HOSMERIT
NR 565 -ADVANCED PHARMACOLOGY MIDTERM
(CHAMBERLAIN) VERSION WITH THE MOST
RECENT QUESTION AND VERIFIED ANSWERS
GUARANTEED PASS
Which is best HTN medication for someone with diabetes ✔✔CORRECTANSWER✔✔ACE
inhibitor and ARB
Which medication to avoid in a patient who is pregnant or breastfeeding? ✔✔CORRECT
ANSWER✔✔Avoid ACE and ARBs in patients who are pregnantor may become pregnant.
Especially ARBs in the second and third trimester.
Medications best for HTN for patient who is pregnant? ✔✔CORRECTANSWER✔✔labetalol,
methyldopa, nifedipine
For general population which HTN class is appropriate? ✔✔CORRECTANSWER✔✔thiazide
diuretics
For African Americans which class of HTN medications is appropriate? ✔✔CORRECT
ANSWER✔✔thiazide, CCB, BB
For a chronic kidney disease, what is the best HTN medication class? ✔✔CORRECT
ANSWER✔✔ACE Inhibitors or ARBS
What class of medications to avoid in African Americans? ✔✔CORRECTANSWER✔✔ACE
inhibitors and ARBS
Thiazide diuretics MOA ✔✔CORRECT ANSWER✔✔blockade of sodium andchloride
reabsorption increases renal excretion of sodium, chloride, potassium, and water
(hyponatremia, hypochloremia, hypokalemia)
,ACE inhibitors MOA ✔✔CORRECT ANSWER✔✔Angiotensin Converting Enzyme
Inhibitors (ACE-I) prevent the conversion of angiotensin I to angiotensin II, which disrupts
the renin-angiotensin-aldosterone system(RAAS).
- reduce levels of angiotensin II (through inhibition of ACE)
- increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
ARBS MOA ✔✔CORRECT ANSWER✔✔Block angiotensin II receptors on blood vessels in
heart and adrenals. Increases renal excretion of sodium andwater. Cause dilation of arterioles
and veins.
End in -sartan
CCB MOA ✔✔CORRECT ANSWER✔✔They work by preventing calcium fromentering the
cells of the heart and arteries. Calcium causes the heart and arteries to squeeze (contract)
more strongly. By blocking calcium, calciumchannel blockers allow blood vessels to relax and
open.
blockade of peripheral arterioles cause dilation and reduces arterial pressure, arterioles of the
heart increases coronary perfusion, blockade of the SA node reduces heart rate, decreases AV
node conduction, myocardiumdecreases force of contraction
Prescribing considerations when carbamazepine is prescribed with warfarin
✔✔CORRECT ANSWER✔✔Carbamazepine lowers the effectiveness of Warfarin. This is
because of the induction of drug-metabolizing enzymes.
There needs to be close monitoring for the Warfarin dose by checking the prothrombin and
INR. The dose may need to be adjusted to counterbalancethe effect of adding or removing the
inducing agent
A patient with HF develops fibrotic changes, what should the provider donext?
✔✔CORRECT ANSWER✔✔ensure that a patient is on an ARB (valsartan) as this inhibits
fibrosis (aldosterone antagonist)
Adverse effects of lasix (flurosemide) ✔✔CORRECT ANSWER✔✔ototoxicity
,What medication causes ototoxicity as well and should not be prescribed with lasix?
