Drug Quiz #1 (2026-2027) - Antianginal (Nitrate) /Antiarrhythmic

P2 Cardiovascular Drug Quiz

Ranolazine (Brand Name)

Ranexa

Ranolazine (MOA)

Inhibits inward sodium current leading to decreased intracellular calcium concentrations, decreasing ventricular tension and myocardial oxygen demand

Ranolazine (FDA Indication; Off Label Use)

Angina; Ventricular arrhythmias

Ranolazine (Dosage Form; Dosing; Hepatic/Renal Dosing)

Oral; 500mg BID; Hepatic: Avoid in hepatic cirrhosis, Renal: CrCl ≤30 mL/min, 500 mg po daily

Ranolazine (Drug Interactions)

CYP3A4/5 inducers, CYP3A4/5 inhibitors, P-gp inducers, P-gp inhibitors, Agents that prolong the QTc interval

Isosorbide mononitrate (Brand Name)

Imdur

Isosorbide mononitrate (MOA)

Strong vasodilator of smooth muscle via nitric oxide activation of guanylate cyclase which increases guanosine 3’5’ monophosphate (cGMP) leading to dephosphorylation of myosin light chains and smooth muscle relaxation

Isosorbide mononitrate (FDA Indication; Off Label Use)

Angina; None

Isosorbide mononitrate (Dosage Form; Dosage; Hepatic/Renal Dosing)

Oral; 30 - 60 mg QD; None

Isosorbide mononitrate (Drug Interaction)

Phosphodiesterase 5 (PDE) inhibitors

Nitroglycerin (Brand Name)

Nitrostat, Nitroquick

Nitroglycerin (MOA)

Strong vasodilator of smooth muscle via nitric oxide activation of guanylate cyclase which increases guanosine 3’5’ monophosphate (cGMP) leading to dephosphorylation of myosin light chains and smooth muscle relaxation

Nitroglycerin (FDA Indication; Off Label Use)

Acute Angina; Extravasation

Nitroglycerin (Dosage Form; Dosage; Hepatic/Renal Dosing)

Oral, Sublingual, Transdermal, Rectal, IV; 1 tab or 1-2 sprays at first sign of angina, repeat every 5 min if needed for total of 3 tabs or doses in 15 minutes; None

Nitroglycerin (Drug Interaction)

Phosphodiesterase 5 (PDE) inhibitors

Digoxin (Brand Name)

Lanoxin, Digitek, Digox

Digoxin (MOA)

Increased AV nodal refractory period via increased vagal tone, sympathetic withdrawal along with exertion of positive inotropic effect

Digoxin (FDA Indication; Off Label Use)

Atrial Fibrillation, Heart Failure; Fetal tachycardia, Supra-ventricular tachyarrhythmias

Digoxin (Dosage Form; Dosage; Hepatic/Renal Dosing)

Oral Tablet, Solution; N/A; N/A

Digoxin (Drug Interaction)

Amiodarone, itraconazole, propafenone, ranolazine, quinidine, beta blockers, diuretics, p-glycoprotein inducers, p-glycoprotein inhibitors, antacids, bile acid sequestrants, sucralfate

Amiodarone (Brand Name)

Pacerone, Cordarone

Amiodarone (MOA)

Prolongs the effective refractory period of atrial and ventricular tissue by blocking potassium conductance.

Amiodarone (FDA Indication; Off Label Use)

Ventricular arrhythmias; Atrial fibrillation, supraventricular arrhythmia

Amiodarone (Dosage Form; Dosage; Hepatic/Renal Dosage)

Oral; 400 mg Q8-12H × 1-2 WK, then 200-400 mg QD; Hepatic: dose adjustment should be considered, Renal: N/A

Amiodarone (Drug Interaction)

Class IA and III antiarrhythmics, other drugs that prolong the QTc interval, beta-blockers and calcium channel blockers, warfarin