WELL DETAILED ANSWERS|LATEST
CORRECT = 100
100
INCORRECT=0
STUDY MATERIALS.......DESIGNED TO HELP YOU SUCCEED
1
, SPOTLIGHT 1
CORRECT WELL DETAILED ANSWERS|LATEST
UPDATE!!!!!!2026|GUARANTEED PASS|GRADED
What assessments should be made before prescribing any antihypertensive agent? -
ANSWER BP, RF, and head to toe assessment. Assess diet, sodium intake, electrolytes,
and potassium levels. Prior to prescribing any antihypertensives, creatinine and BUN levels
should be evaluated. Confirmation of elevated BP at 3 different times. Children over 3 years
old should be assessed at least once at every visit-preferred method for children is by
auscultation, the correct measurement requires using a cuff that is appropriate to the child's
upper arm. 12 lead EKG. UA, albumin, albumin/creatinine ratio. Diabetics or those with renal
disease should have the albumin/creatinine ratio annually. The presence of albuminuria,
micro albuminuria even in the setting of normal GFR is associated with increased
cardiovascular risk. Blood sugar, hct, serum calcium, and lipid profile.
Why are ACE inhibitors the drug of choice in diabetic patients with hypertension? -
ANSWER ACE-Is will improve insulin sensitivity, as well as reduce the effects of DM on
the kidneys. Protect the kidneys, watch for renal function, any creatinine >2.5 requires dose
reduction. Prevents diabetic nephropathy or slow its progression. Reduce albuminuria and
BP. ACEIs and ARBs should be used to treat the HTN. Renal protection, reduces the
conversion of AT II and improve the insulin sensitivity.
What is the drug of choice to improve symptoms for patients taking propranolol? -
ANSWER Ipratropium
What is the most common adverse effect of an ACE inhibitor? - ANSWER Dry, hacking
cough in some patients. Can switch to an angiotensin blocker which won't cause cough.
Reduce dose with either of these if Cr >2.5. Most are associated with hypotension, dizziness,
HA, fatigue, orthostatic hypotension, tachyphylaxis.
2
,What is the action of an ACE inhibitor? - ANSWER Decreases angiotensin II and
aldosterone. Vasodilatation on the venous and arterial sides of the heart. Blocks the RAAS
system leads to rennin acts on angiotensinogen to angiotensin I to angiotensin II through
ACE. Angiotensin II stimulates aldosterone causing sodium and water while losing potassium
via the kidney. ACE is also involved in the inactivation of bradykinin a vasodilator. Bradykin is
what causes the cough (irritating the lungs).
What is the action of an Angiotensin Receptor Blocker? - ANSWER Blocks the
angiotensin II receptor to leading to increasing vascular tone and stimulating vascular
smooth muscle contraction. One of the greatest advantages: doesn't produce the dry,
hacking cough that ACE-Is do. Similar to ACE-I except to bradykinin activity (no cough),
lowers BP, decreases vascular resistance, decreases pulmonary cap wedge pressure,
decreases HR, increases cardiac index.
What ethnic background should not be prescribed long-acting beta-agonists? -
ANSWER African Americans, increased incidence of death in this population
What is tiotropium used to treat? - ANSWER COPD, after patient stops smoking, this
medication slow the progression of COPD.
What is the action of a Calcium Channel Blocker? - ANSWER Decrease the amount of
calcium inside the cell to control blood pressure. Dihydropyridine CCB: inhibits
transmembrane influx of extracellular calcium ions across myocardial and vascular smooth
muscle cell membranes without changing serum calcium concentrations. This results in
inhibition of cardiac and vascular smooth muscle contraction, thereby dilating main coronary
and systemic arteries. Vasodilatation with decreased peripheral resistance and increased
heart rate. Nondihydropyridine CCB: inhibits extracellular calcium ion influx across
membranes of myocardial cells and vascular smooth muscle cells. Resulting in inhibition of
cardiac and vascular smooth muscle contraction and thereby dilating main coronary and
systemic arteries. No effect on serum calcium contractions. Substantial inhibitory effects on
cardiac conduction system, acting principally at AV node, with some effects at sinus node.
