44. Which of the following is the MOST significant concern when prescribing nitrates for chronic angina?
A) Development of tolerance
B) Hyperkalemia
C) Bradycardia
D) Hyperglycemia
45. How can nitrate tolerance be minimized?
A) Administering beta-blockers concurrently
B) Increasing the dose gradually
C) Using a nitrate-free interval of 8–12 hours
D) Using sublingual formulations only
46. Which anti-anginal drug is preferred in pregnant patients?
A) Propranolol
B) Nifedipine
C) Ranolazine
D) Nitroglycerin
47. Which drug should be avoided in patients with asthma or COPD?
A) Propranolol
B) Amlodipine
C) Nitroglycerin
D) Ranolazine
48. Which beta-blocker is recommended for angina patients with diabetes due to its cardioselectivity?
A) Propranolol
B) Atenolol
C) Nadolol
D) Pindolol
49. Which of the following is recommended for immediate relief of angina symptoms?
A) Ranolazine
B) Beta-blockers
C) Sublingual nitroglycerin
D) Aspirin
50. Which of the following should be avoided in elderly patients due to the risk of hypotension and dizziness?
A) Atenolol
B) Metoprolol
C) Nifedipine (short-acting)
D) Ranolazine
51. Why are beta-blockers and nitrates often combined in angina therapy?
A) To counteract reflex tachycardia caused by nitrates
B) To enhance vasodilation
C) To reduce nitrate tolerance
D) To increase oxygen demand
52. Which drug combination should be avoided due to excessive bradycardia?
A) Nitrates and diuretics
B) Beta-blockers and nitrates
C) Beta-blockers and non-dihydropyridine calcium channel blockers (e.g., verapamil)
D) Calcium channel blockers and aspirin
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53. Why is ranolazine often used as an add-on therapy in angina?
A) It acts faster than nitrates
B) It does not significantly lower blood pressure or heart rate
C) It is the only drug that prevents atherosclerosis
D) It enhances calcium channel blocker effects
54. Which of the following drugs reduces platelet aggregation and is often used in patients with angina?
A) Nitroglycerin
B) Ranolazine
C) Aspirin
D) Metoprolol
55. Which of the following medications should NOT be used in patients with bradycardia?
A) Beta-blockers
B) Nitrates
C) Aspirin
D) Statins
56. Which drug is considered first-line for stable angina?
A) Ranolazine
B) Nitrates
C) Beta-blockers
D) Statins
57. Which drug is often prescribed to prevent future cardiovascular events in patients with angina?
A) Aspirin
B) Ranolazine
C) Nitroglycerin
D) Nifedipine
58. Which of the following drug classes improves survival in angina patients?
A) Nitrates
B) Beta-blockers
C) Calcium channel blockers
D) Ranolazine
59. Which medication is NOT used in long-term angina management?
A) Calcium channel blockers
B) Beta-blockers
C) Sublingual nitroglycerin
D) Aspirin
60. Which of the following drugs should be avoided in patients with severe heart failure?
A) Non-dihydropyridine calcium channel blockers (e.g., verapamil)
B) Beta-blockers
C) Aspirin
D) Nitrates
61. A 55-year-old male with stable angina is prescribed metoprolol. What is the primary benefit of this
medication?
A) Improves exercise tolerance
B) Increases coronary blood flow
C) Decreases myocardial oxygen demand
D) Reduces blood clot formation
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62. A patient presents with acute angina and is given sublingual nitroglycerin. What is the expected effect?
A) Increase in blood pressure
B) Rapid vasodilation and pain relief
C) Reduction in heart rate
D) Increase in cardiac contractility
63. A 65-year-old female with a history of angina and hypertension is started on nifedipine. What side effect
should be closely monitored?
A) Hyperkalemia
B) Bradycardia
C) Hypoglycemia
D) Peripheral edema
64. A patient with stable angina has worsening symptoms despite being on nitrates and beta-blockers. What is
the next best step in management?
