PHARMACOLOGY

LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

QUESTION ANSWER RATIONALE

1. KC, a 65 y/o hypertensive female presents C Furosemide – loop diuretic
with bipedal edema and low GFR (serum - Used for patients with acute pulmonary edema, other edematous
creatinine of 3.0 mg/dL). The most effective conditions, acute hypercalcemia
drug for producing diuresis is:
A. Amlodipine Hydrochlorothiazide – thiazide diuretic
B. Losartan - Ineffective when GFR <30-40mL/min
C. Furosemide Amlodipine – dihydropyridine CCB
D. Hydrochlorothiazide Losartan – Angiotensin receptor blocker (ARBs)
2. A 60 year old hypertensive male who had B Adverse effects:
myocardial infarction a few years ago is now Spironolactone - gynecomastia
showing signs of congestive heart failure.
Spironolactone was added to his drug Loop diuretics – ototoxicity & hyperuricemia
regimen. Which of the following adverse Thiazide diuretics – hyperuricemia
effect may be anticipated from this drug? Methyldopa, Hydralazine – lupus-like syndrome
A. Hyperuricemia
B. Gynecomastia
C. Lupus-like syndrome
D. Ototoxicity
3. MS is a 45 y/o male diagnosed with a C Furosemide – increases urinary excretion of Ca2+ and Mg2+ but doesn’t
parathyroid hormone secreting tumor. generally cause hypocalcemia
Temporary treatment for his hypercalcemia - For disorders that cause hypercalcemia, Ca2+ excretion can be
could include administration of: enhanced by treatment with loop diuretics combined with saline
A. Spironolactone infusions.
B. Hydrochlorothiazide
C. Furosemide Hydrochlorothiazide adverse effects – hyperGLUC
D. Acetazolamide hyperGlycemia
hyperLipidemia
hyperUricemia
hyperCalcemia
4. This diuretic binds to mineralocorticoid C Eplerenone
receptors and blocks aldosterone: - MOA: bind to mineralocorticoid receptors and blunt aldosterone
A. Amiloride activity
B. Ethacrynic acid
C. Eplerenone Amiloride & Triamterene – do not block aldosterone, but instead directly
D. Triamterene interfere with Na+ entry through the epithelial Na+ channels (ENaC)

Ethacrynic acid – inhibits NaCl reabsorption in TAL through inhibition of

NKCC2 transporter
5. Which of the following classes of diuretics D Eplerenone – aldosterone antagonist
has beneficial effect in lowering albuminuria - May interfere with some of the fibrotic and inflammatory effects of
in patients with diabetic nephropathy? aldosterone, therefore it can slow the progression of albuminuria in
A. Thiazide diabetic patients
B. Loop diuretic
C. Carbonic anhydrase inhibitor
D. Aldosterone antagonist

6. A 20 y/o student was diagnosed with C Diabetes insipidus

nephrogenic diabetes insipidus not - Either due to deficient production of ADH (neurogenic or central
responsive to ADH supplementation. The diabetes insipidus) or inadequate responsiveness to ADH
most appropriate drug to give to diminish (nephrogenic diabetes insipidus)
polyuria and polydipsia is:
A. Bumetanide Thiazide diuretics: reduce polyuria and polydipsia in both types of DI
B. Acetazolamide Supplementary ADH: for central DI
C. Hydrochlorothiazide
D. Spironolactone

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 1

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

7. This drug acts on the collecting duct and can D Diuretic Segment % filtered Na+
block reabsorption of only 3% of filtered reabsorbed
sodium: Carbonic Proximal tubule 65%
A. Mannitol anhydrase
B. Hydrochlorothiazide inhibitor
C. Ethacrynic acid Loop diuretic Thick ascending 15-25%
D. Triamterene (mannitol, limb of LOH
ethacrynic acid)
Thiazide diuretic Distal convoluted 4-8%
(HCTZ) tubule (DCT)
K+ sparing Cortical collecting 2-5%
diuretics tubule
(triamterene)
8. A 35 y/o male who has been taking an C Toxicities:
unrecalled diuretic developed alkalosis and
ototoxicity. The most likely drug is: Furosemide – hypokalemic metabolic alkalosis, ototoxicity, hyperGLU,
A. Acetazolamide hypomagnesemia
B. Chlorothiazide
C. Furosemide Acetazolamide – hyperchloremic metabolic acidosis
D. Spironolactone Chlorothiazide – hypokalemic metabolic alkalosis, hyperGLUC
Spironolactone – hyperchloremic metabolic acidosis, hyperkalemia,
gynecomastia

