APEA PRESCRIBING - MASTER 1| FROM QUESTION TO
PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 70%.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,The side effect profile of angiotensin receptor blockers (ARBs) is similar to the side effects of:
angiotensin-converting enzymes (ACE) inhibitors.
beta-blockers.
calcium channel blockers.
pressors. Answer: angiotensin-converting enzymes (ACE) inhibitors.
Isosorbide dinitrate (Isordil) is indicated for the treatment of:
acute angina.
chronic angina.
myocardial infarction.
esophageal spasm. Answer: chronic angina.
Isosorbide dinitrate (Isordil) titradose tablets are indicated for the prevention of angina pectoris
due to coronary artery disease. The onset of action of immediate-release oral isosorbide dinitrate
is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.
Therefore, it is not indicated in the treatment of acute angina and myocardial infarction. The
treatment of esophageal spasms disorders is an off-label use.
Non-dihydropyridine calcium channel blockers (i.e. verapamil) may be safely used in patients
with:
heart failure.
bradycardia.
second-degree AV block.
chronic stable angina. Answer: chronic stable angina.
Non-dihydropyridine CCBs (non-DHP CCB; i.e. verapamil [Calan] and diltiazem [Cardizem])
have negative chronotropic and inotropic effects. Therefore, they slow down heart rate and
decrease force of ventricular contractions. Non-DHP CCBs are contraindicated in patients with
heart failure who have reduced ejection fraction, sick sinus syndrome, and second- or third-
degree atrioventricular block. Since non-DHP CCBs increase myocardial blood flow by dilating
coronary arteries, they are beneficial in patients with chronic stable angina.
Patients who are started on olmesartan (Benicar) should be advised to report:
bladder spasms and dysuria.
constipation and weakness.
diarrhea and weight loss.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, metallic taste and easy bruising. Answer: diarrhea and weight loss.
Patients should be advised to report persistent chronic diarrhea and weight loss while taking
olmesartan medoxomil (Benicar). This drug can produce a sprue-like enteropathy characterized
by severe chronic diarrhea and weight loss occurring months to years after initiation of the drug.
Benicar is an angiotensin receptor blocker (ARB). Once other etiologies have been excluded,
discontinue Benicar and consider an alternative hypertension treatment.
The medication that produces vasodilation and thus lowers blood pressure by inhibiting the
formation of angiotensin II is:
amlodipine (Norvasc).
losartan (Cozaar).
enalapril (Vasotec).
metoprolol (Lopressor). Answer: enalapril (Vasotec).
Amlodipine (Norvasc) is a calcium channel blocker, losartan (Cozaar) is an angiotensin II
receptor blocker, and metoprolol (Lopressor) is a beta-blocker.
Dabigatran (Pradaxa), an anticoagulant, is also classified as a:
direct factor Xa inhibitor.
direct thrombin inhibitor.
indirect thrombin inhibitor.
factor V inhibitor. Answer: direct thrombin inhibitor.
Dabigatran (Pradaxa) is a direct thrombin inhibitor (DTI). Medications in this class inactivate
circulating and clotting thrombin (factor IIa). They prevent thrombin (central to the generation
of a thrombus) from attaching fibrinogen to fibrin.
Key advantages of using DTIs instead of heparin is that they: produce a more predictable
anticoagulant effect due to their lack of binding to other plasma proteins; exert an antiplatelet
effect; and do not cause immune-mediated thrombocytopenia.
Loop diuretics such as bumetanide (Bumex):
produce a large volume of diuresis even at very low doses.
are more commonly used in patients with a decreased glomerular filtration rate.
reduce blood pressure as effectively as thiazide diuretics when used as monotherapy.
can be safely administered to patients who have sulfonamide agent allergies. Answer: are more
commonly used in patients with a decreased glomerular filtration rate.
