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Exam 1 Blueprint
50 Questions all multiple choice items. 1.5 hours to complete the exam unless
accommodations are in place.
Know the Mechanism of Action (MOA), Indication, Side Effects, Adverse drug Effects,
Diagnostics & lab during TX, Patient Education for the following medications.
Clonidine
Class: Alpha-2 Adrenergic Agonist
Mechanism of Action (MOA):
Stimulates alpha-2 receptors in the central nervous system, which inhibits sympathetic
outflow, leading to reduced norepinephrine release.
This decreases peripheral vascular resistance, heart rate, and blood pressure.
Indications:
Hypertension (HTN) – as a second-line or adjunctive therapy.
ADHD (Attention Deficit Hyperactivity Disorder) – as an adjunctive therapy.
Opioid withdrawal – to reduce symptoms such as anxiety and agitation.
Pain management – as part of epidural analgesia.
Side Effects:
CNS: Drowsiness, dizziness, fatigue.
CVS: Bradycardia, hypotension.
GI: Dry mouth, constipation.
Other: Weight gain, erectile dysfunction.
Adverse Drug Effects:
Rebound hypertension upon abrupt discontinuation.
Severe bradycardia or hypotension.
Depression or mood changes.
Diagnostics & Lab Monitoring During Treatment:
Blood pressure and heart rate – monitor regularly, especially after dose adjustments.
Renal function tests – in patients with renal impairment.
Mental status evaluation – for mood changes or depression.
Patient Education:
, 2
Do not discontinue abruptly – taper off gradually under medical supervision to prevent
rebound hypertension.
Avoid activities requiring alertness (e.g., driving) until the drug’s effects are known
due to potential drowsiness.
Rise slowly from sitting or lying down to prevent dizziness or orthostatic hypotension.
Avoid alcohol and CNS depressants, as they can enhance sedation.
Take consistently (with or without food) and at the same time each day.
Report symptoms such as severe dizziness, slow heart rate, or mood changes to the
healthcare provider.
Alpha-1 Antagonists (General Classification Information)
Examples: Prazosin, Doxazosin, Terazosin
Mechanism of Action (MOA):
Block alpha-1 adrenergic receptors on vascular smooth muscle, leading to
vasodilation.
Decrease peripheral vascular resistance, which lowers blood pressure.
Indications:
Hypertension (HTN) – usually as adjunctive therapy.
Benign Prostatic Hyperplasia (BPH) – to relieve urinary retention by relaxing bladder
neck and prostate muscles.
PTSD-related nightmares – Prazosin is commonly used.
Side Effects:
Orthostatic hypotension (especially with the first dose).
Dizziness, headache.
Nasal congestion.
Fatigue, drowsiness.
Adverse Drug Effects:
First-dose phenomenon – severe orthostatic hypotension and syncope.
Tachycardia as a reflex response to vasodilation.
Diagnostics & Lab Monitoring During Treatment:
Blood pressure and heart rate – monitor frequently, particularly after the first dose and
with dose increases.
, 3
Liver function tests – in prolonged use, as some alpha-1 antagonists are metabolized
hepatically.
Patient Education:
Take the first dose at bedtime to minimize the risk of first-dose hypotension.
Change positions slowly (e.g., from lying to standing) to prevent dizziness and fainting.
Avoid alcohol, as it can enhance blood pressure-lowering effects and increase dizziness.
Notify healthcare provider if experiencing rapid heartbeat, persistent dizziness, or
swelling in extremities.
Adhere to dosing schedule and do not discontinue abruptly without consulting a
healthcare provider.
Would you like any additional details or clarification on these medications? 😊
Atenolol
Class: Beta-1 Selective Adrenergic Blocker
Mechanism of Action (MOA):
Selectively blocks beta-1 adrenergic receptors in the heart, which leads to:
o Decreased heart rate (negative chronotropic effect).
o Reduced myocardial contractility (negative inotropic effect).
o Lowered cardiac output and blood pressure.
Reduces myocardial oxygen demand, making it useful in angina.
Indications:
Hypertension (HTN) – to lower blood pressure.
Angina pectoris – to reduce chest pain by decreasing oxygen demand.
Post-myocardial infarction (MI) – to prevent recurrence and improve survival.
Arrhythmias – for rate control in supraventricular tachycardia (SVT) and atrial
fibrillation.
