PART VII Drugs for Angina Pectoris Treatment

Modul 1. General clinical pharmacy. Clinical pharmacy in cardiology, rheumatology, pulmonology, nephrology 1 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 E. None of the above ANSWER: A 2 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) E. None of the above ANSWER: C 3 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) E. None of the above ANSWER: D 4 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 E. All of the above ANSWER: D 5 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 E. None of the above ANSWER: D 6 Duration of nitroglycerin action (sublingual) is: A. 10-30 minutes B. 6-8 hours C. 3-5 minutes D. 1.5-2 hours E. 2-3 hours ANSWER: A 7 Side effect of nitrates and nitrite drugs are, EXCEPT: A. Orthostatic hypotension, B. Tachycardia C. GI disturbance D. Throbbing headache E. Facial flushing ANSWER: C 8 Which of the following antianginal agents is a calcium channel blocker? A. Nitroglycerin B. Lidocaine C. Dipyridamole D. Minoxidil E. Nifedipine ANSWER: E 9 Main clinical use of calcium channel blockers is: A. Angina pectoris B. Hypertension C. Supraventricular tachyarrhythmias D. None of the above E. All of the above ANSWER: E 10 Which of the following antianginal agents is a beta-adrenoceptor-blocking drug: A. Dipyridamole B. Validol C. Metoprolol D. Alinidine E. Salmeterol ANSWER: C 11 The following agents are cardioselective beta1-adrenoceptor-blocking drugs labeled for use in angina, EXCEPT: A. Metoprolol B. Bisoprolol C. Atenolol D. Propranolol E. Carvedilol ANSWER: D 12 Which of the following antianginal agents is a potassium channel opener: A. Dipyridamole B. Validol C. Atenolol D. Minoxidil E. Lisinopril ANSWER: D 13 This drug reduces blood pressure by acting on vasomotor centers in the CNS: A. Labetalol B. Clonidine C. Enalapril D. Nifedipine E. Metoprolol ANSWER: B 14 Tick the drug with nonselective beta-adrenoblocking activity: A. Atenolol B. Propranolol C. Metoprolol D. Nebivolol E. Bisoprolol ANSWER: B 15 This drug inhibits the angiotensin-converting enzyme: A. Captopril B. Enalapril C. Ramipril D. None of the above E. All of the above ANSWER: E 16 This drug is a directly acting vasodilator: A. Labetalol B. Clonidine C. Enalapril D. Furosemid E. Nifedipine ANSWER: E 17 Pick out the diuretic agent for hypertension treatment: A. Losartan B. Dichlothiazide C. Captopril D. Amlodipine E. Prazosin ANSWER: B 18 This drug blocks alpha-1 adrenergic receptors: A. Prazosin B. Clonidine C. Enalapril D. Nifedipine E. Bisoprolol ANSWER: A 19 This drug routinely produces some tachycardia: A. Propranolol B. Clonidine C. Enalapril D. Verapamil E. Nifedipine ANSWER: E 20 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 E. All of the above ANSWER: B 21 The reason of diuretics administration for hypertension treatment is: A. Block the adrenergic tran smission 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 E. All of the above ANSWER: B 22 Tick the diuretic agent – aldosterone antagonist: A. Furosemide B. Spironolactone C. Dichlothiazide D. Captopril E. Indapamide ANSWER: B 23 Tick the diuretic agent having a potent and rapid effect: A. Furosemide B. Spironolactone C. Dichlothiazid D. None of the above E. All of the above ANSWER: A 24 Diltiazem is characterized by following: A. Vasodilator B. It has antiarrhythmic effect C. Non-dihydropyridine Ca channel blocker D. Block Ca channels in cardiac tissue & vascular smooth muscles E. All of the above ANSWER: E 25 All of the following statements concerning the use of furosemide are true EXCEPT: A. Loop-acting diuretic B. Membrane ion transport inhibitor C. Inhibits Na/K/2Cl cotransporter in ascending loop of Henle D. Indicated in edema, heart failure, hypercalcemia E. Do not increase ototoxicity of aminoglycoside ANSWER: E 26 Choose true statements concerning the use of methyldopa A. Antihypertensive drug B. Adrenergic alpha 2 receptor agonist C. Converted to active form methyl-norepinephrine which activates central alpha2 receptors D. It is effective in pregnancy E. All of the above ANSWER: E 27 Choose true statements concerning the use of losartan A. Antihypertensives B. Angiotensin receptor