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Pharmacology C.V.S 9b3a70c1

Which one of the following is the most appropriate drug to use for the patient described in parentheses?

A
Captopril (60-year-old woman with diabetic nephropathy)
B
Nitroprusside (50-year-old man with BP of 140195)
C
Losartan (29-year-old pregnant woman)
D
Propranolol (40-year-old patient with peripheral vascular disease)
High-Yield Explanation
ACEIs slow the progression of diabetic nephropathy and are indicated for management of HTN in such patients. Nitroprusside is used IV in severe HTN or hypertensive crisis, not for management of mild-to-moderate HTN. Losartan, which blocks AT-1 receptors, is associated with teratogenic effects during fetal development, as are the ACEIs. Nonselective beta blockers are not ideal for patients who suffer from peripheral vascular disease, diabetes, or asthma. Reserpine causes the release of amines from tumor cells, exacerbating HTN in pheochromocytoma.

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