✔✔CORRECT ANSWER✔✔aminoglycoside antibiotics, end in -cin
What medication might we consider prescribing with a loop diuretic to prevent an electrolyte
imbalance? ✔✔CORRECT ANSWER✔✔potassium sparing diuretic (spironolactone)
black box warning for spironolactone ✔✔CORRECT ANSWER✔✔endocrineeffects -
gynecomastia, menstrual irregularities, hirsutism, deepening of voice HYPERKALEMIA
What is the action of aldosterone? ✔✔CORRECT ANSWER✔✔acts on distaltubules of the
kidney to cause retention of sodium and excretion of potassium and hydrogen. Retention of
Na causes water to be retained as well. Aldosterone increases blood volume which increases
blood pressure
How to migrate adverse effects of aldosterone? ✔✔CORRECT ANSWER✔✔Aldosterone
antagonist (ex/ spironolactone, eplerenone)
common side effects of ACE inhibitors ✔✔CORRECT
ANSWER✔✔angioedema, dry non-productive cough, hyperkalemia, first-dose hypotension
Name of only direct-renin inhibitor? ✔✔CORRECT ANSWER✔✔Aliskiren(Tekturna,
rasilez)
What is the DRI only approved for? ✔✔CORRECT ANSWER✔✔hypertension
What should be avoided with the administration of a DRI? ✔✔CORRECTANSWER✔✔high
fat meals
MOA eplerenone ✔✔CORRECT ANSWER✔✔retention of potassium and increased excretion
of sodium and water
, Inhibitors of what can lead to toxic levels of eplerenone? ✔✔CORRECT
ANSWER✔✔Inhibitors of CYP3A4, increase levels of medication, risk for toxicity
MOST concerning adverse effects of eplerenone ✔✔CORRECTANSWER✔✔hyperkalemia
adverse effects of CCBs in elderly patients ✔✔CORRECT ANSWER✔✔gingivalhyperplasia
(overgrowth of gum tissue) and chronic eczematous rash
verapamil increases the plasma level of what medication by 60%?
✔✔CORRECT ANSWER✔✔digoxin
What should patients avoid taking with CCBs? ✔✔CORRECTANSWER✔✔grapefruit juice
(INHIBITOR)
Can nifedipine be used to treat dysrhythmias? ✔✔CORRECT ANSWER✔✔No
Reflex tachycardia can occur with which CCB? ✔✔CORRECTANSWER✔✔Nifedipine
What patient education should we provide when prescribing vasodilators? ✔✔CORRECT
ANSWER✔✔increased risks for falls, symptoms of hypotension(orthostatic) and advised to sit
if these occurs
common vasodilators medications ✔✔CORRECT ANSWER✔✔ACE inhibitorssuch as
benazepril (Lotensin®) or lisinopril (Prinivil®, Zestril®).
ARBs such as losartan (Cozaar®).
CCBs such as diltiazem (Cardizem®, Tiazac®).
Other direct vasodilators such as hydralazine (Apresoline®), minoxidil(Loniten®) or
nitroglycerin (Nitrostat®).
What is minoxidil reserved for? ✔✔CORRECT ANSWER✔✔severehypertension
NR 565 -ADVANCED PHARMACOLOGY MIDTERM
(CHAMBERLAIN) VERSION WITH THE MOST
RECENT QUESTION AND VERIFIED ANSWERS
GUARANTEED PASS
Which is best HTN medication for someone with diabetes ✔✔CORRECTANSWER✔✔ACE
inhibitor and ARB
Which medication to avoid in a patient who is pregnant or breastfeeding? ✔✔CORRECT
ANSWER✔✔Avoid ACE and ARBs in patients who are pregnantor may become pregnant.
Especially ARBs in the second and third trimester.
Medications best for HTN for patient who is pregnant? ✔✔CORRECTANSWER✔✔labetalol,
methyldopa, nifedipine
For general population which HTN class is appropriate? ✔✔CORRECTANSWER✔✔thiazide
diuretics
For African Americans which class of HTN medications is appropriate? ✔✔CORRECT
ANSWER✔✔thiazide, CCB, BB
For a chronic kidney disease, what is the best HTN medication class? ✔✔CORRECT
ANSWER✔✔ACE Inhibitors or ARBS
What class of medications to avoid in African Americans? ✔✔CORRECTANSWER✔✔ACE
inhibitors and ARBS
Thiazide diuretics MOA ✔✔CORRECT ANSWER✔✔blockade of sodium andchloride
reabsorption increases renal excretion of sodium, chloride, potassium, and water
(hyponatremia, hypochloremia, hypokalemia)
,ACE inhibitors MOA ✔✔CORRECT ANSWER✔✔Angiotensin Converting Enzyme
Inhibitors (ACE-I) prevent the conversion of angiotensin I to angiotensin II, which disrupts
the renin-angiotensin-aldosterone system(RAAS).
- reduce levels of angiotensin II (through inhibition of ACE)
- increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
ARBS MOA ✔✔CORRECT ANSWER✔✔Block angiotensin II receptors on blood vessels in
heart and adrenals. Increases renal excretion of sodium andwater. Cause dilation of arterioles
and veins.
