Final Exam: NR565/ NR 565 Advanced Pharmacology
Care of the Fundamentals Exam | Questions and
Verified Answers (2025/ 2026 Update)- Chamberlain
Adverse Effects of α Blockade - :answers :most significant adverse effect is orthostatic
hypotension; other adverse effects include reflex tachycardia, nasal congestion,
inhibition of ejaculation; sodium retention and increased blood volume
Metabolism of Labetalol, Propanolol, Metoprolol - :answers :Hepatic
Labetalol Lipid Solubility - :answers :Moderate
Drugs Used to Treat Heart Failure - :answers :(1) agents that inhibit the RAAS (ACE
Inhibitors/ARBs), (2) diuretics (3) β blockers.
Prototype Drugs for HF - :answers :RAAS Inhibitors:
Captopril (angiotensin-converting enzyme inhibitor)
Losartan (angiotensin II receptor blocker)
Eplerenone (aldosterone antagonist)
Diuretics:
Hydrochlorothiazide
Furosemide
,Inotropic Agent:
Digoxin (a cardiac glycoside)
β Blocker:
Metoprolol
Drugs that precipitate or exacerbate Heart Failure - :answers :NSAIDS, Alcohol, CCB,
HF ACE Inhibitor Mechanism of Action - :answers :Inhibit ANG1-->ANG2;
Decrease preload/afterload and increase cardiac output;
Decrease VSM tone =decrease BP;
Decrease Aldosterone production = Decrease NA/H20 retention
HF: RAAS Inhibitors - :answers :Captopril (angiotensin-converting enzyme inhibitor)
Losartan (angiotensin II receptor blocker)
Eplerenone (aldosterone antagonist)
ACE Inhibitor Main AE - :answers :Cough; Angioedema; First Dose Hypotension;
Hyperkalemia
HF: Diuretics - :answers :Decrease pulmonary congestion; peripheral edema
Decrease preload/Afterload
Hydrochlorothiazide (mild diuretic)
Furosemide (Lasix) (strong diuretic)
HF: Loop Diuretic - :answers :Furosemide; Preferred for HF due to profound diuresis
or patient w/ renal insufficiency
,Loop Diuretic AE - :answers :hypotension; hypokalemia; increase digitalis toxicity
OH DANG!
Ototoxicity
Hypokalemia
Dehydration
Allergy (Sulfa)
Nephritis
Gout
HF: Inotropic Agent - :answers :Digoxin (a cardiac glycoside)
HF: β Blocker - :answers :Metoprolol; Selective blockade of B1 receptor
HF: ACEIs Therapeutic - :answers :Decrease conversion of ANG1-->ANG2
ACEIs cause dilation of arterioles and veins
Decrease the release of aldosterone=decrease NA/H20 retention;
Decrease VSM=Decrease BP
HF: ARBs - :answers :Second line choice for HF if ACE Inhibitor cannot be tolerated
due to cough/angioedema;
valsartan (Diovan); candesartan (Atacand)
HF: Aldosterone Antagonist - :answers :Block aldosterone receptor; Increase NA/H20
excretion; Increase K+ retention
eplerenone and spironolactone
, Aldosterone Antagonist Main AE; - :answers :Hyperkalemia
Spironolactone BBW - :answers :tumorigenic in chronic toxicity studies in rats.
HF: Inotropics - :answers :Digitalis; Increase Contractile force of heart muscle; Only
indicated for severe left ventriuclar HF
HMG-CoA Reductase Inhibitors (Statins) - :answers :most effective drugs for lowering
LDL and total cholesterol; raise HDL; lower TG;
Prototype HMG-CoA Reductase Inhibitor (Statin): LDL Cholesterol- and Triglyceride-
Lowering Drugs - :answers :Lovastatin
Statin mechanism of Cholesterol Reduction - :answers :inhibition of hepatic HMG-
CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis; increase in
hepatocytes to produce more LDL receptors; Hepatocytes then can better remove more
LDL from the blood;
Statins Monitoring - :answers :Cholesterol levels should be monitored monthly early
in treatment and at longer intervals thereafter.
Statin Contraindications - :answers :contraindicated in pregnant women and in
patients with viral or alcoholic hepatitis. Exercise caution in patients with fatty liver
disease and in those taking fibrates or ezetimibe
Most serious statin-related adverse events - :answers :muscle injury
(myopathy/rhabdomyolysis), liver injury, and kidney damage
Statin Pharmacokinetics - :answers :metabolized by CYP3A4; most of an absorbed
dose is extracted from the blood on its first pass through the liver; rapid hepatic
metabolism followed by excretion primarily in the bile; partial excretion in urine.