What are the adverse effects of a dihydropyridine-type calcium channel blocker? -
ANSWER Causes edema of the feet and hands, especially feet. Amlodipine and
3
, nifedipine. Type 2 (dihydropyridine=vessel loving) = peripheral edema. Type 1 (non-
dihydropyridine=heart loving)=bradycardia, dizziness, hypotension.
A 70-year-old patient is admitted with peripheral edema. He is taking a calcium channel
blocker and metformin. What is the cause of his peripheral edema? - ANSWER The
edema is not related to metformin. Type 1 CCB more commonly exhibit peripheral edema.
Pts report swelling of the hands, feet, ankles, and decreased urine output.
What special populations should not be prescribed pseudoephedrine? -
ANSWER Children under the age of 4, first line treatment for coughs and colds is
increased fluids and symptomatic management. Schedule III- addictive personalities, HTN,
CAD. Children under 4= Infants cause sudden death, not recommended for children under 4.
Anytime thinking of cough and cold medications you should always think of the elderly, very
young and HTN.
How is amlodipine metabolized? - ANSWER All CCBs are metabolized by the liver in
the CYP 3A4. Avoid, don't administer CCB with grapefruit juice, it will increase amlodipine
level. Has a half life of 30-50 hours (56hr in hepatic impairment), eliminated via urine.
A patient is prescribed amlodipine. She develops reflex tachycardia. What is the reason for
the development of bradycardia? - ANSWER It increases the myocardial oxygen
delivery in patients with angina. Sub-peripheral vasodilatation causes such a dramatic drop
in BP that baroreceptor reflex is triggered. The baroreceptors are in the aortic arch. The
baroreceptor causes sympathetic stimulation of the heart. It increases pulse, it increases
contractile force. Peripheral or facial edema can result. Hypotension is a common adverse
effect of CCB. A beta blocker can be administered to prevent the reflex tachycardia. When
prescribing CCB you always start low and progress slow. Older patients should be started at
half the regular dose. Decrease in SA and AV node conduction velocity occurs.
What drug should be prescribed for a patient with nasal congestion with hypertension? -
ANSWER Nasal oxymetazoline or nasal azelastine. Cromolyn sodium, ipratropium
bromide, or corticosteroids by inhalation can be used safely for nasal congestion by patients
with HTN.
4
CORRECT = 100
100
INCORRECT=0
STUDY MATERIALS.......DESIGNED TO HELP YOU SUCCEED
1
, SPOTLIGHT 1
CORRECT WELL DETAILED ANSWERS|LATEST
UPDATE!!!!!!2026|GUARANTEED PASS|GRADED
What assessments should be made before prescribing any antihypertensive agent? -
ANSWER BP, RF, and head to toe assessment. Assess diet, sodium intake, electrolytes,
and potassium levels. Prior to prescribing any antihypertensives, creatinine and BUN levels
should be evaluated. Confirmation of elevated BP at 3 different times. Children over 3 years
old should be assessed at least once at every visit-preferred method for children is by
auscultation, the correct measurement requires using a cuff that is appropriate to the child's
upper arm. 12 lead EKG. UA, albumin, albumin/creatinine ratio. Diabetics or those with renal
disease should have the albumin/creatinine ratio annually. The presence of albuminuria,
micro albuminuria even in the setting of normal GFR is associated with increased
cardiovascular risk. Blood sugar, hct, serum calcium, and lipid profile.
Why are ACE inhibitors the drug of choice in diabetic patients with hypertension? -
ANSWER ACE-Is will improve insulin sensitivity, as well as reduce the effects of DM on
the kidneys. Protect the kidneys, watch for renal function, any creatinine >2.5 requires dose
reduction. Prevents diabetic nephropathy or slow its progression. Reduce albuminuria and
BP. ACEIs and ARBs should be used to treat the HTN. Renal protection, reduces the
conversion of AT II and improve the insulin sensitivity.
What is the drug of choice to improve symptoms for patients taking propranolol? -
ANSWER Ipratropium
What is the most common adverse effect of an ACE inhibitor? - ANSWER Dry, hacking
cough in some patients. Can switch to an angiotensin blocker which won't cause cough.
Reduce dose with either of these if Cr >2.5. Most are associated with hypotension, dizziness,
HA, fatigue, orthostatic hypotension, tachyphylaxis.
