Latihan Soal Ujian Masuk Apoteker dan UKMPPAI | Materi Kardiovaskular Part 1

Summary

This video script is a detailed educational guide on managing hypertension, hyperlipidemia, and other cardiovascular conditions, focusing on the safe use of medications in various patient populations. Key topics include the selection of antihypertensive drugs for asthma patients, pregnancy, chronic kidney disease, and those with liver issues. The script also emphasizes the side effects of common medications, such as ACE inhibitors and diuretics, and provides essential information on drug interactions and safety concerns. The goal is to enhance pharmacists' understanding of cardiovascular drug therapy in real-world clinical scenarios.

Takeaways

• 😀 Cardioselective beta-blockers, such as bisoprolol, are the preferred choice for treating hypertension in asthma patients, as they do not exacerbate bronchoconstriction.
• 😀 ACE inhibitors (ACEi) and Angiotensin II Receptor Blockers (ARBs), like telmisartan, are contraindicated in pregnancy due to potential teratogenic effects on fetal development.
• 😀 In pregnant women with hypertension and signs of preeclampsia or eclampsia, nifedipine is a safe antihypertensive that can prevent premature labor and manage blood pressure.
• 😀 Niacin is known to cause hepatotoxicity, especially in high doses, leading to increased liver enzymes such as AST and ALT.
• 😀 For patients with chronic kidney disease (CKD) and hypertension, a combination of an ACE inhibitor like captopril and a calcium channel blocker such as amlodipine is effective for managing blood pressure.
• 😀 Diuretics like furosemide can raise uric acid levels and potentially lead to hyperuricemia, a known side effect of diuretics.
• 😀 ACE inhibitors like captopril can cause a persistent dry cough by increasing bradykinin levels, which is a well-known side effect of this class of drugs.
• 😀 High-intensity statins, such as atorvastatin (40-80 mg), are more effective for patients who do not respond to moderate-intensity statins in managing hyperlipidemia.
• 😀 For patients with hypertension and chronic kidney disease on hemodialysis, hydrochlorothiazide is a suitable diuretic option for managing fluid balance and blood pressure.
• 😀 Amlodipine, a calcium channel blocker, is associated with peripheral edema as a common side effect due to increased microvascular pressure.

Q & A

Why is the selection of antihypertensive beta-blockers crucial for asthma sufferers?

The selection of antihypertensive beta-blockers is crucial for asthma sufferers because non-selective beta-blockers (e.g., propanolol) can cause bronchodilation or narrowing of the airways, which can worsen asthma. Cardioselective beta-blockers, such as bisoprolol, primarily block beta-1 receptors in the heart and are safer for asthma patients.

Which antihypertensive drug is contraindicated for pregnant women?

Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) are contraindicated in pregnant women because they can impair fetal development by inhibiting angiotensin, which is necessary for fetal growth.

What is the recommended drug for a pregnant woman with preeclampsia?

For a pregnant woman with preeclampsia, nifedipine is a recommended drug. It is an antihypertensive that is safe during pregnancy and also has a tocolytic effect, helping prevent uterine contractions and premature birth.

Which drug is responsible for the hepatotoxicity seen in a patient with an increased serum ALT or AST?

Niacin (vitamin B3) is responsible for hepatotoxicity, which is characterized by an increase in liver enzymes like ALT and AST, especially when taken in high doses.

What combination of antihypertensive medications is suitable for a patient with chronic kidney disease (CKD)?

For patients with chronic kidney disease (CKD), the combination of an ACE inhibitor (e.g., captopril) and a calcium channel blocker (e.g., amlodipine) is a common and appropriate choice.

What is the common cause of hyperuricemia in a patient using furosemide, metformin, and other drugs?

Furosemide, a diuretic, can increase uric acid levels by inhibiting its elimination in the kidneys, which can lead to hyperuricemia, especially in patients on prolonged therapy.

Which drug in the patient's regimen is most likely to cause a persistent dry cough?

Captopril, an ACE inhibitor, is most likely responsible for causing a dry cough. This occurs due to the accumulation of bradykinin, which is not broken down due to ACE inhibition.

Which high-intensity statin can be used for a patient with hyperlipidemia who does not respond to moderate-intensity statins?

Atorvastatin 40 mg to 80 mg is a high-intensity statin that can significantly lower LDL cholesterol levels by more than 50%, making it appropriate for patients who do not respond to moderate-intensity statins.

What drug combination is appropriate for a hypertensive patient with diabetes mellitus and heart failure?

A combination of captopril (ACE inhibitor) and amlodipine (calcium channel blocker) is a suitable option for managing hypertension in patients with diabetes mellitus and heart failure.

Which antihypertensive drug is most likely to cause edema in a patient?

Amlodipine, a calcium channel blocker (CCB), is most likely to cause edema as a side effect due to increased microstatic pressure, leading to fluid accumulation in the lower extremities.