Care of the Fundamentals Exam | Questions and
Verified Answers (2025/ 2026 Update)- Chamberlain
Adverse Effects of α Blockade - :answers :most significant adverse effect is orthostatic
hypotension; other adverse effects include reflex tachycardia, nasal congestion,
inhibition of ejaculation; sodium retention and increased blood volume
Metabolism of Labetalol, Propanolol, Metoprolol - :answers :Hepatic
Labetalol Lipid Solubility - :answers :Moderate
Drugs Used to Treat Heart Failure - :answers :(1) agents that inhibit the RAAS (ACE
Inhibitors/ARBs), (2) diuretics (3) β blockers.
Prototype Drugs for HF - :answers :RAAS Inhibitors:
Captopril (angiotensin-converting enzyme inhibitor)
Losartan (angiotensin II receptor blocker)
Eplerenone (aldosterone antagonist)
Diuretics:
Hydrochlorothiazide
Furosemide
,Inotropic Agent:
Digoxin (a cardiac glycoside)
β Blocker:
Metoprolol
Drugs that precipitate or exacerbate Heart Failure - :answers :NSAIDS, Alcohol, CCB,
HF ACE Inhibitor Mechanism of Action - :answers :Inhibit ANG1-->ANG2;
Decrease preload/afterload and increase cardiac output;
Decrease VSM tone =decrease BP;
Decrease Aldosterone production = Decrease NA/H20 retention
HF: RAAS Inhibitors - :answers :Captopril (angiotensin-converting enzyme inhibitor)
Losartan (angiotensin II receptor blocker)
Eplerenone (aldosterone antagonist)
ACE Inhibitor Main AE - :answers :Cough; Angioedema; First Dose Hypotension;
Hyperkalemia
HF: Diuretics - :answers :Decrease pulmonary congestion; peripheral edema
Decrease preload/Afterload
Hydrochlorothiazide (mild diuretic)
Furosemide (Lasix) (strong diuretic)
HF: Loop Diuretic - :answers :Furosemide; Preferred for HF due to profound diuresis
or patient w/ renal insufficiency
,Loop Diuretic AE - :answers :hypotension; hypokalemia; increase digitalis toxicity
OH DANG!
Ototoxicity
Hypokalemia
Dehydration
Allergy (Sulfa)
Nephritis
Gout
HF: Inotropic Agent - :answers :Digoxin (a cardiac glycoside)
HF: β Blocker - :answers :Metoprolol; Selective blockade of B1 receptor
HF: ACEIs Therapeutic - :answers :Decrease conversion of ANG1-->ANG2
ACEIs cause dilation of arterioles and veins
Decrease the release of aldosterone=decrease NA/H20 retention;
Decrease VSM=Decrease BP
HF: ARBs - :answers :Second line choice for HF if ACE Inhibitor cannot be tolerated
due to cough/angioedema;
valsartan (Diovan); candesartan (Atacand)
HF: Aldosterone Antagonist - :answers :Block aldosterone receptor; Increase NA/H20
excretion; Increase K+ retention
eplerenone and spironolactone
, Aldosterone Antagonist Main AE; - :answers :Hyperkalemia
Spironolactone BBW - :answers :tumorigenic in chronic toxicity studies in rats.
HF: Inotropics - :answers :Digitalis; Increase Contractile force of heart muscle; Only
indicated for severe left ventriuclar HF
HMG-CoA Reductase Inhibitors (Statins) - :answers :most effective drugs for lowering
LDL and total cholesterol; raise HDL; lower TG;
Prototype HMG-CoA Reductase Inhibitor (Statin): LDL Cholesterol- and Triglyceride-
Lowering Drugs - :answers :Lovastatin
Statin mechanism of Cholesterol Reduction - :answers :inhibition of hepatic HMG-
CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis; increase in
hepatocytes to produce more LDL receptors; Hepatocytes then can better remove more
LDL from the blood;
Statins Monitoring - :answers :Cholesterol levels should be monitored monthly early
in treatment and at longer intervals thereafter.
Statin Contraindications - :answers :contraindicated in pregnant women and in
patients with viral or alcoholic hepatitis. Exercise caution in patients with fatty liver
disease and in those taking fibrates or ezetimibe
Most serious statin-related adverse events - :answers :muscle injury
(myopathy/rhabdomyolysis), liver injury, and kidney damage
Statin Pharmacokinetics - :answers :metabolized by CYP3A4; most of an absorbed
dose is extracted from the blood on its first pass through the liver; rapid hepatic
metabolism followed by excretion primarily in the bile; partial excretion in urine.