antagonist C. Blocks AT II receptor in vascular smooth muscles & adrenal cortex D. All of the above E. None of the above ANSWER: D 28 Correct statements about glucocorticoids include all of the following, EXCEPT: A. Effects of glucocorticoids are mediated by widely distributed glucocorticoid receptors that are members of the superfamily of nuclear receptors. B. Glucocorticoids have dose-related metabolic effects on carbohydrate, protein, and fat metabolism. C. Glucocorticoids have pro-inflammatory effects. D. Glucocorticoids have catabolic effects in lymphoid and connective tissue, muscle, fat, and skin. E. Glucocorticoids have antiallergic effects ANSWER: C 29 Which of the following glucocorticoids is a short- to medium-acting drug? A. Prednisolon B. Dexamethasone C. Triamcinolone D. All of the above E. None of the above ANSWER: A 30 Which of the following glucocorticoids is a long-acting drug? A. Prednisolon B. Dexamethasone C. Triamcinolone D. All of the above E. None of the above ANSWER: B 31 Anti-inflammatory effect of glucocorticoids is caused by A. Reducing the prostaglandin and leukotriene which results from inhibition of phospholipase A2 B. Reducing macrophages migration into the site of inflammation C. Decreasing capillary permeability D. All of the above E. None of the above ANSWER: D 32 Which of the following statements concerning the anti-inflammatory effect of glucocorticoids is TRUE? A. Anti-inflammatory effect of glucocorticoids results from inhibition of cyclooxygenase B. Anti-inflammatory effect of glucocorticoids results from inhibition of phospholipase A2 and reducing prostaglandin and leukotriene synthesis C. None of the above D. Induction of cyclooxygenase II expression which results in reducing amount of an enzyme available to produce prostaglandins E. All of the above ANSWER: B 33 Immunosupressive effect of glucocorticoids is caused by: A. Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages and other antigen-presenting cells B. Suppression of cyclooxygenase II expression which results in reducing amount of an enzyme available to produce prostoglandins C. None of the above D. Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis. E. All of the above ANSWER: A 34 Which of the following statements concerning the anti-inflammatory effect of NSAIDs are TRUE? A. Anti-inflammatory effect of NSAIDs results from inhibition of cyclooxygenase B. Anti-inflammatory effect of NSAIDs results from inhibition of phospholipase A2 and reducing prostaglandin and leukotriene synthesis C. Anti-inflammatory effect of NSAIDs results from induction of cyclooxygenase II expression which results in reducing the amount of an enzyme available to produce prostoglandins D. All of the above E. None of the above ANSWER: A 35 Indication of glucocorticoids is: A. Chronic (Addison’s disease) and acute adrenocortical insufficiency B. Organ transplants (prevention and treatment of rejection – immunosuppression) C. Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis). D. All of the above E. None of the above ANSWER: D 36 Indications of glucocorticoids are following, EXCEPT: A. Gastrointestinal diseases (inflammatory bowel disease) B. Postmenopausal hormonal therapy C. Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis) D. Skin diseases (atopic dermatitis, dermatoses, localized neurodermatitis) E. None of the above ANSWER: B 37 Serious side effects of glucocorticoids include the following, EXCEPT: A. Acute peptic ulcers B. Iatrogenic Cushing’s syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face – moon faces) C. Salicylism (vomiting, tinnitus, decreased hearing, and vertigo) D. Hypomania or acute psychosis E. None of the above ANSWER: C 38 Serious side effects of glucocorticoids include the following: A. Adrenal suppression B. Insomnia, behavioral changes (primarily hypomania) C. Rounding, puffiness, fat deposition and plethora alter the appearance of the face – moon faces D. All of the above E. None of the above ANSWER: D 39 Which of the following property combinations is peculiar to the majority of NSAIDs? A. Antihistaminic, antipyretic, analgesic B. Immunodepressive, anti-inflammatory, analgesic