A) Add ranolazine
B) Increase nitrate dose
C) Discontinue beta-blockers
D) Start digoxin
65. A patient with angina reports headache and flushing after taking his prescribed medication. Which drug is
most likely responsible?
A) Nitroglycerin
B) Metoprolol
C) Ranolazine
D) Aspirin
66. A 72-year-old patient with angina and heart failure is prescribed a calcium channel blocker. Which drug is
the safest option?
A) Verapamil
B) Amlodipine
C) Diltiazem
D) Nifedipine (short-acting)
67. A patient with unstable angina is given aspirin. What is the primary reason for this treatment?
A) To prevent platelet aggregation
B) To relieve chest pain
C) To reduce blood pressure
D) To lower cholesterol
68. Which drug should be avoided in a patient with angina and severe asthma?
A) Amlodipine
B) Propranolol
C) Nitroglycerin
D) Aspirin
69. A patient presents with chest pain due to Prinzmetal’s angina. What is the drug of choice?
A) Calcium channel blockers
B) Beta-blockers
C) Aspirin
D) Digoxin
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70. A 58-year-old man on nitroglycerin therapy experiences frequent episodes of dizziness and syncope. What is
the likely cause?
A) Coronary artery constriction
B) Reflex bradycardia
C) Excessive vasodilation leading to hypotension
D) Increased myocardial oxygen demand
71. A patient with angina is found to have a heart rate of 48 bpm. Which medication should be avoided?
A) Beta-blockers
B) Nitrates
C) Aspirin
D) Ranolazine
72. A patient with stable angina is given a drug that reduces myocardial oxygen demand by decreasing both
heart rate and contractility. Which drug is this?
A) Ranolazine
B) Nitrates
C) Beta-blockers
D) Aspirin
73. Which drug should NOT be given with sildenafil due to the risk of severe hypotension?
A) Aspirin
B) Beta-blockers
C) Nitroglycerin
D) Ranolazine
74. Which angina medication can cause constipation as a side effect?
A) Metoprolol
B) Nitroglycerin
C) Verapamil
D) Aspirin
75. A patient taking nitrates for chronic stable angina is prescribed a new medication that inhibits the breakdown
of cGMP. Which drug should be avoided?
A) Sildenafil
B) Atenolol
C) Aspirin
D) Ranolazine
76. Which of the following drugs should be avoided in patients with severe bradycardia?
A) Ranolazine
B) Nitrates
C) Aspirin
D) Verapamil
77. Which anti-anginal drug should be used with caution in patients with prolonged QT interval?
A) Beta-blockers
B) Ranolazine
C) Nitrates
D) Aspirin
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78. Which of the following drugs has NO significant effect on blood pressure?
A) Ranolazine
B) Verapamil
C) Nitroglycerin
D) Beta-blockers
79. Which drug is preferred for angina patients with low blood pressure?
A) Amlodipine
B) Beta-blockers
C) Ranolazine
D) Isosorbide dinitrate
80. Which of the following anti-anginal drugs is least likely to cause hypotension?
A) Ranolazine
B) Nitroglycerin
C) Amlodipine
D) Beta-blockers
81. Which drug class improves survival in patients with angina and previous myocardial infarction?
A) Beta-blockers
B) Nitrates
C) Calcium channel blockers
D) Ranolazine
82. Which medication is primarily used to prevent angina but DOES NOT provide immediate relief?
A) Nitroglycerin sublingual
B) Isosorbide mononitrate
C) Verapamil
D) Ranolazine
83. Which of the following drugs should NOT be used in acute angina attacks?
A) Amlodipine
B) Nitroglycerin
C) Ranolazine
D) Aspirin
84. Which medication reduces angina symptoms by decreasing myocardial oxygen demand?
A) Nitrates
B) Aspirin
C) Beta-blockers
D) Statins
85. Which drug is commonly prescribed to prevent thrombotic events in patients with angina?
A) Aspirin
B) Ranolazine
C) Isosorbide dinitrate
D) Digoxin
86. Which drug is MOST effective at preventing angina triggered by exertion?
A) Ranolazine
B) Nitrates
C) Aspirin
D) Beta-blockers
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