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NR 565 PHARMACOLOGY: WEEK #3 EXAM QUESTIONS AND ANSWERS
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NR 565 PHARMACOLOGY: WEEK #3 EXAM QUESTIONS AND ANSWERS
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NR 565 PHARMACOLOGY: WEEK #3EXAM QUESTIONS AND ANSWERS
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
DM/HTN treatment plan - Answer-1st: ACEI or ARB
African-Americans: start with CCB or thiazide diuretic
CDK/HTN treatment plan - Answer-1st: ACEI or ARB
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