Question

GB is a 62 year old male with hypertension who has been visiting your facility for exercise therapy in treatment of his hypertension.  His blood pressure is normally 124/92 with a pulse rate of 72.  He has been taking captopril and furosemide for his hypertension.    

1. What do the drugs furosemide and captopril specifically do to help treat GB’s hypertension?
2. What specific things should you be most aware of when prescribing and monitoring GB’s exercise when taking these drugs?
3. What if GB were prescribed captopril and amiloride – What type of drugs are these?  Captopril can cause K+ retention; what would be the most serious adverse reaction that could result? Why?

One day GB reports to you for exercise and when taking his resting blood pressure and pulse note his blood pressure is 118/64, his pulse rate is 150 and highly irregular.  GB indicates he has felt very weak and tired lately almost didn’t show up to exercise.   You refer him to his physician who obtains an ECG and determines he has atrial fibrillation.

4. What physiological mechanisms caused GB’s pulse rate to be high and irregular and his blood pressure low?
5. What specifically, about atrial fibrillation makes the patient feel very weak and tired?

The physician prescribes dofetilide to try to convert GB back to sinus rhythm.  

6. What is meant by “sinus rhythm”?
7. What type of drug is dofetilide and what is the mechanism of action to convert atrial fibrillation to sinus rhythm.

The physician is unsuccessful at converting  GB back to sinus rhythm with the drug so he his placed on chronic therapy of metoprolol and warfarin.

8. What types of drugs are metoprolol and warfarin and what is the specific mechanism of action used to help treat patients with atrial fibrillation?
9. What are specific things to keep in mind when safely prescribing and monitoring exercise for GB?

Answer 1

Answer: The furosemide belongs to the diuretic which reduces the high blood pressure by preventing absorption of too much salt. The captopril is an angiotensin converting enzyme. The combination of both the drug led to decrease in the triglycerides level as by increasing the serum albumin as well as alkaline phosphate levels. Hence this drug reduces the hypertension.