9. A 45 y/o female is taking a diuretic for her C Hydrochlorothiazide

hypertension and heart failure. Lately, her - Indications: hypertension, CHF. Nephrogenic DI, nephrolithiasis
blood sugar levels and LDL increased. She - Toxicities: hyperGLUC
must be taking:
A. Amiloride
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
10. A patient with severe systolic heart failure B/C Thiazide diuretics can be used to significantly reduce the dose of loop
and low GFR is given a loop diuretic. diuretics need to promote diuresis in patients with GFR of 5-15mL/min.
However, patient seems not to respond to a (Katzung)
loop diuretic alone. The class of diuretic that
can be added in this instance to produce a
more potent diuresis is a:
A. Carbonic anhydrase inhibitor
B. Thiazide
C. Aldosterone antagonist
D. Inhibitor of epithelial Na channels
11. Hydrochlorothiazide is useful in patients with B Hydrochlorothiazide – increases overall reabsorption of Ca++ therefore can be
kidney stones by addressing which metabolic used in patients with hypercalciuria.
problem?
A. Hypocitraturia
B. Hypercalciuria
C. Hypophosphatemia
D. Hypermagnesemia
12. This limits the diuretic efficacy of C Acetazolamide (CAI) toxicities
acetazolamide: - Hyperchloremic metabolic acidosis
A. Metabolic alkalosis - Hypokalemia
B. Hyperkalemia - Hypercalciuria
C. Metabolic acidosis
D. Hypercalcemia

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 2

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

13. Cirrhotic patients are often resistant to loop B Cirrhotic patients are often resistant to loop diuretics because:
diuretics because of: - Decreased tubular secretion of the drug
A. Increased tubular secretion of the drug - High aldosterone levels
B. High aldosterone levels
C. Increased urinary drug excretion
D. Low renin levels

14. A 29 y/o teacher was diagnosed with B Thiazide diuretics cause HYPOkalemia.
diabetic nephropathy and mild heart failure Indapamide is a sulfonamide qualitatively similar to thiazide diuretics. Thus,
and has laboratory evidence of also has HYPOkalemic properties.
hyperkalemia. The safest diuretic to give is:
A. Mannitol Mannitol indirectly increases urinary extraction of K and causes hyperkalemia
B. Indapamide Triamterene & Eplerenone are K sparing diuretics and may aggravate
C. Triamterene hyperkalemia
D. Eplerenone

15. Which of the following is the most likely D Thiazide-induced hyponatremia

cause of thiazide-induced hyponatremia? - Hypovolemia-induced increase in ADH
A. Volume depletion - Decrease of diluting capacity of kidney
B. Decrease in the concentrating capacity - Increase thirst
of the nephrons
C. Increase in serum K+ levels
D. Hypovolemia-induced increase in ADH

16. A G1P0 24 weeks AOG patient recently had C Methyldopa adverse effects:
BP of 150/190, with ++ protein in the urine. - Inhibition of centers for wakefulness and alertness
She developed somnolence, decreased -> sedation
enthusiasm, and lack of appetite after 1 - Depression
week. What anti-hypertensive agent was
most likely prescribed to her? Drugs used for HTN in pregnancy
A. Irbesartan - Methyldopa
B. Reserpine - Hydralazine
C. Methyldopa - Nifedipine
D. Hydralazine - Labetalol

17. Centrally acting antihypertensives commonly D Centrally acting antihypertensives

has this mechanism of action. - MOA: agonist at presynaptic alpha 2 adrenergic neurons
A. Antagonist to presynaptic alpha 2 - Reduce sympathetic outflow from vasomotor centers in the
adrenergic neurons brainstem (CNS)
B. Acts in the hypothalamus to reduce - Methyldopa, Clonidine
sympathetic outflow
C. Acts in the peripheral nervous system to Cocaine - acts in the PNS to block reuptake of NE
block reuptake of norepinephrine
D. Agonist at presynaptic alpha 2
adrenergic neurons

