequence of which of the following anticoagulant agents? A. Heparin B. Alteplase C. Warfarin D. Clopidogrel
C. Warfarin
Antilipidemic drug most likely to reduce serum digoxin (Lanoxin, Lanoxicaps) levels, and thiazide levels: A. clofibrate B. gemfibrozil C. cholestyramine D. pravastatin
C. cholestyramine
An 85-year-old woman is brought in to the emergency department following a fall. Head CT shows an acute subdural hemorrhage. A review of medical records shows that she is currently being treated with warfarin for atrial fibrillation. Her INR is found to be in the therapeutic range. Which of the following is the next best step in the treatment of this patient's condition? A. Administer intravenous vitamin K B. Administer oral vitamin K C. Stop warfarin therapy D. Administer fresh frozen plasma (FFP) E. Administer protamine F. Administer platelets
D. Administer fresh frozen plasma (FFP)
Which one of the following is characteristic of nifedipine treatment in patients with essential hypertension? A. Competitively blocks angiotensin II at its receptor B. Decreases calcium efflux from skeletal muscle C. Decreases renin concentration in the blood D. Decreases calcium influx into smooth muscle E. Decreases calcium flux into the urine
D. Decreases calcium influx into smooth muscle
On which segment of the nephron do thiazide diuretics exert their most significant mechanism of action? A. Proximal convoluted tubule B. Ascending loop of Henle C. Descending loop of Henle D. Distal convoluted tubule E. Collecting ducts
D. Distal convoluted tubule
The patient is started on gemfibrozil. Which of the following is a major mechanism of gemfibrozil's action? A. Increased excretion of bile acid salts B. Increased expression of high-affinity LDL receptors C. Increased secretion of VLDL by the liver D. Increased triglyceride hydrolysis by lipoprotein lipase E. Reduced uptake of dietary cholesterol
D. Increased triglyceride hydrolysis by lipoprotein lipase
Which of the following is the mechanism of action of loop diuretics? A. Decrease the number of opened Na+ channels. B. Blocking the mineralocorticoid receptors. C. Increase the glomerular filtration rate. D. Inhibition of the Na+-K+-2Cl− cotransporter in the luminal membrane.
D. Inhibition of the Na+-K+-2Cl− cotransporter in the luminal membrane.
A 45-year-old New Zealand woman who has just returned from holiday in London. She came to the clinic because she has noticed that her left leg has become swollen and painful. A blood test showed that her D-dimers were elevated. An ultrasound was then ordered and the results showed that this was in fact a deep vein thrombosis. You prescribe her with low molecular weight heparin (LMWH) and also start her on warfarin. What is the therapeutic range of warfarin? A. Activated partial thromboplastin time (APTT) of 25-35 seconds B. Thrombin clotting time (TCT) of 14-16 seconds C. Prothrombin time (PT) of 11-13 seconds D. International normalized ratio (INR) of 2-3
D. International normalized ratio (INR) of 2-3
A 54-year-old woman is diagnosed with heart failure (HF). You prescribe captopril, a medication proven to reduce her mortality. This agent delivers several benefits to patients with HF. Which of the following effects is caused by this drug? A. It has a high affinity for angiotensin II receptors B. It promotes increased peripheral vascular resistance C. It decreases cardiac output and increases afterload D. It causes vasodilation and induces natriuresis E. It increases preload
D. It causes vasodilation and induces natriuresis
A 56-year-old man comes to the hospital for an open resection of a gastrinoma. He has a 20-year history of gastroesophageal reflux disease, a 15-year history of type 2 diabetes mellitus, and a 10-year history of congestive heart failure. Current medications include pantoprazole, metformin, glyburide, lisinopril, and metoprolol. He has a history of severe allergy to propofol, for which thiopental is given as an anesthetic induction agent. After thiopental administration, the patient's cardiac output drops severely, necessitating the use of vasopressors and inotropes. Which of the following medications is the most likely precipitating factor in the patient's sudden decrease in cardiac output? A. Glyburide B. Lisinopril C. Metformin D. Metoprolol E. Pantoprazole
D. Metoprolol
A patient is admitted to the emergency department with severe tachycardia after a drug overdose. His family reports that he has been depressed about his hypertension. Which one of the following drugs increases the heart rate in a dose-dependent manner? A. Captopril- ACE-I B. Hydrochlorothiazide- thiazide diuretic C. Losartan- ARB D. Minoxidil- systemic effects E. Verapamil -CCB
