www.pharmacyprep.

com
Copyright 2000-2010 Tips Inc Prevent Piracy 8-1
8
PHARMACY PREP

ISCHEMIC HEART DISEASES


1. A 57-year-old male patient with shortness of breath, swollen ankle, high blood
pressure and exercise-induced angina comes to the pharmacy with an Rx of digoxin
0.20 mg/day. He is already taking HCTZ, Verapamil and Nitro lingual spray PRN.
What do you tell his doctor?
I Fill the prescription the way it is
II Change HCTZ to Furosemide
III Decrease the dosage of digoxin
a. I only
b. III only
c. I and II
d. II and III
e. All of the above
Ans-D

Next 1 Questions refer to the following scenario
2-A 36-year female receptionist medical history includes migraine and angina. Which of
the following can she use?
I. Nifedipine
II. Nitrate
III. Verapamil
a. I only
b. III only
c. I and II only
d. II and III only
e. All of the above
Ans-B

Next 2 Questions refer to the following scenario
3. Which medication CAN NOT BE used for Prinzmetal angina (vasospastic angina)?
A. Amlodipine
B. Metoprolol
C. ASA
D. Verapamil
E. Diltiazem
www.pharmacyprep.com
Copyright 2000-2010 Tips Inc Prevent Piracy 8-2
Ans-B
Tips:
TC page 275, avoid beta blockers in Prinzmetal angina, beta blockers cause
vasoconstriction (vasospasm)

Next 3 Questions refer to the following scenario
AA. is a 62 year-old male, presents with the following prescriptions after being
discharged from hospital: nitroglycerin patch (Nitro-Dur) 0.4mg daily, ASA (Aspirin)
81 mg daily and metoprolol (Lopressor) 25mg twice daily.
Past Medical History indicates Stable angina x 2 years, no known allergies, current
medication Nitroglycerin (Nitrostat) sublingual tablets 0.6 mg prn.

4-What is the recommended length of time that AA. Should go without wearing the
nitroglycerine patch daily to avoid tolerance?
A-2-4 hours
B-10-12 hours
C-6-8 hours
D-14-16 hours
Comments: Drug free period (nitrate free)
Ans-B

5 - What is an important point to discuss with AA, regarding nitroglycerin patch use?
I-Rotate application site regularly
II-Redness at application site requires drug discontinuation
III-Remove patch while bathing or showering and occlusive dressings may increase
absorption.
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans-A
Comments: Keep patch on while bathing or showering.

36-Which side effects is AA. The most at risk of experiencing?
A-Hyperkalemia
B-Hypotension
C-Cough
D-Dry mouth
E-Irritation
Ans-B

7 . Which of the following counselling tips regarding nitroglycerin sublingual tablet use
is NOT appropriate to provide AA.?
A-Tablets should be stored tightly capped glass bottle
B-Discard cotton plug from bottle.
www.pharmacyprep.com
Copyright 2000-2010 Tips Inc Prevent Piracy 8-3
C- Persistent chest pain after using 3 doses in a 15-minute interval should prompt G.M. to
seek immediate medical attention
D- A tingling or burning sensation when dissolved under the tongue is a reliable test for
potency.
E- Tablets should not be chewed or crushed.
Ans-D

8. Patient with prosthetic valve replacement in his heart was discharged after having a
cerebral ischemic attack. The patient is intolerant to ASA. Best prophylactic treatment
to be prescribed for the patient is/are:
(A) Ticlid (Ticlopidine)
(B) Clopidogrel (Plavix 75mg)
(C) Dipyridamole 400mg/day
(D) Dipyridamole plus Warfarin
(E) None of the above
Answer: (D)
Reference: Therapeutic Choices 5
th
edition Page 510