18. A 75 y/o hypertensive male with hesitancy C Alpha adrenergic antagonists

and dribbling of urine was seen for easy - DOC for hypertensive patients with BPH
fatigability and shortness of breath. He was - Everything that ends with zosin (Prazosin, Doxazosin)
on 2 medications one of which was thiazide. - Urinary bladders has alpha receptors
He relates that he discontinued his diuretic - Inhibition of alpha receptors in the bladder will promote bladder
but continued the other medication. Name sphincter and prostate relaxation -> increase urinary outflow
the group to which the other
antihypertensive drug likely belongs:
A. Calcium channel blocker
B. Alpha 2 agonist
C. Alpha 1 adrenergic antagonist
D. ACE inhibitor

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 3

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

19. Lipid soluble beta blockers have the A LIPID soluble WATER soluble
following pharmacokinetic profile: Absorption Almost complete Incomplete
A. Significant first pass effect Bioavailability Highly variable Less variable
B. Consistent bioavailability Half-life Relatively short Longer than average
C. Long half life Metabolism Hepatic No considerable
D. Incomplete oral absorption metabolism
Elimination GI/kidney Unchanged kidney
Examples Propranolol Atenolol
Metoprolol Nadolol

20. RRD, a 70 y/o male smoker, diabetic A Drugs used for aortic dissection
presented at the ER with chest heaviness - Labetalol
accompanied by severe, tearing back pain. - Nitroprusside
BP was 230/120 and ECG did not reveal
acute MI. CT aortogram revealed aortic
dissection. What are the drugs of choice for
this patient?
A. Labetalol, Nitroprusside
B. Nicardipine, Minoxidil
C. Perindopril, Prazosin
D. Diazoxide, Labetalol

21. RRD had surgery for aortic dissection and D ACE inhibitors
was eventually discharged after 2 weeks. His - Used in treating patients with chronic kidney disease because they
blood sugar was controlled but urinalysis diminish proteinuria and stabilize renal function (even in the
revealed +3 proteinuria. Give the absence of lowering of blood pressure)
antihypertensive of choice. - Slows the progression of kidney disease due to high blood pressure
A. Non-dihydropyridine calcium channel or diabetes
blocker
B. Alpha 2 agonist
C. Renin inhibitor
D. ACE inhibitor

22. B.F. a 22 y/o medical student consulted at C A systolic click with a mid-systolic murmur is commonly heard among
the health clinic for palpitation. She patients with Mitral Valve Prolapse (MVP).
consumes up to 5 cups of coffee daily
because she is behind in her grades. On PE, Patients with MVP and palpitations associated with anxiety or fatigue often
BP 110/70, with systolic click at the apex respond to therapy with cardioselective beta blockers.
accompanied by a 2/6 mid-systolic murmur. (https://www.ncbi.nlm.nih.gov/pubmed/10865929?dopt=Abstract)
What is the initial drug of choice?
A. Non-selective short acting B-blocker
B. Phenylalkylamine calcium channel
blockers
C. B1-selective long acting beta blocker
D. Non-selective vasodilator beta blocker

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 4

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

23. The following antihypertensive inhibits C Reserpine – inhibits vesicular catecholamine transporter that facilitates
vesicular catecholamine transport and vesicular storage
storage:
A. Methyldopa Guanabenz – inhibits the release of NE
B. Guanabenz
C. Reserpine
D. Clonidine

24. Irbesartan was substituted for Lisinopril after C Bradykinin and Substance P are responsible for the cough and angioedema
H.B developed a bothersome dry cough. seen with ACEI.
What is the culprit for the cough of H.B.?
A. Overproduction of renin
B. Sulfhydryl group
C. Substance P
D. Chymase