End in -sartan
CCB MOA ✔✔CORRECT ANSWER✔✔They work by preventing calcium fromentering the
cells of the heart and arteries. Calcium causes the heart and arteries to squeeze (contract)
more strongly. By blocking calcium, calciumchannel blockers allow blood vessels to relax and
open.
blockade of peripheral arterioles cause dilation and reduces arterial pressure, arterioles of the
heart increases coronary perfusion, blockade of the SA node reduces heart rate, decreases AV
node conduction, myocardiumdecreases force of contraction
Prescribing considerations when carbamazepine is prescribed with warfarin
✔✔CORRECT ANSWER✔✔Carbamazepine lowers the effectiveness of Warfarin. This is
because of the induction of drug-metabolizing enzymes.
There needs to be close monitoring for the Warfarin dose by checking the prothrombin and
INR. The dose may need to be adjusted to counterbalancethe effect of adding or removing the
inducing agent
A patient with HF develops fibrotic changes, what should the provider donext?
✔✔CORRECT ANSWER✔✔ensure that a patient is on an ARB (valsartan) as this inhibits
fibrosis (aldosterone antagonist)
Adverse effects of lasix (flurosemide) ✔✔CORRECT ANSWER✔✔ototoxicity
,What medication causes ototoxicity as well and should not be prescribed with lasix?
✔✔CORRECT ANSWER✔✔aminoglycoside antibiotics, end in -cin
What medication might we consider prescribing with a loop diuretic to prevent an electrolyte
imbalance? ✔✔CORRECT ANSWER✔✔potassium sparing diuretic (spironolactone)
black box warning for spironolactone ✔✔CORRECT ANSWER✔✔endocrineeffects -
gynecomastia, menstrual irregularities, hirsutism, deepening of voice HYPERKALEMIA
What is the action of aldosterone? ✔✔CORRECT ANSWER✔✔acts on distaltubules of the
kidney to cause retention of sodium and excretion of potassium and hydrogen. Retention of
Na causes water to be retained as well. Aldosterone increases blood volume which increases
blood pressure
How to migrate adverse effects of aldosterone? ✔✔CORRECT ANSWER✔✔Aldosterone
antagonist (ex/ spironolactone, eplerenone)
common side effects of ACE inhibitors ✔✔CORRECT
ANSWER✔✔angioedema, dry non-productive cough, hyperkalemia, first-dose hypotension
Name of only direct-renin inhibitor? ✔✔CORRECT ANSWER✔✔Aliskiren(Tekturna,
rasilez)
What is the DRI only approved for? ✔✔CORRECT ANSWER✔✔hypertension
What should be avoided with the administration of a DRI? ✔✔CORRECTANSWER✔✔high
fat meals
MOA eplerenone ✔✔CORRECT ANSWER✔✔retention of potassium and increased excretion
of sodium and water
, Inhibitors of what can lead to toxic levels of eplerenone? ✔✔CORRECT
ANSWER✔✔Inhibitors of CYP3A4, increase levels of medication, risk for toxicity
MOST concerning adverse effects of eplerenone ✔✔CORRECTANSWER✔✔hyperkalemia
adverse effects of CCBs in elderly patients ✔✔CORRECT ANSWER✔✔gingivalhyperplasia
(overgrowth of gum tissue) and chronic eczematous rash
verapamil increases the plasma level of what medication by 60%?
✔✔CORRECT ANSWER✔✔digoxin
What should patients avoid taking with CCBs? ✔✔CORRECTANSWER✔✔grapefruit juice
(INHIBITOR)
Can nifedipine be used to treat dysrhythmias? ✔✔CORRECT ANSWER✔✔No
Reflex tachycardia can occur with which CCB? ✔✔CORRECTANSWER✔✔Nifedipine
What patient education should we provide when prescribing vasodilators? ✔✔CORRECT
ANSWER✔✔increased risks for falls, symptoms of hypotension(orthostatic) and advised to sit
if these occurs
common vasodilators medications ✔✔CORRECT ANSWER✔✔ACE inhibitorssuch as
benazepril (Lotensin®) or lisinopril (Prinivil®, Zestril®).
ARBs such as losartan (Cozaar®).
CCBs such as diltiazem (Cardizem®, Tiazac®).
Other direct vasodilators such as hydralazine (Apresoline®), minoxidil(Loniten®) or
nitroglycerin (Nitrostat®).
What is minoxidil reserved for? ✔✔CORRECT ANSWER✔✔severehypertension