D. Minoxidil
If the patient has a history of gout, which of the following drugs is most likely to exacerbate this condition? A. Colestipol B. Ezetimibe C. Gemfibrozil D. Niacin E. Simvastatin
D. Niacin
An 85-year-old man with hypertension and hyperlipidemia comes to the emergency department because of chest discomfort and shortness of breath that started two hours ago while shoveling snow. During the past 10 years, he has had similar episodes of chest pain, which resolved with rest. His pulse is 94/min, respirations are 22/min, and blood pressure is 134/86 mm Hg. An ECG is obtained. Treatment with oxygen, morphine, nitroglycerin, aspirin, and metoprolol is initiated. The patient reports feeling faint, and his blood pressure falls to 92/54 mm Hg. Which of the following is the most likely cause of his hypotension? A. Aspirin B. Metoprolol C. Morphine D. Nitroglycerin E. Oxygen
D. Nitroglycerin
A 45-year-old man is brought to the emergency department with mental obtundation. He is found to have a blood pressure of 220/160 and retinal hemorrhages. Which one of the following is used in severe hypertensive emergencies, is short-acting, acts on a G protein-coupled receptor, and must be given by intravenous infusion? A. Aliskiren B. Captopril C. Fenoldopam D. Nitroprusside
D. Nitroprusside
Which of the following is very short-acting and acts by releasing nitric oxide? A. Atenolol B. Captopril C. Diltiazem D. Nitroprusside
D. Nitroprusside
A physician administers norepinephrine in order to increase a patient's blood vessel tension. Which of the following drugs acts like a competitive inhibitor of norepinephrine in this case? A. Atropine B. Isoproterenol C. Propranolol D. Phentolamine E. Phenoxybenzamine
D. Phentolamine
A 50 year-old patient with diabetes mellitus and asthma presents to your clinic with untreated stage 1 hypertension. Which of the following medications is most likely to cause adverse side effects in this patient? A. Chlorthalidone B. Furosemide C. Lisinopril D. Propranolol E. Verapamil.
D. Propranolol
A 70 year old woman who underwent an aortic valve replacement two years ago is taking warfarin. For the past 2 years she has had no complications. Last week, after experiencing some depression, she noticed that the INR on her home INR monitoring kit read a value of 0.5. Which of the following is she likely taking in addition to warfarin? A. Cimetidine B. Erythromycin C. Grapefruit Juice D. St. John's Wort E. Verapamil
D. St. John's Wort
A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance? A. Angioedema B. Glaucoma C. Headache D. dry cough E. Ventricular arrhythmias
D. dry cough
A 69 year-old woman was admitted to the ICU post- Cath emergency with hypotension. She had a history of coronary artery disease, Type II diabetes mellitus, and hypertension. At home she was treated with atenolol, simvastatin, ramipril, and hydrocortisone. On admission she had BP ranging between 70/40 to 100/30, HR 90-100, temperature of 38.3°C. Lab results include WBC 11.3k cells/cc, Hgb 10.1 mg/dL, creatinine 0.62 mg/dl, BUN 14 mg/dL, sodium 143 mEq/L. On admission, which of the following drug would you stop immediately? A. atenolol, B. simvastatin, C. ramipril, D. hydrocortisone E. A and C
E. A and C
A 45-year-old woman comes to the emergency department because of sudden numbness in her left arm and leg for the past two hours. She also reports blurry vision in her left eye. Once there, she is administered alteplase intravenously. Which one of the following best describes the mechanism of action of this medication? A. Binding tightly to antithrombin III B. Inhibition of cyclooxygenase-I C. Inhibition of glutamate carboxylation D. Inhibition of adenosine diphosphate receptor E. Activation of plasminogen bound to fibrin
E. Activation of plasminogen bound to fibrin
Aldosterone antagonists act on which part of the nephron? A. Bowman's capsule B. Proximal convoluted tubule C. Descending limb of loop of Henle D. Ascending limb of loop of Henle E. Distal convoluted tubule and collecting duct
E. Distal convoluted tubule and collecting duct