C. Antipyretic, analgesic, anti-inflammatory D. Anti-inflammatory, immunodepressive, antihistaminic E. All of the above ANSWER: C 40 Which of the following NSAIDs is a propionic acid derivative? A. Ibuprofen B. Indomethacin C. Metamizole (Analgin) D. Diclofenac E. All of the above ANSWER: A 41 Which of the following NSAIDs is an indol derivative? A. Ibuprofen B. Indomethacin C. Meclofenamic acid D. Diclofenac E. All of the above ANSWER: B 42 Which of the following NSAIDs is a pyrazolone derivative? A. Ibuprofen B. Indomethacin C. Metamizole (Analgin) D. Diclofenac E. None of the above ANSWER: C 43 Which of the following NSAIDs is an oxicam derivative? A. Piroxicam B. Indomethacin C. Meclofenamic acid D. Diclofenac E. None of the above ANSWER: A 44 Which of the following NSAIDs is a selective COX-2 inhibitor? A. Piroxicam B. Indomethacin C. Celecoxib D. Diclofenac E. None of the above ANSWER: C 45 Indication for aspirin administration are the following, EXCEPT: A. Inflammatory conditions B. Decreasing the incidence of transient ischemic attack, unstable angina, coronary artery thrombosis with myocardial infarction, and thrombosis after coronary artery bypass grafting C. None of the above D. Relieving severe visceral pain, e.g. myocardial infarction, cancer pain condition, renal or biliary colic E. Reducing elevated body temperature ANSWER: D 46 Side effects of aspirin include following: A. Gastric upset (intolerance) B. Salicylism (vomiting, tinnitus, decreased hearing, and vertigo) C. Gastric ulcers and upper gastrointestinal bleeding D. All of the above E. None of the above ANSWER: D 47 Pharmacodynamics involves the study of following EXCEPT: A. Biological effects of drugs B. Absorption and distribution of drugs C. Mechanisms of drug action D. Drug interactions E. Therapeutic effects of drugs ANSWER: B 48 Pharmacodynamics involves the study of following? A. Mechanisms of drug action B. Biotransformation of drugs in the organism C. Distribution of drugs in the organism D. Excretion of drug from the organism E. Binding to proteins ANSWER: A 49 An agonist is a substance that: A. Interacts with the receptor without producing any effect B. Interacts with the receptor and initiates changes in cell function, producing various effects C. Increases concentration of another substance to produce effect D. Interacts with plasma proteins and doesn’t produce any effect E. All of the above ANSWER: B 50 Give the definition for a therapeutical dose: A. The amount of a substance to produce the minimal biological effect B. The amount of a substance to produce effects hazardous for an organism C. The amount of a substance to produce the required effect in most patients D. The amount of a substance to accelerate an increase of concentration of medicine in an organism E. The amount of a substance to produce the minimal adverse effects ANSWER:C 51 Which effect may lead to toxic reactions when a drug is taken continuously or repeatedly? A. Refractoriness B. Cumulative effect C. Tolerance D. Tachyphylaxis E. Idiosyncrazy ANSWER: B 52 What term is used to describe a more gradual decrease in responsiveness to a drug, taking days or weeks to develop? A. Refractoriness B. Cumulative effect C. Tolerance D. Tachyphylaxis E. Idiosyncrazy ANSWER: C 53 What is the type of drug-to-drug interaction which is connected with processes of absorption, biotransformation, distribution and excretion? A. Pharmacodynamic interaction B. Physical interaction C. Chemical interaction D. Pharmaceutical interaction E. Pharmacokinetic interaction ANSWER: E 54 What is the type of drug-to-drug interaction which is the result of interaction at receptor, cell, enzyme or organ level? A. Pharmacodynamic interaction B. Physical interaction C. Pharmaceutical interaction D. Pharmacokinetic interaction E. Chemical interaction ANSWER: A 55 A teratogenic action is: A. Toxic action on the liver B. Negative action on the fetus causing fetal malformation C. Toxic action on blood system D. Toxic action on kidneys E. The ability of a substance to cause cancer ANSWER: B 56 Therapeutic index (TI) is: A. A ratio used to evaluate the safety and usefulness of a drug for indication B. A ratio used to