NR 565 Pharmacology: Week 3 Exam
with Complete Solutions
Hypertension - ANSWER-Underlying vascular dysfunction that leads to end organ
damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - ANSWER-Stage 1 HTN; preferred initial
therapy for african-americans
Mechanism of action: Diuretics - ANSWER-Decrease blood volume, venous pressure,
and preload
Mechanism of action: Thiazide diuretics - ANSWER-Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - ANSWER-Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - ANSWER-HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
Side effects: Thiazide diuretics - ANSWER-Hyperglycemia, hyperuricemia,
hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - ANSWER-Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
4 factors that influence drug selection - ANSWER-1. Special populations
(pregnant/nursing/older adult)
2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - ANSWER-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 - ANSWER-Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - ANSWER-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 - ANSWER-ACEIs and ARBs
Mechanism of action: Calcium channel blockers - ANSWER-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 - ANSWER-Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
Contraindications: Calcium channel blockers - ANSWER-Due to inotropic/chronotropic
effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - ANSWER-"Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - ANSWER-Calcium channel blockers
Order HTN medications are typically prescribed - ANSWER-Thiazide diuretics
ACEIs
ARBs
CCBs
Beta-blockers
Heart failure treatment plan - ANSWER-1st: ACEI or ARB
Add: Beta-blockers + diuretics
Add other drugs as needed
with Complete Solutions
Hypertension - ANSWER-Underlying vascular dysfunction that leads to end organ
damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - ANSWER-Stage 1 HTN; preferred initial
therapy for african-americans
Mechanism of action: Diuretics - ANSWER-Decrease blood volume, venous pressure,
and preload
Mechanism of action: Thiazide diuretics - ANSWER-Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - ANSWER-Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - ANSWER-HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
Side effects: Thiazide diuretics - ANSWER-Hyperglycemia, hyperuricemia,
hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - ANSWER-Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
4 factors that influence drug selection - ANSWER-1. Special populations
(pregnant/nursing/older adult)
2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - ANSWER-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 - ANSWER-Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - ANSWER-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 - ANSWER-ACEIs and ARBs
Mechanism of action: Calcium channel blockers - ANSWER-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 - ANSWER-Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
Contraindications: Calcium channel blockers - ANSWER-Due to inotropic/chronotropic
effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - ANSWER-"Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - ANSWER-Calcium channel blockers
Order HTN medications are typically prescribed - ANSWER-Thiazide diuretics
ACEIs
ARBs
CCBs
Beta-blockers
Heart failure treatment plan - ANSWER-1st: ACEI or ARB
Add: Beta-blockers + diuretics
Add other drugs as needed