Migraine prophylaxis – off-label use.
Side Effects:
CNS: Fatigue, dizziness, depression.
CVS: Bradycardia, hypotension.
Respiratory: Shortness of breath (less common due to beta-1 selectivity but possible at
high doses).
GI: Nausea, diarrhea.
Other: Cold extremities, erectile dysfunction.
, 4
Adverse Drug Effects:
Bradycardia or heart block.
Hypotension.
Bronchospasm (in asthmatic patients or at high doses due to beta-2 receptor crossover).
Exacerbation of heart failure in patients with severe left ventricular dysfunction.
Rebound hypertension or tachycardia upon abrupt discontinuation.
Diagnostics & Lab Monitoring During Treatment:
Blood pressure and heart rate – monitor regularly.
ECG – in patients with arrhythmias or heart disease.
Renal function tests – since atenolol is primarily excreted by the kidneys.
Blood glucose levels – in diabetic patients, as atenolol may mask symptoms of
hypoglycemia.
Patient Education:
Do not discontinue abruptly – to avoid rebound hypertension or tachycardia. Gradual
tapering is necessary.
Take consistently at the same time each day, with or without food.
Monitor blood pressure and heart rate regularly at home.
Recognize symptoms of hypotension (dizziness, lightheadedness) and how to respond.
In diabetic patients, be aware that it may mask symptoms of hypoglycemia (e.g.,
tachycardia).
Avoid alcohol and OTC decongestants as they can interact and increase blood pressure.
Report symptoms such as shortness of breath, swelling of extremities, or severe
dizziness to a healthcare provider.
Beta Blockers (General Classification Information)
Examples: Metoprolol (beta-1 selective), Propranolol (non-selective), Carvedilol (alpha and beta
activity).
Mechanism of Action (MOA):
Block beta-adrenergic receptors (beta-1 in the heart, beta-2 in the lungs and blood
vessels), leading to:
o Reduced heart rate and contractility (negative chronotropy and inotropy).
o Decreased myocardial oxygen demand.
o Lowered blood pressure due to reduced cardiac output and inhibition of renin
release from the kidneys.
Exam 1 Blueprint
50 Questions all multiple choice items. 1.5 hours to complete the exam unless
accommodations are in place.
Know the Mechanism of Action (MOA), Indication, Side Effects, Adverse drug Effects,
Diagnostics & lab during TX, Patient Education for the following medications.
Clonidine
Class: Alpha-2 Adrenergic Agonist
Mechanism of Action (MOA):
Stimulates alpha-2 receptors in the central nervous system, which inhibits sympathetic
outflow, leading to reduced norepinephrine release.
This decreases peripheral vascular resistance, heart rate, and blood pressure.
Indications:
Hypertension (HTN) – as a second-line or adjunctive therapy.
ADHD (Attention Deficit Hyperactivity Disorder) – as an adjunctive therapy.
Opioid withdrawal – to reduce symptoms such as anxiety and agitation.
Pain management – as part of epidural analgesia.
Side Effects:
CNS: Drowsiness, dizziness, fatigue.
CVS: Bradycardia, hypotension.
GI: Dry mouth, constipation.
Other: Weight gain, erectile dysfunction.
Adverse Drug Effects:
Rebound hypertension upon abrupt discontinuation.
Severe bradycardia or hypotension.
Depression or mood changes.
Diagnostics & Lab Monitoring During Treatment:
Blood pressure and heart rate – monitor regularly, especially after dose adjustments.
Renal function tests – in patients with renal impairment.
Mental status evaluation – for mood changes or depression.
Patient Education:
, 2
Do not discontinue abruptly – taper off gradually under medical supervision to prevent
rebound hypertension.
Avoid activities requiring alertness (e.g., driving) until the drug’s effects are known
due to potential drowsiness.
Rise slowly from sitting or lying down to prevent dizziness or orthostatic hypotension.
Avoid alcohol and CNS depressants, as they can enhance sedation.
Take consistently (with or without food) and at the same time each day.
Report symptoms such as severe dizziness, slow heart rate, or mood changes to the
healthcare provider.
Alpha-1 Antagonists (General Classification Information)
Examples: Prazosin, Doxazosin, Terazosin
Mechanism of Action (MOA):
Block alpha-1 adrenergic receptors on vascular smooth muscle, leading to
vasodilation.
