Advanced Pharm: Final Exam
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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
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2. Decreases detrusor muscle contractility
3. Lowers supine blood pressure more than standing pressure
4. Relaxes smooth muscle in the bladder neck - ANS 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 - ANS 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 - ANS 1. Not miss
a dose or stop taking the drug because of potential rebound hypertension
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Clonidine has several off-label uses, including:
1. Alcohol and nicotine withdrawal
2. Post-herpetic neuralgia
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3. Both 1 and 2
4. Neither 1 nor 2 - ANS 3. Both 1 and 2
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen
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is atenolol. Beta blockers treat hypertension by:
1. Increasing heart rate to improve cardiac output
2. Reducing vascular smooth muscle tone
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3. Increasing aldosterone-mediated volume activity
4. Reducing aqueous humor production - ANS 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
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3. Reflex orthostatic changes
4. Decreased triglycerides and cholesterol - ANS 2. Impaired insulin release
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed
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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.
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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. - ANS 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 - ANS 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 - ANS 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:
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1. Symptoms are severe
2. Patient has not responded to other therapies
3. Patient has concurrent hypertension
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4. Left ventricular dysfunction is diagnosed - ANS 4. Left ventricular dysfunction is
diagnosed
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
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consequences of rapid withdrawal are those with:
1. Angina
2. Coronary artery disease
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3. Both 1 and 2
4. Neither 1 nor 2 - ANS 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.
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3. The dosage should be tapered over a period of weeks.
4. The dosage should be decreased by one-half every 4 days. - ANS 4. The dosage should
be decreased by one-half every 4 days.
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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
D
decreased blood glucose?
1. Dizziness
2. Increased heart rate
3. Nervousness and shakiness
4. Diaphoresis - ANS 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
A
R
U
LA
C
O
D
, A
R
U
LA
C
O
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
D
2. Decreases detrusor muscle contractility
3. Lowers supine blood pressure more than standing pressure
4. Relaxes smooth muscle in the bladder neck - ANS 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 - ANS 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 - ANS 1. Not miss
a dose or stop taking the drug because of potential rebound hypertension
A
Clonidine has several off-label uses, including:
1. Alcohol and nicotine withdrawal
2. Post-herpetic neuralgia
R
3. Both 1 and 2
4. Neither 1 nor 2 - ANS 3. Both 1 and 2
Jim is being treated for hypertension. Because he has a history of heart attack, the drug chosen
U
is atenolol. Beta blockers treat hypertension by:
1. Increasing heart rate to improve cardiac output
2. Reducing vascular smooth muscle tone
LA
3. Increasing aldosterone-mediated volume activity
4. Reducing aqueous humor production - ANS 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
C
3. Reflex orthostatic changes
4. Decreased triglycerides and cholesterol - ANS 2. Impaired insulin release
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed
O
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.
D
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. - ANS 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 - ANS 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 - ANS 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:
A
1. Symptoms are severe
2. Patient has not responded to other therapies
3. Patient has concurrent hypertension
R
4. Left ventricular dysfunction is diagnosed - ANS 4. Left ventricular dysfunction is
diagnosed
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious
U
consequences of rapid withdrawal are those with:
1. Angina
2. Coronary artery disease
LA
3. Both 1 and 2
4. Neither 1 nor 2 - ANS 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.
C
3. The dosage should be tapered over a period of weeks.
4. The dosage should be decreased by one-half every 4 days. - ANS 4. The dosage should
be decreased by one-half every 4 days.
O
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
D
decreased blood glucose?
1. Dizziness
2. Increased heart rate
3. Nervousness and shakiness
4. Diaphoresis - ANS 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