2
,What is the action of an ACE inhibitor? - ANSWER Decreases angiotensin II and
aldosterone. Vasodilatation on the venous and arterial sides of the heart. Blocks the RAAS
system leads to rennin acts on angiotensinogen to angiotensin I to angiotensin II through
ACE. Angiotensin II stimulates aldosterone causing sodium and water while losing potassium
via the kidney. ACE is also involved in the inactivation of bradykinin a vasodilator. Bradykin is
what causes the cough (irritating the lungs).
What is the action of an Angiotensin Receptor Blocker? - ANSWER Blocks the
angiotensin II receptor to leading to increasing vascular tone and stimulating vascular
smooth muscle contraction. One of the greatest advantages: doesn't produce the dry,
hacking cough that ACE-Is do. Similar to ACE-I except to bradykinin activity (no cough),
lowers BP, decreases vascular resistance, decreases pulmonary cap wedge pressure,
decreases HR, increases cardiac index.
What ethnic background should not be prescribed long-acting beta-agonists? -
ANSWER African Americans, increased incidence of death in this population
What is tiotropium used to treat? - ANSWER COPD, after patient stops smoking, this
medication slow the progression of COPD.
What is the action of a Calcium Channel Blocker? - ANSWER Decrease the amount of
calcium inside the cell to control blood pressure. Dihydropyridine CCB: inhibits
transmembrane influx of extracellular calcium ions across myocardial and vascular smooth
muscle cell membranes without changing serum calcium concentrations. This results in
inhibition of cardiac and vascular smooth muscle contraction, thereby dilating main coronary
and systemic arteries. Vasodilatation with decreased peripheral resistance and increased
heart rate. Nondihydropyridine CCB: inhibits extracellular calcium ion influx across
membranes of myocardial cells and vascular smooth muscle cells. Resulting in inhibition of
cardiac and vascular smooth muscle contraction and thereby dilating main coronary and
systemic arteries. No effect on serum calcium contractions. Substantial inhibitory effects on
cardiac conduction system, acting principally at AV node, with some effects at sinus node.
What are the adverse effects of a dihydropyridine-type calcium channel blocker? -
ANSWER Causes edema of the feet and hands, especially feet. Amlodipine and
3
, nifedipine. Type 2 (dihydropyridine=vessel loving) = peripheral edema. Type 1 (non-
dihydropyridine=heart loving)=bradycardia, dizziness, hypotension.
A 70-year-old patient is admitted with peripheral edema. He is taking a calcium channel
blocker and metformin. What is the cause of his peripheral edema? - ANSWER The
edema is not related to metformin. Type 1 CCB more commonly exhibit peripheral edema.
Pts report swelling of the hands, feet, ankles, and decreased urine output.
What special populations should not be prescribed pseudoephedrine? -
ANSWER Children under the age of 4, first line treatment for coughs and colds is
increased fluids and symptomatic management. Schedule III- addictive personalities, HTN,
CAD. Children under 4= Infants cause sudden death, not recommended for children under 4.
Anytime thinking of cough and cold medications you should always think of the elderly, very
young and HTN.
How is amlodipine metabolized? - ANSWER All CCBs are metabolized by the liver in
the CYP 3A4. Avoid, don't administer CCB with grapefruit juice, it will increase amlodipine
level. Has a half life of 30-50 hours (56hr in hepatic impairment), eliminated via urine.
A patient is prescribed amlodipine. She develops reflex tachycardia. What is the reason for
the development of bradycardia? - ANSWER It increases the myocardial oxygen
delivery in patients with angina. Sub-peripheral vasodilatation causes such a dramatic drop
in BP that baroreceptor reflex is triggered. The baroreceptors are in the aortic arch. The
baroreceptor causes sympathetic stimulation of the heart. It increases pulse, it increases
contractile force. Peripheral or facial edema can result. Hypotension is a common adverse
effect of CCB. A beta blocker can be administered to prevent the reflex tachycardia. When
prescribing CCB you always start low and progress slow. Older patients should be started at
half the regular dose. Decrease in SA and AV node conduction velocity occurs.
What drug should be prescribed for a patient with nasal congestion with hypertension? -
ANSWER Nasal oxymetazoline or nasal azelastine. Cromolyn sodium, ipratropium
bromide, or corticosteroids by inhalation can be used safely for nasal congestion by patients
with HTN.
4
