Which of the antihypertensive drugs most likely caused adverse effects in the patient with prostatic hyperplasia?

Correct Answer: D

Rationale: The patient with prostatic hyperplasia was experiencing frequent nocturia and was diagnosed with poorly controlled hypertension. The addition of a new drug to the therapy likely caused adverse effects related to the patient's prostatic hyperplasia. Prazosin, an alpha-1 blocker, is known to relax smooth muscle in the prostate and bladder neck, potentially worsening symptoms of prostatic hyperplasia such as increased urinary frequency and urgency. Therefore, Prazosin is the most likely drug to have caused adverse effects in this patient.

Correct Answer: B

Rationale: In the context of pharmacology of cardiovascular drugs, understanding the mechanism of action of medications used in different types of angina is crucial. In this case, the correct answer is B) Nifedipine. Nifedipine is a calcium channel blocker that exerts spasmolytic actions by inhibiting calcium influx into smooth muscle cells, leading to vasodilation. This vasodilation helps to increase coronary blood supply by reducing coronary artery spasm, making it an effective treatment for Prinzmetal's angina, which is characterized by coronary artery spasm. Now, let's discuss why the other options are incorrect: A) Nitroglycerin: Nitroglycerin is a vasodilator that primarily acts on veins, reducing preload and myocardial oxygen demand. While it is commonly used in the treatment of angina, it does not have direct spasmolytic actions to increase coronary blood supply. C) Timolol: Timolol is a beta-blocker that works by reducing heart rate and contractility, thus decreasing myocardial oxygen demand. It does not have spasmolytic actions to increase coronary blood supply. D) Isosorbide mononitrate: Isosorbide mononitrate is a nitrate that, like nitroglycerin, primarily acts as a vasodilator to reduce preload and myocardial oxygen demand. It does not possess spasmolytic actions to increase coronary blood supply. Educationally, understanding the specific mechanisms of action of different classes of cardiovascular drugs is essential for selecting the most appropriate medication for different types of angina. Nifedipine's spasmolytic actions make it a suitable choice for Prinzmetal's angina, highlighting the importance of targeting specific mechanisms of the condition for optimal treatment outcomes.

Correct Answer: B

Rationale: In the context of pharmacology of cardiovascular drugs, understanding the specific mechanisms of action of each drug class is crucial to predict their potential side effects. In this case, the correct answer is B) Nifedipine, as it belongs to the dihydropyridine calcium channel blockers (CCBs) class. Nifedipine primarily acts on vascular smooth muscle to cause vasodilation, but it can also lead to reflex tachycardia due to its potent vasodilatory effects. This reflex tachycardia is a compensatory response by the body to maintain cardiac output in the face of decreased systemic vascular resistance. A) Amlodipine is also a dihydropyridine CCB like nifedipine, but it is less likely to induce reflex tachycardia compared to nifedipine due to its longer duration of action and smoother pharmacokinetic profile. C) Diltiazem and D) Verapamil are non-dihydropyridine CCBs. These drugs primarily act on the myocardium to decrease cardiac contractility and heart rate. They are more likely to cause bradycardia rather than tachycardia as a side effect. Educationally, this question highlights the importance of recognizing the different subtypes of calcium channel blockers and their specific effects on the cardiovascular system. It underscores the need for healthcare professionals to be aware of potential side effects associated with different antianginal drugs to make informed clinical decisions and provide safe and effective patient care. Understanding these nuances can help in optimizing therapy and managing adverse effects in patients with cardiovascular conditions.

Correct Answer: B

Rationale: Nitroglycerin ointment is commonly used in the treatment of angina pectoris, a condition characterized by chest pain due to reduced blood flow to the heart. The correct concentration of nitroglycerin ointment in clinical use is 2%. This concentration is effective in dilating blood vessels, reducing the workload of the heart, and increasing oxygen supply to the heart muscle, thereby relieving angina symptoms. Option A) 1% is too low a concentration to provide effective vasodilation and symptom relief in angina patients. Option C) 5% and Option D) 10% are too high concentrations and can increase the risk of side effects such as severe hypotension, headaches, and reflex tachycardia. In an educational context, understanding the appropriate concentration of nitroglycerin ointment is crucial for healthcare professionals prescribing and administering this medication. Knowledge of the correct concentration ensures safe and effective management of angina patients, optimizing their quality of life and reducing the risk of adverse events.

Correct Answer: A

Rationale: The correct answer is option A) BP of 70/40. In this scenario, a low blood pressure (hypotension) triggers the release of renin from the kidneys. Renin is released in response to low blood pressure to kickstart the renin-angiotensin-aldosterone system (RAAS) cascade, which ultimately leads to vasoconstriction and an increase in blood pressure. Option B) BP of 145/95 is within the normal range for hypertension management with an ACE inhibitor, so it would not trigger the release of renin. Option C) Pulse of 100 and option D) Pulse of 50 are related to heart rate and not directly involved in the release of renin in response to blood pressure changes. From an educational perspective, understanding the physiological mechanisms behind drug actions is crucial in pharmacology. Knowing how medications interact with the body, including the RAAS system in this case, helps healthcare professionals make informed decisions about drug therapy and patient care. This question highlights the importance of monitoring vital signs and understanding their implications in managing cardiovascular conditions.