Drugs used in heart failure

  

  1. The following group of drugs are used in heart failure except:

  1. Diuretics;

  2. Angiotensin-converting enzyme inhibitors (ACE);

  3. beta -adrenoceptor blockers;

  4. alfa, beta- adrenoceptor agonist.


  1.   Choose the correct answer, (clinical uses of diuretics):

  1. Are useful only in early stage of heart failure (HF);

  2. Loop diuretics (eg, furosemide) are effective in acute pulmonary edema and in severe chronic heart failure;

  3. Thiazides (eg, hydrochlorothiazide) may be adequate only in severe chronic heart failure;

  4. Spironolactone is contraindicated in hepatic cirrhosis.


  1.   Choose the correct answer, (clinical uses of ACE inhibitors (eg, captopril):

  1. Increase morbidity and mortality in patients with severe chronic heart failure;

  2. Are second-line agents in heart failure and are used orally;

  3. Angiotension II-receptors (Losartan) are used if ACE inhibitors are not tolerated;

  4. Have a significant effect on cardiac contractility or the manifestations of acute decompensation.


  1.   Toxicities of ACE inhibitors include:

  1. Cough;

  2. Constipation;

  3. Vasoppressor effect;

  4. Hemolytic anemia.


  1.   Choose right answer (Uses of beta-blochers during chronic heart failure):

  1. Certain B-adrenoblockers (eg carvedilol and metoprolol) have been shown to prolong life in chronic heart failure;

  2. Beta-adrenoblocking agents are contraindicated in chronic heart failure;

  3. Beta adrenoblocking agents may increase renin and angiotensin production;

  4. B-adrenoreceptor blockers may cause bronchodilation.


  1.   Choose right answers (clinical use of Dobutamine and Dopamine):

  1. Dobutamine is a B1-adrenoceptor selective agonist given parenterally for severe acute heart failure;

  2. Dobutamine has a long duration of action;

  3. Dobutamine and dopamine increase cardiac force and increase preload and afterload;

  4. Toxicities of dobutamine and Dopamine include bradycardia.


  1.   Digoxin (mechanism of action):

  1. Used primarily for heart failure, activates Na+K+-ATP-ase, increases intracellular sodium;

  2. Used primarily for heart failure inhibits Na+K+-ATP-ase increases intracellular calcium;

  3. Digoxin half-life is 4-6 hours;

  4. Digoxin is available only as intravenous preparation.


  1.   Digoxin causes (effects):

  1. Positive chronotropic effect;

  2. Positive dromotropic effect;

  3. Cardiac parasympathomimetic effect that reduces AV conduction. This action is useful in atrial fibrillation;

  4. Tachycardia during its therapeutic action.


  1.   Digoxin (toxicity):

  1. Is less toxic;

  2. Causes constipation;

  3. Severe overdose causes cardiac arrest; this lethal poisoning must be treated with dogoxin antibodies;

  4. Reduces preload.


  1.   Phosphodiesterase inhibitors include the following drugs, except:

  1. Amrinone;

  2. Milrinone;

  3. Aminophylline;

  4. Spironolactone


  1.   Phosphodiesterase inhibitors:

  1. Inhibit phosphodiesterase (PDE) and thereby decrease the amount of cAMP in cardiac tissue and vessels;

  2. Are occasionally used parenterally in chronic heart failure;

  3. Are used parenterally for acute decompensation in heart failure;

  4. Amrininone and milrinone unlike theophylline and aminophylline can cause seizures.


  1.   In chronic heart failure are used orally:

  1. Nitroprusside;

  2. Neseritide;

  3. Nitroglycerine sublingual;

  4. Isosorbide dinitrate;


  1.   In acute heart decompensation are administered intravenously following drugs, except:

  1. Nitroglycerin;

  2. Digitoxine;

  3. Nesiritide (vasodilator that also has diuretic properties);

  4. Hydralazine


  1.   A 57-year-old man with atrial flutter is initially treated with quinidine to control the arrhythmia. He is released from the hospital, and while his condition improves, sporadic arrhythmias continue. Which of the following drugs might be used as an adjunct to quinidine in the treatment of the atrial flutter?

  1. Digitalis 

  2. Lidocaine 

  3. Procainamide

  4. Nifedipine 


  1.   In terms of the ability of drugs like digoxin to increase cardiac contractility, their primary action on cardiac cells is

  1. activation of adenylylcyclase

  2. inactivation of Na channels

  3. activation of the slow Ca2+ channel

  4. inhibition of Na+/K+-ATPase