Cardiovascular drugs: vericiguat: 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.

Try it

Pharmacology · Cardiovascular drugs: vericiguat

Sample item

A patient with heart failure and reduced ejection fraction is admitted again despite optimal therapy. Vericiguat is added. What is its mechanism of action?

AInhibition of neprilysin, raising natriuretic peptide levelsBBlockade of the If current in the sinus nodeCDirect stimulation of soluble guanylate cyclase, enhancing nitric oxide signalling and raising cGMPDInhibition of the sodium-glucose cotransporter in the proximal tubule

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

The answer and the reasoning

C. Direct stimulation of soluble guanylate cyclase, enhancing nitric oxide signalling and raising cGMP

Vericiguat stimulates soluble guanylate cyclase both directly and by sensitising it to nitric oxide, raising cGMP in vascular smooth muscle and myocardium. It lowers cardiovascular death and heart failure hospitalisation after a worsening event. It is contraindicated in pregnancy and with other soluble guanylate cyclase stimulators such as riociguat.

Option by option

A. Inhibition of neprilysin, raising natriuretic peptide levels
Neprilysin inhibition is the action of sacubitril.
B. Blockade of the If current in the sinus node
If current blockade is the action of ivabradine.
C. Direct stimulation of soluble guanylate cyclase, enhancing nitric oxide signalling and raising cGMP (correct)
Correct. Vericiguat is a soluble guanylate cyclase stimulator.
D. Inhibition of the sodium-glucose cotransporter in the proximal tubule
SGLT2 blockade is the action of dapagliflozin and empagliflozin.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Direct stimulation of soluble guanylate cyclase, enhancing nitric oxide signalling and raising cGMP. Vericiguat stimulates soluble guanylate cyclase both directly and by sensitising it to nitric oxide, raising cGMP in vascular smooth muscle and myocardium.

Why is "Inhibition of neprilysin, raising natriuretic peptide levels" not the answer?

Neprilysin inhibition is the action of sacubitril.

Why is "Blockade of the If current in the sinus node" not the answer?

If current blockade is the action of ivabradine.

Why is "Inhibition of the sodium-glucose cotransporter in the proximal tubule" not the answer?

SGLT2 blockade is the action of dapagliflozin and empagliflozin.

What concept does this question test?

It tests Cardiovascular drugs: vericiguat in Pharmacology. It lowers cardiovascular death and heart failure hospitalisation after a worsening event. It is contraindicated in pregnancy and with other soluble guanylate cyclase stimulators such as riociguat.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: vericiguat?

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.