NR 565 Pharmacology: Week 3 questions and
answers 2025 update
Hypertension - ✔✔ANS Underlying vascular dysfunction that leads to end organ damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - ✔✔ANS Stage 1 HTN; preferred initial therapy for
african-americans
Mechanism of action: Diuretics - ✔✔ANS Decrease blood volume, venous pressure, and preload
Mechanism of action: Thiazide diuretics - ✔✔ANS Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - ✔✔ANS Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - ✔✔ANS HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
Side effects: Thiazide diuretics - ✔✔ANS Hyperglycemia, hyperuricemia, hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - ✔✔ANS Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
4 factors that influence drug selection - ✔✔ANS 1. Special populations (pregnant/nursing/older adult)
,2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - ✔✔ANS Block conversion of angiotensin I to II
Results in vasoconstriction
Drug of choice for DM/CKD due to renal protection
Side effects: ACEIs and ARBs - ✔✔ANS Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - ✔✔ANS Moderate-severe kidney disease (monitor GFR)
Renal artery stenosis
Acute renal failure
Pregnancy category C/1st and D/2nd trimester (fetal kidney malformation + hypotension)
HTN medications to avoid in African-Americans - ✔✔ANS ACEIs and ARBs
Mechanism of action: Calcium channel blockers - ✔✔ANS Vasodilation by blocking voltage-gated Ca++
channels in cardiac smooth muscle and blood vessels
Inotropic effect: heart is depressed
Chronotropic effect: heart is slowed down
Side effects: Calcium channel blockers - ✔✔ANS Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
, Contraindications: Calcium channel blockers - ✔✔ANS Due to inotropic/chronotropic effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - ✔✔ANS "Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - ✔✔ANS Calcium channel blockers
Order HTN medications are typically prescribed - ✔✔ANS Thiazide diuretics
ACEIs
ARBs
CCBs
Beta-blockers
Heart failure treatment plan - ✔✔ANS 1st: ACEI or ARB
Add: Beta-blockers + diuretics
Add other drugs as needed
DM/HTN treatment plan - ✔✔ANS 1st: ACEI or ARB
African-Americans: start with CCB or thiazide diuretic
CDK/HTN treatment plan - ✔✔ANS 1st: ACEI or ARB
Add: CCB or diuretic
answers 2025 update
Hypertension - ✔✔ANS Underlying vascular dysfunction that leads to end organ damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - ✔✔ANS Stage 1 HTN; preferred initial therapy for
african-americans
Mechanism of action: Diuretics - ✔✔ANS Decrease blood volume, venous pressure, and preload
Mechanism of action: Thiazide diuretics - ✔✔ANS Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - ✔✔ANS Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - ✔✔ANS HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
Side effects: Thiazide diuretics - ✔✔ANS Hyperglycemia, hyperuricemia, hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - ✔✔ANS Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
4 factors that influence drug selection - ✔✔ANS 1. Special populations (pregnant/nursing/older adult)
,2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - ✔✔ANS Block conversion of angiotensin I to II
Results in vasoconstriction
Drug of choice for DM/CKD due to renal protection
Side effects: ACEIs and ARBs - ✔✔ANS Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - ✔✔ANS Moderate-severe kidney disease (monitor GFR)
Renal artery stenosis
Acute renal failure
Pregnancy category C/1st and D/2nd trimester (fetal kidney malformation + hypotension)
HTN medications to avoid in African-Americans - ✔✔ANS ACEIs and ARBs
Mechanism of action: Calcium channel blockers - ✔✔ANS Vasodilation by blocking voltage-gated Ca++
channels in cardiac smooth muscle and blood vessels
Inotropic effect: heart is depressed
Chronotropic effect: heart is slowed down
Side effects: Calcium channel blockers - ✔✔ANS Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
, Contraindications: Calcium channel blockers - ✔✔ANS Due to inotropic/chronotropic effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - ✔✔ANS "Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - ✔✔ANS Calcium channel blockers
Order HTN medications are typically prescribed - ✔✔ANS Thiazide diuretics
ACEIs
ARBs
CCBs
Beta-blockers
Heart failure treatment plan - ✔✔ANS 1st: ACEI or ARB
Add: Beta-blockers + diuretics
Add other drugs as needed
DM/HTN treatment plan - ✔✔ANS 1st: ACEI or ARB
African-Americans: start with CCB or thiazide diuretic
CDK/HTN treatment plan - ✔✔ANS 1st: ACEI or ARB
Add: CCB or diuretic
