Exam 16: Drugs for Hypertension

Pressure is higher in the vessels farthest from the heart.

What does the term "silent killer" mean?

Essential hypertension is the elevation of blood pressure that has no determined cause and is the most common type of hypertension.

Mr. Smith is a 75 year old male who has been taking ramipril 5 mg and hydrochlorothiazide 12.5 mg for hypertension for the last 2 years. He is very compliant, takes regular blood pressure readings at home, walks daily, and follows a diet rich in potassium but low in salt. Two weeks ago, Mr. Smith's physician changed his blood pressure medication to ramipril 10 mg and spironolactone instead of hydrochlorothiazide. When in the pharmacy today, Mr. Smith mentions that he is dizzy, especially in the morning, and he feels like his heart is racing. His blood pressure is normal. What would you do and why?

Mr. Jones is dropping into the pharmacy today to fill his nifedipine prescription and he is telling you stories about his upcoming three month visit to Florida, where he loves to drink fresh orange or grapefruit juice. What would you do and why?

The client is taking nifedipine. You are asked to explain how the drug works. Your best response is:

If the blood volume is decreased, blood pressure will rise.

Left untreated, hypertension can cause strokes, heart attack, heart and kidney failure, dementia, and erectile dysfunction.

Mrs. Jones is refilling her Altace-HCT and her verapamil prescriptions. When processing the refills, you notice that Mrs. Jones last filled both prescriptions 8 weeks ago yet only received a 30-day supply of each medication. What would you do and why?

A patient is prescribed multiple medications for hypertension. The patient asks the pharmacist which of the medications prescribed is an ACE inhibitor. Which response by the pharmacist is appropriate?

The pharmacist is teaching the patient about side effects of medications for hypertension. Which side effects will the pharmacist educate the patient to contact the physician if they occur? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

The stepped care approach to hypertensive treatment allows for which of the following:

Which lifestyle changes can be the most beneficial to a patient to delay the progression from prehypertension to hypertension? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

The three factors responsible for blood pressure are:

If hypertension remains uncontrolled with medication and lifestyle changes, the physician will prescribe higher doses of the same drug until pressure is under control.

Mrs. Smith is a 51 year old woman, married with two children in university. She has no drug coverage and pays cash for her prescriptions. She has asthma, osteoarthritis, GERD, hypertension, and hyperlipidemia. Her current medications are ramipril 5 mg once daily, hydrochlorothiazide 12.5 mg once daily, verapamil 240 mg once daily, Bricanyl turbuhaler one to two puffs when necessary, naproxen 500 mg twice daily, Zocor 20 mg once daily and Nexium 40 mg once daily. Mrs. Smith would like to reduce her drug costs as she is finding it difficult to purchase her medications each month. She admits to you, in order to save some money, that she sometimes skips doses of some of her medications or only takes them when she feels she needs them. It is hard for her to follow Canadian's food guide as the price of fresh vegetables and fruit have risen significantly in the last year. Processed foods and take out are so much easier and less expensive than cooking a healthy meal. Mrs. Jones cannot afford a gym membership but likes to exercise in order to reduce her stress levels and keep her weight under control. She is complaining of dizziness mid-morning, especially when she gets out of her desk chair to get her second cup of coffee, and gets frequent nocturnal leg cramps, especially in hot weather. How can you, as a pharmacy technician, help Mrs. Smith today?

The RAA system is an important for blood pressure regulation in the body.

ARBs and ACE Inhibitors both work on the RAA system while beta-blockers and alpha-blockers work on cholinergic receptors.

What happens in the body when blood flow increases and resistance of arteries increases?

What happens to the human body when high blood pressure goes untreated?