Cardiovascular drugs: short-acting dihydropyridines after infarction: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular drugs: short-acting dihydropyridines after infarction

Sample item

A man five days after myocardial infarction has recurrent angina and a blood pressure of 160/100 mmHg. Which drug, given as an immediate-release capsule, should be avoided because reflex sympathetic activation is associated with increased mortality?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Short-acting nifedipine

Immediate-release nifedipine causes abrupt vasodilatation with reflex tachycardia and sympathetic activation, which can worsen ischaemia and was linked to higher mortality in coronary disease. Beta blockers, ACE inhibitors and nitrates are standard after infarction. Long-acting dihydropyridines are acceptable if needed.

Option by option

  • A. Atenolol

    Atenolol reduces heart rate and mortality after infarction.

  • B. Short-acting nifedipine (correct)

    Correct. Abrupt vasodilatation with reflex tachycardia can aggravate ischaemia and raise mortality.

  • C. Isosorbide mononitrate

    Isosorbide mononitrate relieves angina without reflex activation of this size.

  • D. Ramipril

    Ramipril improves survival after infarction, especially with left ventricular dysfunction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Short-acting nifedipine. Immediate-release nifedipine causes abrupt vasodilatation with reflex tachycardia and sympathetic activation, which can worsen ischaemia and was linked to higher mortality in coronary disease.

Why is "Atenolol" not the answer?

Atenolol reduces heart rate and mortality after infarction.

Why is "Isosorbide mononitrate" not the answer?

Isosorbide mononitrate relieves angina without reflex activation of this size.

Why is "Ramipril" not the answer?

Ramipril improves survival after infarction, especially with left ventricular dysfunction.

What concept does this question test?

It tests Cardiovascular drugs: short-acting dihydropyridines after infarction in Pharmacology. Beta blockers, ACE inhibitors and nitrates are standard after infarction. Long-acting dihydropyridines are acceptable if needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular drugs: short-acting dihydropyridines after infarction?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.