25. Nifedipine acts to: B Nifedipine

A. Decrease the sensitivity of the - Calcium channel blocker
ryanodine receptor - MOA: blocks the voltage-gated L-type calcium channels in tissues
B. Prevent the activation of L-type calcium resulting to the reduction of intracellular calcium
channels on the T tubules
C. Increase intracellular Ca by inhibiting
Na+-K+ ATPase
D. Block the active site of actin

26. The vasodilating property of nebivolol is B Nebivolol

mainly due to - Beta1 selective blocker with vasodilating properties
A. Beta blocking property - Vasodilating effect is due to an increase in endothelial release of
B. Release of nitric oxide nitric oxide via induction of endothelial nitric oxide synthase
C. Ability to inhibit ACE
D. Ability to block alpha 1 receptors

27. This contributes to the antihypertensive B Enalapril

effect of Enalapril: - ACE inhibitor
A. Increased renin - ACE is also needed for the breakdown of bradykinin therefore if
B. Decreased breakdown of bradykinin ACE is inhibited, there is a decrease breakdown of bradykinin
C. Decreased sympathetic outflow - Bradykinin helps stimulate the release of nitric oxide and
D. Increased aldosterone prostacyclin

28. J.P. a 62 y/o hypertensive patient was
referred by a urologist because of easy
fatigability and orthopnea. J.P. attributes his
symptoms to “growing old” and refuses to
take more than 2 medications. Grade 2
bipedal edema was noted during inspection
and bilateral crackles were evident during
auscultation. He is taking doxazosin given by
the referring urologist for grade III BPH.
What is the best second drug for J.P.?
A. Tamsulosin
B. Nifedipine
C. Hydrochlorothiazide
D. Furosemide
C Hypertensive patient also present signs and symptoms that are indicative of
CHF
§ Tamsulosin – alpha 1 blocker used for reduction of symptoms of BPH
§ Nifedipine – DHP CCB; Not indicated for the patient due to its side
effect of peripheral edema; Has the ability to stimulate RAS which
would result to further fluid retention exacerbating symptoms of
congestion
§ Hydrochlorothiazide – clinically indicated for patients with: HTN,
CHF; 1st line diuretic used for hypertensive geriatric patients (JNC 8)
§ Furosemide – high ceiling diuretic but are preferred for the
treatment of Na+ and water retention where renal dysfunction is
evident or more severe grades of heart failure are present

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 5

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

29. This is a compelling indication for the C Compelling indications of beta blockers in hypertension
administration of Metoprolol: - After myocardial infarct
A. Third degree AV block in a post MI - Heart failure
patient with hypotension - High CHD risk
B. Pulmonary edema - Diabetes mellitus
C. After an acute MI
D. Male patient with erectile dysfunction

30. A patient who has hypertension and diabetes A Sulfa drugs causes Stevens Johnson Syndrome
and currently on multiple drugs, developed
Stevens Johnson Syndrome. The most likely Captopril – has a sulfhydryl group and usually causes skin reactions
culprit is:
A. Captopril
B. Prazosin
C. Amlodipine
D. Metoprolol

31. A 50 y/o diabetic male, with chronic stable D Nitrates such as isosorbide mononitrate are contraindicated in patients who
angina consulted a urologist because of used Sildenafil within 24 hours
erectile dysfunction for which he was given
Sildenafil. Which of the following Sildenafil potentiates the action of nitrates and this may lead to severe
medications that he is current taking must hypotension and myocardial infarction. It is recommended that at least 6
not be taken together with Sildenafil? hours pass between use of a nitrate and the ingestion of sildenafil.
A. Diltiazem
B. Clopidogrel
C. Atorvastatin
D. Isosorbide mononitrate

32. A 45 y/o female was admitted because of A/C Patients with RV infarction are preload sensitive (due to poor RV
chest pain radiating to the epigastric area. contractility) and can develop severe hypotension in response to nitrates or
The ECG showed possible right ventricular other preload-reducing agents like diuretics.
infarction. Which of the following antianginal (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716484/)
drugs must not be given?
A. Isosorbide dinitrate
B. Trimetazidine
C. Metoprolol
D. ASA