Decrease peripheral vascular resistance, which lowers blood pressure.
Indications:
Hypertension (HTN) – usually as adjunctive therapy.
Benign Prostatic Hyperplasia (BPH) – to relieve urinary retention by relaxing bladder
neck and prostate muscles.
PTSD-related nightmares – Prazosin is commonly used.
Side Effects:
Orthostatic hypotension (especially with the first dose).
Dizziness, headache.
Nasal congestion.
Fatigue, drowsiness.
Adverse Drug Effects:
First-dose phenomenon – severe orthostatic hypotension and syncope.
Tachycardia as a reflex response to vasodilation.
Diagnostics & Lab Monitoring During Treatment:
Blood pressure and heart rate – monitor frequently, particularly after the first dose and
with dose increases.
, 3
Liver function tests – in prolonged use, as some alpha-1 antagonists are metabolized
hepatically.
Patient Education:
Take the first dose at bedtime to minimize the risk of first-dose hypotension.
Change positions slowly (e.g., from lying to standing) to prevent dizziness and fainting.
Avoid alcohol, as it can enhance blood pressure-lowering effects and increase dizziness.
Notify healthcare provider if experiencing rapid heartbeat, persistent dizziness, or
swelling in extremities.
Adhere to dosing schedule and do not discontinue abruptly without consulting a
healthcare provider.
Would you like any additional details or clarification on these medications? 😊
Atenolol
Class: Beta-1 Selective Adrenergic Blocker
Mechanism of Action (MOA):
Selectively blocks beta-1 adrenergic receptors in the heart, which leads to:
o Decreased heart rate (negative chronotropic effect).
o Reduced myocardial contractility (negative inotropic effect).
o Lowered cardiac output and blood pressure.
Reduces myocardial oxygen demand, making it useful in angina.
Indications:
Hypertension (HTN) – to lower blood pressure.
Angina pectoris – to reduce chest pain by decreasing oxygen demand.
Post-myocardial infarction (MI) – to prevent recurrence and improve survival.
Arrhythmias – for rate control in supraventricular tachycardia (SVT) and atrial
fibrillation.
Migraine prophylaxis – off-label use.
Side Effects:
CNS: Fatigue, dizziness, depression.
CVS: Bradycardia, hypotension.
Respiratory: Shortness of breath (less common due to beta-1 selectivity but possible at
high doses).
GI: Nausea, diarrhea.
Other: Cold extremities, erectile dysfunction.
, 4
Adverse Drug Effects:
Bradycardia or heart block.
Hypotension.
Bronchospasm (in asthmatic patients or at high doses due to beta-2 receptor crossover).
Exacerbation of heart failure in patients with severe left ventricular dysfunction.
Rebound hypertension or tachycardia upon abrupt discontinuation.
Diagnostics & Lab Monitoring During Treatment:
Blood pressure and heart rate – monitor regularly.
ECG – in patients with arrhythmias or heart disease.
Renal function tests – since atenolol is primarily excreted by the kidneys.
Blood glucose levels – in diabetic patients, as atenolol may mask symptoms of
hypoglycemia.
Patient Education:
Do not discontinue abruptly – to avoid rebound hypertension or tachycardia. Gradual
tapering is necessary.
Take consistently at the same time each day, with or without food.
Monitor blood pressure and heart rate regularly at home.
Recognize symptoms of hypotension (dizziness, lightheadedness) and how to respond.
In diabetic patients, be aware that it may mask symptoms of hypoglycemia (e.g.,
tachycardia).
Avoid alcohol and OTC decongestants as they can interact and increase blood pressure.
Report symptoms such as shortness of breath, swelling of extremities, or severe
dizziness to a healthcare provider.
Beta Blockers (General Classification Information)
Examples: Metoprolol (beta-1 selective), Propranolol (non-selective), Carvedilol (alpha and beta
activity).
Mechanism of Action (MOA):
Block beta-adrenergic receptors (beta-1 in the heart, beta-2 in the lungs and blood
vessels), leading to:
o Reduced heart rate and contractility (negative chronotropy and inotropy).
o Decreased myocardial oxygen demand.
o Lowered blood pressure due to reduced cardiac output and inhibition of renin
release from the kidneys.
