1 NR 508 PHARMACOLOGY FINAL EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRAD ED A+ 1st line treatment for HTN ( non-black, no CKD) Correct Answer: ACEI (arb), thiazide, ccb 1st line treatment for HTN for black pts (no ckd) Correct Answer: thiazide, ccb 1st line option for HTN for anyone with CKD Correct Answer: ACEI (arb) Types of diuretics Correct Answer: thiazides, loop diuretics, k -sparing preferred diuretic with renal impairment Correct Answer: loop -diuretics 2 diuretics - S/E & D/I Correct Answer: S/E All - hypokalemia, arrhythmia, metbolic alkalosis, fatigue, postrual hypotension, hyperlipidemia S/E for k -sparing - hyperkalemia, gynecomastia, peptic ulcer) S/E for thiazides - hyperglycemia & hypercalcemia S/E for loop hypocalcemia D/I All - digoxin (hypokalemia/toxicity risk), NSAIDs (reduce diuresis), lithium (toxicity risk), corticosteroids (e nhance hypokalemia), anti -diabetic drugs (decrease anti -diabetic levels) D/I for thiazides - BB's - increase hyperglycemia/ hyperlipidemia D/I for loops - aminoglycosides = ototoxicity & nephrotoxicity which diuretic causes post diuretic sodium retentio n Correct Answer: loop diuretics post -diuretic effect, a compensatory sodium -retention process that begins as the diuretic action wanes. 3 Diuretics that do not contain a sulfonamide derivative Correct Answer: ****ethacrynic acid*** also: amiloride, hydrochloride, eplerenone, spironolactone, and triamterene (safe for pt with allergy to sulfa) CHF drugs including diuretic choices Correct Answer: First line: ACEI's or ARB, Beta -blocker, diuretics (loop & potassium sparing) -ACEI's & ARB's decrease mo rtality -if ACEI contraindicated: use ARB or Hydralizine & Isosorbide (decrease mortality/less effective than ACEI) -Beta -blockers: decrease mortality, NEVER when active failure, ONLY after diuresed & other medications -Digoxin: add if needed for systolic HF **if 1st line tx not enough.........******* 4 Spironolactone & Eplerenone Nitrates and hydralazine (lower mortality in class 3&4 for African American) Calcium channel blockers (Can worsen hf use caution **BUT NEV ER IN SYSTOLIC DYSFUNCTION - thats for digoxin) (DA BD is aa sad) Diuretics ACE inhibitors Beta -Blockers (after acute) Digoxin (Syst. HF/A -fib/diuretic failure) Know migraine management and prophylactics Correct Answer: *NSAIDS or APAP *Triptans (suma triptan/imitrex, zolmatriptan/zomig, rizatriptan/maxalt) -nasal, oral, subq -use no more than 2d/wk -C/I-recent use of MAOIs, ergots, or SSRIs, CVD, CAD, TIA, HTN, pregnancy
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