33. A 60 y/o male presents in the emergency
room because of near loss of consciousness
because of third degree AV block. He is
currently on metoprolol because of
hypertension. A month ago, he consulted
and was diagnosed to have ischemic heart
disease and another drug was added. Which
of the following was the added drug?
A. Ivabradine
B. Verapamil
C. Isosorbide mononitrate
D. Nifedipine
B Calcium channel blockers toxicities
- AV block
- CHF
- Cardiac depression
- Cardiac arrest
- Bradycardia
Non-dihydropyridine CCBs act like beta blockers
- Verapamil – Artery < cardiac; suppresses AV node
- May cause 3rd degree AV block if given with beta blockers
DIhydroPyrIdINE CCBs (-dipines)
- Nifedipine – artery >>> cardiac

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 6

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

34. A 57 y/o male has coronary artery disease. C Betaxolol

Which of the following drugs when given in - Beta blocker
combination with isosorbide mononitrate - Negative chronotropic effect (decrease HR)
will cause a decrease in heart rate?
A. Nifedipine Nifedipine – vasoselective calcium channel blocker
B. Trimetazidine - Causes reflex tachycardia
C. Betaxolol Trimetazidine – no/minimal effect on BP/HR
D. Clopidogrel

35. A 68 y/o female presents with symptoms of B Patient is already hypotensive so avoid antihypertensive drugs such as beta
classic angina. On PE: BP 90/80, PR 68/min. blockers and CCBs (further decrease BP)
which of the following drugs is the most
appropriate to give? Drugs that has no effect on BP
A. Metoprolol - Trimetazidine
B. Trimetazidine - Ivabradine
C. Diltiazem
D. Verapamil

36. TG was admitted because of ST elevation B ACE inhibitors (Perindopril)

myocardial infarction. Which of the following - Help prevent adverse LV remodeling
possible take home medications will prevent - Delay progression of heart failure
his heart from progressive ventricular - Decrease sudden death and recurrent MI
dilatation with time?
A. Amlodipine
B. Perindopril
C. Aliskiren
D. Verapamil
37. A 40 y/o male was brought to the emergency A Fibrinolytic drugs are used to rapidly lyse the thrombi in cases of acute MI to
room because of chest pain that started 4 restore blood flow. (Reperfusion)
hours earlier. Which of the following drugs
will relieve his chest pain by achieving Examples: -KINASE, -TEPLASE
reperfusion? StreptoKINASE
A. Streptokinase UroKINASE
B. Enoxaparin AlTEPLASE
C. Clopidogrel ReTEPLASE
D. Tirofiban TenecTEPLASE

38. Which of the following anticoagulants should D Conjunctive heparin is necessary to reduce re-occlusion of the infarcted
be given to the above patient (#37) to vessel and is given in patients receiving fibrinolytic agents. (Class IIa evidence)
prevent thromboembolic events?
A. Ticlopidine
B. Alteplase
C. Tirofiban
D. Unfractionated heparin

39. The anginal relief seen with ranolazine is due D Ranolazine

to: - MOA: reduces late sodium current (INA) that facilitates calcium
A. Decrease in heart rate entry via the sodium-calcium exchanger
B. Decrease in systolic wall stress - Reduces intracellular calcium concentration
C. Decrease in ATP utilization - Reduces diastolic wall stress and intramural small vessel
D. Decrease in diastolic wall stress compression

Decreases heart rate: Beta blockers, non-DHP CCBs, If Na channel blocker

(Ivabradine)
Decrease in systolic wall stress: beta blockers and CCBs
Decrease ATP utilization: Trimetazidine

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 7

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

40. A known CAD patient presents in the B Epigastric pain and melena are symptoms of peptic ulcer disease which may
emergency room because of melena. A week be caused by decreased gastroprotective effects of prostaglandins.
earlier, he has been having epigastric pain.
Which antiplatelet drug is he probably ADP Inhibitors: Clopidogrel, Prasugrel, Ticagrelor
taking? Prostaglandin inhibitor: Aspirin (also considered as NSAID)
A. Clopidogrel
B. Aspirin
C. Prasugrel
D. Ticagrelor