evaluate the effectiveness of a drug C. A ratio used to evaluate the bioavailability of a drug D. A ratio used to evaluate the elimination of a drug E. None of the above ANSWER: A 57 Indicate the expectorant with the reflex mechanism: A. Sodium benzoate B. Derivatives of Ipecacucnha and Thermopsis C. Trypsin D. Ambroxol E. Bromhexine ANSWER: B 58 Tick the antitussive agent with a peripheral effect: A. Codeine B. Tusuprex C. Libexine D. Glaucine hydrochloride E. None of the above ANSWER: C 59 Which of these groups of drugs is used for asthma treatment? A. Methylxanthines B. M-cholinoblocking agents C. Beta2 – agonists D. Steroids E. All of the above ANSWER: E 60 Pick out the bronchodilator drug related to xanthine: A. Atropine B. Ipratropium C. Orciprenaline D. Adrenaline E. Theophylline ANSWER: E 61 Which of the following M-cholinoblocking agents is used especially as an anti- asthmatic? A. Atropine B. Ipratropium C. Platiphylline D. Metacin E. None of the above ANSWER: B 62 All of the following drugs are inhaled glucocorticoids EXCEPT: A. Triamcinolone B. Beclometazone C. Sodium cromoglycate D. Budesonide E. Fluticazone ANSWER: C 63 Choose the drug belonging to membranestabilizing agents: A. Zileutin B. Sodium cromoglycate C. Zafirlucast D. Montelucast E. Budesonide ANSWER: B 64 A 46-year-old patient has ischemic heart disease, angina on exertion, II functional class. What is the drug of choice in treatment of acute attack? A. Nitroglycerin sublingually B. Platelet inhibiting agents (aspirin) C. Spasmolitics (No-spa) IV D. Digitalis IV E. Sedative agents (Seduxenum) orally ANSWER: A 65 A 52-year-old patient complains of intensive and prolonged retrosternal pains, decreased exercise tolerance for 5 days. Which of the following groups is the most useful? A. nitrates B. dyslipidemic drugs C. diuretics D. ACE inhibitors E. Digitalis ANSWER: A 66 A 55-year-old men has stenocardia on exertion II. Taking of nitroglycerin potentiate a severe headache. Which of the following drugs is the most useful in this case? A. Molsidomin B. Amiodaron C. Nifedipine D. Propranolol E. Verapamil ANSWER: A 67 A patient of 42 year has arterial hypertension with bradyarrhythmia. Which of the following drugs is necessary to administer? A. Klonidine B. Nifedipine C. Bisoprolol D. Diltiazem E. Methyldopa ANSWER: B 68 A woman 56 years old with hypertension edema develops on lower extremities, moist wheezes in the lower parts of lungs. What must be administered in the complex therapy of the patient? A. Betaadrenomimetics, B. Diuretics, C. Glucocorticoids, D. Preparations of calcium, E. M-cholinolitics. ANSWER: B

69 Patients suffering from congestive heart failure will show signs and symptoms of peripheral vasoconstriction, moist skin, pale complextion because of: A. Na and water retention B. decreased renin release C. increased sympathetic tone D. decreased vagal tone E. decreased aldosterone levels ANSWER: C 70 In the patient with the considerable peripheral edema the by turns using of dihlothiazid, ethacrynic acid and furosemide did not result in the considerable diuretic effect. The analysis of blood indicated the considerable increasing of aldosteron level. Prescribe drug for treatment. A. Mannitol

B. Spironolactone

C. Clopamid

D. Triamterene

E. Amiloride

ANSWER: B

71 The patient with severe allergic bronchial asthma has been treated by oral drug during 7 months. Hypertension, “moon face”, obese trunk, oedema, insomnia occur. What drugs does he used? A. Patient used one of orally used glucocorticoids, e.g. prednisolonum. B. Patient used one of beta-agonists. C. Patient used cromolynum. D. Patient used euphyllinum E. Patient used all above. ANSWER: A 72 Patient 65 years old suffers from bronchial asthma. Adrenergic receptor activator is used for treatment, After two weeks of management a pain near heart, palpitation. How can these side effects be prevent? It is necessary to prescribe A. selective beta2-adrenergic receptor stimulator, for example salbutamolum. B. glucocorticoids. C. theophylline. D. anticholinergics E. cromolyn sodium. ANSWER: A 73 During auscultation of patient P., 60 years old, with chronic non-obstructive bronchitis, dry