Advanced Pharm: Final Exam
Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic
hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
1. Increases peripheral vasoconstriction
2. Decreases detrusor muscle contractility
3. Lowers supine blood pressure more than standing pressure
4. Relaxes smooth muscle in the bladder neck - verified answer 4. Relaxes smooth muscle in the
bladder neck
To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should
do all of the following EXCEPT:
1. Take the dose at bedtime
2. Sit up slowly and dangle their feet before standing
3. Monitor their blood pressure and skip a dose if the pressure is less than 120/80
4. Weigh daily and report weight gain of greater than 2 pounds in one day - verified answer 3.
Monitor their blood pressure and skip a dose if the pressure is less than 120/80
John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should:
1. Not miss a dose or stop taking the drug because of potential rebound hypertension
2. Increase fiber in the diet to treat any diarrhea that may occur
3. Reduce fluid intake to less than 2 liters per day to prevent fluid retention
4. Avoid sitting for long periods, as this can lead to deep vein thrombosis - verified answer 1. Not
miss a dose or stop taking the drug because of potential rebound hypertension
Clonidine has several off-label uses, including:
1. Alcohol and nicotine withdrawal
2. Post-herpetic neuralgia
3. Both 1 and 2
4. Neither 1 nor 2 - verified answer 3. Both 1 and 2
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is
atenolol. Beta blockers treat hypertension by:
,1. Increasing heart rate to improve cardiac output
2. Reducing vascular smooth muscle tone
3. Increasing aldosterone-mediated volume activity
4. Reducing aqueous humor production - verified answer 2. Reducing vascular smooth muscle tone
Which of the following adverse effects are less likely in a beta 1-selective blocker?
1. Dysrhythmias
2. Impaired insulin release
3. Reflex orthostatic changes
4. Decreased triglycerides and cholesterol - verified answer 2. Impaired insulin release
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol.
You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related
to his nadolol?
1. Extend the dosage interval.
2. Decrease the dose by 75%.
3. Take no action because this value is expected in the older adult.
4. Schedule a serum creatinine level to validate the CrCl value. - verified answer 1. Extend the
dosage interval.
Beta blockers are the drugs of choice for exertional angina because they:
1. Improve myocardial oxygen supply by vasodilating the coronary arteries
2. Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance
3. Both 1 and 2
4. Neither 1 nor 2 - verified answer 2. Decrease myocardial oxygen demand by decreasing heart
rate and vascular resistance
Adherence to beta blocker therapy may be affected by their:
1. Short half-lives requiring twice daily dosing
2. Tendency to elevate lipid levels
3. Effects on the male genitalia, which may produce impotence
,4. None of the above - verified answer 3. Effects on the male genitalia, which may produce
impotence
Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment
should be initiated when the:
1. Symptoms are severe
2. Patient has not responded to other therapies
3. Patient has concurrent hypertension
4. Left ventricular dysfunction is diagnosed - verified answer 4. Left ventricular dysfunction is
diagnosed
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
consequences of rapid withdrawal are those with:
1. Angina
2. Coronary artery disease
3. Both 1 and 2
4. Neither 1 nor 2 - verified answer 3. Both 1 and 2
To prevent life-threatening events from rapid withdrawal of a beta blocker:
1. The dosage interval should be increased by 1 hour each day.
2. An alpha blocker should be added to the treatment regimen before withdrawal.
3. The dosage should be tapered over a period of weeks.
4. The dosage should be decreased by one-half every 4 days. - verified answer 4. The dosage should
be decreased by one-half every 4 days.
Beta blockers are prescribed for diabetics with caution because of their ability to produce
hypoglycemia and block the common symptoms of it. Which of the following symptoms of
hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible
decreased blood glucose?
1. Dizziness
2. Increased heart rate
3. Nervousness and shakiness
4. Diaphoresis - verified answer 4. Diaphoresis
, Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
1. Vasodilate the peripheral vasculature
2. Decrease cardiac output
3. Increase renal vascular resistance
4. Reduce atherosclerosis secondary to elevated serum lipoproteins - verified answer 1. Vasodilate
the peripheral vasculature
Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the
following drug classes?
1. Histamine 2 blockers
2. Quinolones
3. Serotonin re-uptake inhibitors
4. All of the above - verified answer 4. All of the above
Alpha-beta blockers are especially effective to treat hypertension for which ethnic group?