Loop diuretics are commonly used to control volume retention and are more commonly
prescribed for patients with decreased glomerular filtration rate or heart failure. Loop diuretics
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 70%.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,The side effect profile of angiotensin receptor blockers (ARBs) is similar to the side effects of:
angiotensin-converting enzymes (ACE) inhibitors.
beta-blockers.
calcium channel blockers.
pressors. Answer: angiotensin-converting enzymes (ACE) inhibitors.
Isosorbide dinitrate (Isordil) is indicated for the treatment of:
acute angina.
chronic angina.
myocardial infarction.
esophageal spasm. Answer: chronic angina.
Isosorbide dinitrate (Isordil) titradose tablets are indicated for the prevention of angina pectoris
due to coronary artery disease. The onset of action of immediate-release oral isosorbide dinitrate
is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.
Therefore, it is not indicated in the treatment of acute angina and myocardial infarction. The
treatment of esophageal spasms disorders is an off-label use.
Non-dihydropyridine calcium channel blockers (i.e. verapamil) may be safely used in patients
with:
heart failure.
bradycardia.
second-degree AV block.
chronic stable angina. Answer: chronic stable angina.
Non-dihydropyridine CCBs (non-DHP CCB; i.e. verapamil [Calan] and diltiazem [Cardizem])
have negative chronotropic and inotropic effects. Therefore, they slow down heart rate and
decrease force of ventricular contractions. Non-DHP CCBs are contraindicated in patients with
heart failure who have reduced ejection fraction, sick sinus syndrome, and second- or third-
degree atrioventricular block. Since non-DHP CCBs increase myocardial blood flow by dilating
coronary arteries, they are beneficial in patients with chronic stable angina.
Patients who are started on olmesartan (Benicar) should be advised to report:
bladder spasms and dysuria.
constipation and weakness.
diarrhea and weight loss.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, metallic taste and easy bruising. Answer: diarrhea and weight loss.
Patients should be advised to report persistent chronic diarrhea and weight loss while taking
olmesartan medoxomil (Benicar). This drug can produce a sprue-like enteropathy characterized
by severe chronic diarrhea and weight loss occurring months to years after initiation of the drug.
Benicar is an angiotensin receptor blocker (ARB). Once other etiologies have been excluded,
discontinue Benicar and consider an alternative hypertension treatment.
The medication that produces vasodilation and thus lowers blood pressure by inhibiting the
formation of angiotensin II is:
amlodipine (Norvasc).
losartan (Cozaar).
enalapril (Vasotec).
metoprolol (Lopressor). Answer: enalapril (Vasotec).
Amlodipine (Norvasc) is a calcium channel blocker, losartan (Cozaar) is an angiotensin II
receptor blocker, and metoprolol (Lopressor) is a beta-blocker.
Dabigatran (Pradaxa), an anticoagulant, is also classified as a:
direct factor Xa inhibitor.
direct thrombin inhibitor.
indirect thrombin inhibitor.
factor V inhibitor. Answer: direct thrombin inhibitor.
Dabigatran (Pradaxa) is a direct thrombin inhibitor (DTI). Medications in this class inactivate
circulating and clotting thrombin (factor IIa). They prevent thrombin (central to the generation
of a thrombus) from attaching fibrinogen to fibrin.
Key advantages of using DTIs instead of heparin is that they: produce a more predictable
anticoagulant effect due to their lack of binding to other plasma proteins; exert an antiplatelet
effect; and do not cause immune-mediated thrombocytopenia.
Loop diuretics such as bumetanide (Bumex):
produce a large volume of diuresis even at very low doses.
are more commonly used in patients with a decreased glomerular filtration rate.
reduce blood pressure as effectively as thiazide diuretics when used as monotherapy.
can be safely administered to patients who have sulfonamide agent allergies. Answer: are more
commonly used in patients with a decreased glomerular filtration rate.
Loop diuretics are commonly used to control volume retention and are more commonly
prescribed for patients with decreased glomerular filtration rate or heart failure. Loop diuretics
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