41. Which of the following is true regarding the A Increased prothrombin time Decreased prothrombin time
drug-drug interaction between warfarin and PK PD PK PD
cholestyramine? Amiodarone Drugs Barbiturates Drugs
A. Decrease in prothrombin time, Cimetidine Aspirin Cholestyramine Diuretics
pharmacokinetic interaction Disulfiram 3rd gen ceph Rifampin Vit K
B. Decrease in prothrombin time, Metronidazole Heparin Body factors
pharmacodynamic interaction Fluconazole Body factors Hereditary
C. Increase in prothrombin time, Phenylbutazone Hepatic disease Resistance
pharmacokinetic interaction Sulfinpyrazone HYPERthyroidism HYPOthyroidism
D. Increase in prothrombin time, TMP-SMX
pharmacodynamic interaction
Match the anticoagulant with the indication: Drug Indication
UFH NSTEACS with early invasive therapy (PCI)
A. Unfractionated heparin STEMI with no reperfusion therapy
B. Enoxaparin Bridging therapy following mechanical valve
C. Warfarin replacement
D. Dabigatran Enoxaparin NSTEACS with non-invasive therapy
STEMI with no reperfusion therapy
42. STEMI with no reperfusion therapy 42. A/B Bridging therapy following mechanical valve
43. Bridging therapy following mechanical valve 43. A/B replacement
replacement Prevention of thromboembolism
44. Deep vein thrombosis 44. D Anticoagulation in pregnant women
45. Valvular AF 45. C Warfarin Valvular and non-valvular AF
Prevention of thromboembolism
Prosthetic heart valves
Dabigatran Non-valvular AF
Prevention of thromboembolism in patients
undergoing hip and knee replacement
surgery
Quantitative comparison Thiazide – side effect: hypercalcemia (hyperGLUC)
A if 1>2 Furosemide – increase Calcium urinary excretion
B if 1<2
C if 1=2 Furosemide – increase Magnesium urinary excretion

46. Serum calcium 46. A Chlorothiazide – side effect: hyperuricemia (hyperGLUC)

(1) Thiazide
(2) Furosemide
47. Urine magnesium 47. B
(1) Thiazide
(2) Furosemide
48. Serum uric acid 48. A
(1) Chlorothiazide
(2) Eplerenone

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 8

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

True or False Diltiazem – calcium channel blocker; blocks voltage gated L-type calcium
channels
Which of the following is true regarding the
mechanism of vasodilatation by drugs? Hydralazine – direct relaxation of arteriolar smooth muscle due to a fall in
49. Nitroglycerin increases cGMP 49. A intracellular calcium concentration
50. Diltiazem promotes calcium channel opening 50. B
51. Nicorandil opens potassium channels 51. A
resulting to hyperpolarization
52. Hydralazine increases cAMP 52. B

Antihypertensive(s) which may cause postural Antihypertensive drugs with postural hypotension
hypertension - α1-blockers (Prazosin, Terazosin, Doxazosin)
- α2-agonist (Guanadrel)
53. Long acting nifedipine 53. B
54. Furosemide 54. B
55. Prazosin 55. A

PRESCRIPTION

A 52 year old asthmatic with nocturnal coughing 3x a week and diabetic has blood pressure ranging from 140-150/90-
95 taken every morning for the past 2 months. HBA1c = 7 and Urinalysis = proteinuria (++). Choose from below the most
appropriate anti-hypertensive drug for him and make a prescription good for one month.

(A) Preparation: Metoprolol 50 mg tablet

Recommended Dose: 50 mg bid, PO

(B) Preparation: Enalapril 5 mg tablet

Recommended Dose: 5 mg qd, PO

(C) Preparation: Losartan 50 mg tablet

Recommended Dose: 50 mg qd, PO

(D) Preparation: Amlodipine 5 mg tablet

Recommended Dose: 5 mg qd, PO

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 9

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 10

 PHARMACOLOGY
LONG EXAMINATION 2
Diuretics, Anti-Hypertensives, Anti-Anginal, Anti-Platelets, Fibrinolytics, Anticoagulants 11/27/18

Javier, J. R. | Pensotes, D. V. | Petilla, K. D. | Pleños, J.M. 11