A 43-year-old man has heterozygous familial hypercholesterolemia. His serum concentrations of total cholesterol and LDL are markedly elevated. His serum concentration of HDL cholesterol, VLDL cholesterol, and triglycerides are normal or slightly elevated. The patient's mother and older brother died of myocardial infarctions before the age of 50. This patient recently experienced mild chest pain when walking upstairs and has been diagnosed as having angina of effort. The patient is somewhat overweight. He drinks alcohol most evenings and smokes about 1 pack of cigarettes per week. Consumption of alcohol is associated with which of the following changes in serum lipid concentrations? A. Decreased chylomicrons B. Decreased HDL cholesterol C. Decreased VLDL cholesterol D. Increased LDL cholesterol E. Increased triglyceride
E. Increased triglyceride
A 25-year-old female with a preeclampsia is treated with labetalol. Select the mechanism of action of labetalol. A. α-adrenergic agonist B. α-adrenergic antagonist C. β-adrenergic agonist D. β-adrenergic antagonist E. Mixed α and β antagonist
E. Mixed α and β antagonist
A 62-year-old male is rushed to the emergency department (ED) for what he believes is his second myocardial infarction (MI). His medical history is significant for pheochromocytoma (renal tumor) at the age of 58. After receiving aspirin, morphine, and face mask oxygen in the field, the patient arrives to the ED tachycardic (105 bpm), diaphoretic, and hypertensive (216/121). A 12 lead electrocardiogram shows ST-elevation in I, aVL, and V5-V6. The attending physician suspects a lateral wall infarction. Which of following should be given to this patient and why? A. Atropine B. Isoproterenol C. Propranolol D. Phentolamine E. Phenoxybenzamine
E. Phenoxybenzamine
If this patient is pregnant, which of the following drugs should be avoided because of a risk of harming the fetus? A. Cholestyramine B. Ezetimibe C. Fenofibrate D. Niacin E. Pravastatin
E. Pravastatin
An adult patient exhibiting a modest elevation in LDL (120 mg/dL) and elevated triglycerides (700 mg/dL) that did not respond adequately to a dietary effort to control them would be most likely to respond favorably by drug monotherapy with: cholestyramine colestipol Gemfibrozil niacin
Gemfibrozil
A 44-year-old male comes to the clinic complaining that he is experiencing a problem with his sexual health for the past month. He says that he does not get erections like he used to have despite feeling the urge. Along with heart failure, he also has angina and hypertension and is on regular oral medications which include amlodipine, atorvastatin, nitroglycerine, spironolactone, and losartan. After a detailed evaluation of his current medications, it is concluded that he has drug-induced erectile dysfunction. Which one of the following medications may have caused this patient's symptom? Amlodipine Atorvastatin Nitroglycerine Spironolactone Losartan
Spironolactone
Drugs of this antilipidemic class may cause in a few patients rhabdomyolysis and myoglobinuria: bile acid-binding resins nicotinic acid Statins fibartes
Statins
A 59-year-old male presents to a clinic with exertional chest pain for the past several months. He says that the pain is central in his chest and relieved with rest. The physical examination was unremarkable. An electrocardiogram was normal, but an exercise tolerance test revealed ST-segment depression in chest leads V1-V4. He is prescribed nitroglycerin to be taken in the first half of the day. Which of the following statements best describes the reason behind the timing of this medication? To prevent collapse To avoid nitrate headache More effective in patients with angina due to anemia To prevent methemoglobinemia To avoid nitrate tolerance
To avoid nitrate tolerance
In an elderly diabetic patient with a moderate risk for coronary artery disease (LDL: 150 mg/dL, normal triglycerides) the best lipid lowering drug with the lowest incidence of noticeable side effects would be: atorvastatin cholestyramine colestipol gemfibrozil nicotinic acid
atorvastatin
Constipation and a bloating sensation -- most common complaints of this antilipidemic drug: pravastatin niacin gemfibrozil cholestyramine
cholestyramine
Binding resins (cholestyramine, colestipol) are effective in lowering serum LDL cholesterol levels however, will incrase TG because they cause: A. reduction in biliary blood flow B. compensatory C. hypertriglyceridemia D. enhanced VLDL synthesis E. upregulation of hepatic LDL receptors
compensatory hypertriglyceridemia
Drugs in the class of HMG-CoA reductase inhibitors can cause all of the following potentially serious complications (particularly if combined with fibric acid derivatives)? constipation & impaction flushing & pruritus hyperglycemia & polyuria hyperuricemia & gout myositis & rhabdomyolysis
myositis & rhabdomyolysis
Antilipid medication -- structural analog of HMG-CoA intermediate: cholestyramine gemfibrozil pravastatin niacin
niacin