1. White
2. Asian
3. African American
4. Native American - verified answer 3. African American
Bethanechol:
1. Increases detrusor muscle tone to empty the bladder
2. Decreases gastric acid secretion to treat peptic ulcer disease
3. Stimulates voluntary muscle tone to improve strength
4. Reduces bronchial airway constriction to treat asthma - verified answer 1. Increases detrusor
muscle tone to empty the bladder
Clinical dosing of Bethanechol:
1. Begins at the highest effective dose to obtain a rapid response
2. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is
achieved
Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic
hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
1. Increases peripheral vasoconstriction
2. Decreases detrusor muscle contractility
3. Lowers supine blood pressure more than standing pressure
4. Relaxes smooth muscle in the bladder neck - verified answer 4. Relaxes smooth muscle in the
bladder neck
To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should
do all of the following EXCEPT:
1. Take the dose at bedtime
2. Sit up slowly and dangle their feet before standing
3. Monitor their blood pressure and skip a dose if the pressure is less than 120/80
4. Weigh daily and report weight gain of greater than 2 pounds in one day - verified answer 3.
Monitor their blood pressure and skip a dose if the pressure is less than 120/80
John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should:
1. Not miss a dose or stop taking the drug because of potential rebound hypertension
2. Increase fiber in the diet to treat any diarrhea that may occur
3. Reduce fluid intake to less than 2 liters per day to prevent fluid retention
4. Avoid sitting for long periods, as this can lead to deep vein thrombosis - verified answer 1. Not
miss a dose or stop taking the drug because of potential rebound hypertension
Clonidine has several off-label uses, including:
1. Alcohol and nicotine withdrawal
2. Post-herpetic neuralgia
3. Both 1 and 2
4. Neither 1 nor 2 - verified answer 3. Both 1 and 2
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen is
atenolol. Beta blockers treat hypertension by:
,1. Increasing heart rate to improve cardiac output
2. Reducing vascular smooth muscle tone
3. Increasing aldosterone-mediated volume activity
4. Reducing aqueous humor production - verified answer 2. Reducing vascular smooth muscle tone
Which of the following adverse effects are less likely in a beta 1-selective blocker?
1. Dysrhythmias
2. Impaired insulin release
3. Reflex orthostatic changes
4. Decreased triglycerides and cholesterol - verified answer 2. Impaired insulin release
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol.
You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related
to his nadolol?
1. Extend the dosage interval.
2. Decrease the dose by 75%.
3. Take no action because this value is expected in the older adult.
4. Schedule a serum creatinine level to validate the CrCl value. - verified answer 1. Extend the
dosage interval.
Beta blockers are the drugs of choice for exertional angina because they:
1. Improve myocardial oxygen supply by vasodilating the coronary arteries
2. Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance
3. Both 1 and 2
4. Neither 1 nor 2 - verified answer 2. Decrease myocardial oxygen demand by decreasing heart
rate and vascular resistance
Adherence to beta blocker therapy may be affected by their:
1. Short half-lives requiring twice daily dosing
2. Tendency to elevate lipid levels
3. Effects on the male genitalia, which may produce impotence
,4. None of the above - verified answer 3. Effects on the male genitalia, which may produce
impotence
Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment
should be initiated when the:
1. Symptoms are severe
2. Patient has not responded to other therapies
3. Patient has concurrent hypertension
4. Left ventricular dysfunction is diagnosed - verified answer 4. Left ventricular dysfunction is
diagnosed
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
consequences of rapid withdrawal are those with:
1. Angina
2. Coronary artery disease
3. Both 1 and 2
4. Neither 1 nor 2 - verified answer 3. Both 1 and 2
To prevent life-threatening events from rapid withdrawal of a beta blocker:
1. The dosage interval should be increased by 1 hour each day.
2. An alpha blocker should be added to the treatment regimen before withdrawal.
3. The dosage should be tapered over a period of weeks.
4. The dosage should be decreased by one-half every 4 days. - verified answer 4. The dosage should
be decreased by one-half every 4 days.
Beta blockers are prescribed for diabetics with caution because of their ability to produce
hypoglycemia and block the common symptoms of it. Which of the following symptoms of
hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible
decreased blood glucose?
1. Dizziness
2. Increased heart rate
3. Nervousness and shakiness
4. Diaphoresis - verified answer 4. Diaphoresis
, Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
1. Vasodilate the peripheral vasculature
2. Decrease cardiac output
3. Increase renal vascular resistance
4. Reduce atherosclerosis secondary to elevated serum lipoproteins - verified answer 1. Vasodilate
the peripheral vasculature
Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the
following drug classes?
1. Histamine 2 blockers
2. Quinolones
3. Serotonin re-uptake inhibitors
4. All of the above - verified answer 4. All of the above
Alpha-beta blockers are especially effective to treat hypertension for which ethnic group?
1. White
2. Asian
3. African American
4. Native American - verified answer 3. African American
Bethanechol:
1. Increases detrusor muscle tone to empty the bladder
2. Decreases gastric acid secretion to treat peptic ulcer disease
3. Stimulates voluntary muscle tone to improve strength
4. Reduces bronchial airway constriction to treat asthma - verified answer 1. Increases detrusor
muscle tone to empty the bladder
Clinical dosing of Bethanechol:
1. Begins at the highest effective dose to obtain a rapid response
2. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is
achieved
