Pharmacology Antihypertensives #16

Question

The nurse is caring for a patient with a new diagnosis of hypertension. The patient also has a history of type 2 diabetes and microalbuminuria. Which drug therapy will the nurse anticipate for the patient?

Answers

  1. Nifedipine
    • Rationale:

      This answer is not correct because calcium channel blockers, such as nifedipine, are not recommended as first line therapy for treating hypertension with diabetes and underlying kidney disease. CCBs are usually second-line antihypertensive agents.

  2. Clonidine
    • Rationale:

      This answer is not correct because alpha-agonists, such as clonidine, are not considered as first line therapy and some may actually cause sodium retention. Clonidine also has inconsistent effects on proteinuria.

  3. Captopril
    • Rationale:

      This answer is correct because captopril is an angiotensin converting enzyme inhibitor (ACE inhibitor) and preferred to treat hypertension and for reduction in macrovascular complications with type 2 diabetes because the medications reduce the deterioration of the glomerular filtration rate and albuminuria. ARBs may also be utilized.

  4. Verapamil
    • Rationale:

      This answer is not correct because calcium channel blockers, such as verapamil, are not recommended as first line therapy for treating hypertension with diabetes and underlying kidney disease. CCBs are usually second-line antihypertensive agents.

Overview

Captopril is an angiotensin converting enzyme inhibitor (ACE inhibitor) and preferred to treat hypertension and for reduction in macrovascular complications with type 2 diabetes.

Explanation

The correct answer is C. Captopril is an ACEI and preferred for reduction in macrovascular complications with type 2 diabetes because the medications reduce the deterioration of the glomerular filtration rate and albuminuria. ARBs may also be utilized. Selection B is incorrect since alpha-agonists are not considered as first line therapy and some may actually cause sodium retention and may not affect proteinuria. Selection A and Selection D are incorrect because Calcium channel blockers (verapimil) are not recommended as first line therapy for treating hypertension with diabetes and underlying kidney disease. CCBs are usually second-lie antihypertensive agents.

Learning Outcomes

Captopril is a medication often used for hypertension in patients. It is in the class of angiotensin converting enzyme inhibitor (ACE inhibitor) antihypertensives.

Test Taking Tip

ACE inhibitors often have a suffix of “-pril”.

Video Rationale