Final Exam NR 565 Advanced Pharmacology
Care of the Fundamentals Exam | Questions
and Answers (2024/ 2025
Therapeutic action of HTN drug classifications used - Thiazide diuretics MOA
blockade of sodium and chloride reabsorption. increases renal excretion of sodium,
chloride, potassium, and water (hyponatremia, hypochloremia, hypokalemia)
ACE inhibitors MOA
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)2. increasing levels
of bradykinin (through inhibition of kinase 11) End in -pril
ARBS MOA
Block angiotensin II receptors on blood vessels in the heart and adrenals. Increases
renal excretion of sodium and water. Cause dilation of arterioles and veins. End in -
sartan
CCB MOA
They work by preventing calcium from entering the cells of the heart and arteries.
Calcium causes the heart and arteries to squeeze (contract) more strongly. By blocking
calcium, calcium channel blockers allow blood vessels to relax and open. blockade of
peripheral arterioles causes dilation and reduces arterial pressure, arterioles of the
heart increase coronary perfusion, blockade of the SA node reduces heart rate,
decreases AV node conduction, myocardium decreases the force of contraction
Ethnic groups impacted by certain HTN drug classifications - Which medication to avoid
in a patient who is pregnant or breastfeeding?
Avoid ACE and ARBs in patients who are pregnant or may become pregnant. Especially
ARBs in the second and third trimesters.
What medications are best for HTN for a patient who is pregnant?
labetalol, methyldopa, nifedipine
For the general population which HTN class is appropriate?
thiazide diuretics
For African Americans which class of HTN medications is appropriate?
thiazide, CCB, BB
, For chronic kidney disease, what is the best HTN medication class?
ACE Inhibitors or ARBS
What class of medications to avoid in African Americans?
ACE inhibitors and ARBS
Prescribing considerations when carbamazepine is prescribed with warfarin -
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
counterbalance the effect of adding or removing the inducing agent
Beta-blockers
o Their use with nitroglycerin and tachycardia
o Know examples
o Risk of stopping them abruptly
o What happens when given to someone with asthma? - -Beta Blockers suppress
nitroglycerin-induced tachycardia.
They do so by preventing sympathetic activation of beta-1 adrenergic receptors in the
heart.
-End in -olol
-Stopping abruptly can increase the incidence and intensity of anginal attacks and may
even precipitate MI
-May cause bronchospasms
Diuretics
o Contradictions to thiazide diuretics
o Monitoring needs - -Sulfa Allergy
-Pts w severe renal impairment and/or/cardiovascular issues
-History of gout
-diabetes
-hyperlipidemia
-weight
-vitals
-blood glucose
-BUN & creatinine/kidney function
-electrolytes - sodium, potassium, calcium, magnesium
Heart failure
o What to prescribe in response to fibrotic changes
Effects of cardiac glycosides - ensure that a patient is on an ARB (valsartan) as this
inhibits fibrosis (aldosterone antagonist)
Quinidine and digoxin
Care of the Fundamentals Exam | Questions
and Answers (2024/ 2025
Therapeutic action of HTN drug classifications used - Thiazide diuretics MOA
blockade of sodium and chloride reabsorption. increases renal excretion of sodium,
chloride, potassium, and water (hyponatremia, hypochloremia, hypokalemia)
ACE inhibitors MOA
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)2. increasing levels
of bradykinin (through inhibition of kinase 11) End in -pril
ARBS MOA
Block angiotensin II receptors on blood vessels in the heart and adrenals. Increases
renal excretion of sodium and water. Cause dilation of arterioles and veins. End in -
sartan
CCB MOA
They work by preventing calcium from entering the cells of the heart and arteries.
Calcium causes the heart and arteries to squeeze (contract) more strongly. By blocking
calcium, calcium channel blockers allow blood vessels to relax and open. blockade of
peripheral arterioles causes dilation and reduces arterial pressure, arterioles of the
heart increase coronary perfusion, blockade of the SA node reduces heart rate,
decreases AV node conduction, myocardium decreases the force of contraction
Ethnic groups impacted by certain HTN drug classifications - Which medication to avoid
in a patient who is pregnant or breastfeeding?
Avoid ACE and ARBs in patients who are pregnant or may become pregnant. Especially
ARBs in the second and third trimesters.
What medications are best for HTN for a patient who is pregnant?
labetalol, methyldopa, nifedipine
For the general population which HTN class is appropriate?
thiazide diuretics
For African Americans which class of HTN medications is appropriate?
thiazide, CCB, BB
, For chronic kidney disease, what is the best HTN medication class?
ACE Inhibitors or ARBS
What class of medications to avoid in African Americans?
ACE inhibitors and ARBS
Prescribing considerations when carbamazepine is prescribed with warfarin -
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
counterbalance the effect of adding or removing the inducing agent
Beta-blockers
o Their use with nitroglycerin and tachycardia
o Know examples
o Risk of stopping them abruptly
o What happens when given to someone with asthma? - -Beta Blockers suppress
nitroglycerin-induced tachycardia.
They do so by preventing sympathetic activation of beta-1 adrenergic receptors in the
heart.
-End in -olol
-Stopping abruptly can increase the incidence and intensity of anginal attacks and may
even precipitate MI
-May cause bronchospasms
Diuretics
o Contradictions to thiazide diuretics
o Monitoring needs - -Sulfa Allergy
-Pts w severe renal impairment and/or/cardiovascular issues
-History of gout
-diabetes
-hyperlipidemia
-weight
-vitals
-blood glucose
-BUN & creatinine/kidney function
-electrolytes - sodium, potassium, calcium, magnesium
Heart failure
o What to prescribe in response to fibrotic changes
Effects of cardiac glycosides - ensure that a patient is on an ARB (valsartan) as this
inhibits fibrosis (aldosterone antagonist)
Quinidine and digoxin