buzzling rales above all parts of the lungs were heard as well as weakened vesicular breathing. What medical preparation is it necessary to prescribe to the patient? A. Diuretics; B. Antitussive agents; C. Expectorants; D. Broncholitics; E. beta-blockers. ANSWER: C 74 A 56-yr-old man wheezes and coughs. He has tried to give up smoking, but he finds it very difficult. He is thin and healthy looking with a rounded chest. His breathing is noisy. His cough is unproductive. What treatment has to be prescribed? A. Amoxycillin B. Prednisolone C. Ipratropium D. Salbutamol E. Bronchial lavage ANSWER: C 75 A 20-yr-old woman presents with a week's history of fever, rigors arid productive rusty cough. CXR shows right lower lobe consolidation. Prescribe treatment A. Erythromycin B. Co-trimoxazole C. Prednisolone D. Amoxicillin E. Salbutamol inhaler ANSWER: D 76 A 52-year-old woman with a history of eczema and heavy alcohol use begins taking ibuprofen to control hip and knee pain due to osteoarthritis. Over the course of 6 months, as the pain worsens, she increases her dosage to a high level (600 mg four times daily).What toxicity is most likely to occur, and why? A. Abnormal heart rhythms; alcohol induces cytochrome P450 isozymes that convert ibuprofen to a cardiotoxic free radical metabolite B. Necrotizing fasciitis; eczema predisposes an individual to this toxicity of ibuprofen C. Gastric ulceration; heavy alcohol use increases the susceptibility of an individual to ibuprofeninduced GI toxicity D. Confusion and ataxia; these CNS toxicities of ibuprofen are additive with those of ethanol E. Eosinophilia; this rare complication of ibuprofen therapy is exacerbated by the immunosuppression frequently seen in alcoholics ANSWER: C 77 A 24-year-old AIDS patient is interested in starting chemoprophylaxis for Pneumocystis pneumonia (PCP) and cerebral toxoplasmosis. He has no drug allergies.Which of the following prophylactic agents is appropriate for the prevention of both PCP and cerebral toxoplasmosis? A. Nitrofurantoin B. Trimethoprim–sulfamethoxazole C. Norfloxacin D. Methenamine E. Nalidixic acid ANSWER: B 78 A 6-year-old relatively healthy boy is diagnosed with external otitis and was prescribed a 7-day course of TMP-SMX.Which of the following is the basic mechanism of action of the sulfonamides? A. Selective inhibition of incorporation of PABA into human cell folic acid synthesis. B. Competitive inhibition of incorporation of PABA into microbial folic acid. C. Inhibition of transpeptidation reaction in bacterial cell wall synthesis. D. Changes in DNA gyrases and active efflux transport system resulting in decreased permeability of drug. E. Structural changes in dihydropteroate synthase and overproduction of PABA. ANSWER: B 79 Which of the following drugs used in the treatment of gout has as its primary effect the reduction of uric acid synthesis A. Allopurinol B. Sulfinpyrazone C. Colchicine D. Indomethacin E. Cyclosporine ANSWER: A 80 Non-narcotic analgesics are mainly effective against pain associated with: A. Inflammation or tissue damage B. Trauma C. Myocardial infarction D. Surgery E. All of the above ANSWER: A 81 Non-narcotic agents cause: A. Respiratory depression B. Antipyretic effect C. Euphoria D. Physical dependence E. Abstinence syndrome ANSWER: B 82 Select the non-narcotic drug, which is a paraaminophenol derivative: A. Analgin B. Aspirin C. Baclophen D. Paracetamol E. Ketoprofen ANSWER: D 83 Which of the following non-narcotic agents is salicylic acid derivative? A. Phenylbutazone B. Ketamine C. Aspirin D. Tramadol E. Paracetamol ANSWER: C 84 Tick pirazolone derivative: A. Methylsalicylate B. Analgin C. Paracetamol D. Ketoralac E. Indometacine ANSWER: B 85 Most of non-narcotic analgesics have: A. Anti-inflammatory effect B. Analgesic effect C. Antipyretic effect D. All of the above E. None of the above ANSWER: D 86 Correct statements concerning aspirin include all of the following EXCEPT: A. It inhibits mainly peripheral COX B. It does not have an anti-inflammatory effect C. It inhibits platelet aggregation D. It stimulates respiration by a direct action on the respiratory center E. It can produce ulceration ANSWER: B 87 For which of the following conditions could aspirin be used prophylactically? A. Noncardiogenic pulmonary edema B. Peptic ulcers C. Thromboembolism D. Metabolic acidosis E. Glomerulonephritis ANSWER: C 88 In course of combined therapy a patient with chronic cardiac insufficiency was taking digitoxin and Furosemide. As a result he had extreme muscular weakness. What electrolyte imbalances may be revealed in his blood? A. Hyperkaliemia B. Hypokaliemia C. Hypocalcemia D. Hypernatriemia E. Hypercalcemia ANSWER: B 89 A 50 year old patient with ischemic disease was prescribed an antiplatelet preparation. The patient was taking o verdoses of this preparation. It resulted in nausea, vomiting, stomach pain during fasting. What preparation was the patient prescribed? A. Pentoxyphilline B. Ticlide C. Acetylsalicylic acid D. Paracetamol E. Dipiridamole ANSWER: C 90 A doctor administered Allopurinol to a 26-year-old young man with the symptoms of gout. What pharmacological action of Allopurinol ensures therapeutical effect? A. By increasing uric acid excretion B. By inhibiting leucocyte migration into the joint C. By inhibiting uric acid synthesis D. By general analgetic effect E. By general anti-inflammatory effect ANSWER: C 91 The drug applied at the case of hypersusceptibility to nitroglycerine for removing attack of angina pectoris A. Aspirin B. Atropine C. Piracetame D. Papaverine E. Molsidomine ANSWER: E 92 A 53-year-old woman suffers from heart attacks. The patient is bothered by severe chest pain, arrhythmia, and short breath. What drug is the most expedient for prescription in this case to provide first aid? A. Nitrosorbidum. B. Nitroglycerinum. C. Amiodaronum. D. Propranololum. E. Sustac-forte. ANSWER: B 93 A 65-year-old patient felt retro-sternal pain while waiting in a queue during the visit to a dermatologist. What drug is the most effective in this case? A. Cordiaminum. B. Validolum. C. Sustac-forte. D. Nitroglycerinum. E. Analginum. ANSWER: D 94 A doctor has prescribed losartan to a patient with essential hypertension. What pharmacological property of this drug provides therapeutic effect? A. Blockade of beta-adrenoreceptors. B. Blockade of alpha-adrenoreceptors. C. BIockade of angiotensin receptors. D. Blockade of angiotensin-converting enzyme. E. Antagonism with calcium ions. ANSWER: C 95 A drug in the form of aerosol was prescribed to a patient with angina pectoris. The patient had retrosternal pain and used an antianginal drug. The pain disappeared, but the patient began to complain of headache and vertigo. What drug has been used by the patient? A. Nitroglycerinum. B. Propranololum. C. Metoproloium. D. Validolum. ANSWER: A 96 A patient has been suffering from bronchial asthma for a long time. Recently he had attacks of angina pectoris. Which of the drugs is contraindicated? A. Propranololum. B. Nitroglycerinum. C. Sustac-forte. D. Nifedipinum. E. Dipyridamolum. F. Verapamilum. ANSWER: A 97 A patient with cardiogenic shock, hypotension, asthma, and edemas was prescribed a nonglycosidic cardiotonic. Which drug was injected to the patient? A. Coffeinum-natrii benzoas. B. Dobutaminum. C. Cordiaminum. D. Aethimizolum. E. Bemegridum. ANSWER: B 98 A patient with hypertensive disease has an attack of bronchial asthma. What medicine should be taken to stop the attack? A. Adrenalini hydrochloridum. B. Salbutamolum. C. Isadrinum. D. Aminophyllinum. E. Ephedrini hydrochloridum. ANSWER: B 99 A patient with hypertensive disease with an accompanying obstructive bronchitis receives propranolole in complex therapy. After a while attacks of asthma occured. What is the cause of the side effect? A. Blockade of beta2-adrenorcceptors of bronchi. B. Blockade of beta1-adrenoreceptors of bronchi. C. Stimulation serotonin-adrenoreceptors of bronchi. D. Blockade of alpha2-adrenoreceptors of bronchi. E. Stimulation of NMDA receptors of bronchi. ANSWER: A 100 At the patient after injecting drug for the medical treatment of hypertensive crisis tachycardia, and orthosthatic hypotension in the vertical position has developed. What drug was injected? A. Reserpine B. Clophelinum C. Magnesium sulfate D. Dibazolum E. Verapamilum ANSWER: B