Which of the following is NOT a logical explanation for the reduced

effect of beta blockers as anti-hypertensives in the elderly. *

Fewer beta adrenoceptors leads to a compensatory increase in
noradrenaline secretion
Fewer beta adrenoceptors means that their overall contribution to
hypertension must be less
Atherosclerosis is the major cause of hypertension in the elderly and is not
influenced by beta blockers
Beta blocker induced reflex vasoconstriction is increased due to reduced
baroreceptor sensitivity
Mr E was treated with a beta blocker in addition to the standard
triple therapy for hypertension. Why might the beta blocker cause
cold extremities? *
Reduces cardiac output so blood flow reduced to extremities.
Prevents peripheral vasodilation
Induces hypoglycaemia which interferes with heat production and
temperature regulation.
Reduction in central sympathetic nerve activity which controls temperature
regulation.
Ritonavir is known to induce mild nausea in some patients. What
would be your first course of action to try to reduce ritonavir induced
nausea in patients? *
Ensure ritonavir is swallowed with plenty of water
Co-administer an anti-emetic agent
Reduce the dose of ritonavir
Advise patients to take ritonavir after meals
Which of the drugs identified in the table would see plasma
concentrations increase the most if co-administered with ritonavir? *
Warfarin
Caffeine
Carbamazepine
Acetaminophen
Patient characteristics may be associated with drug distribution &
clearance. 4 patients were administered a highly lipid soluble beta
blocker. Using the data in the table, which of the following patients
would likely have the longest beta blocker half-life? *

Patient NU
Patient BR
Patient CT
Patient AP
How would you interpret the following set of results: Blood pressure
– 130/80mmHg, total cholesterol – 6.4mmol/l, HIV+ viral load – 20
copies/ml? *
Hypotensive, low total cholesterol, undetectable viral load
Hypertensive, low total cholesterol, low viral load
Normotensive, high total cholesterol, undetectable viral load
Hypotensive, high total cholesterol, high viral load
How were the different branches of the autonomic nervous system
affected by the HIV? *
Decreased PNS only
Decreased PNS and SNS
Decreased SNS only
Decreased PNS and increased SNS
The graph shows the change in the plasma concentration of three
different statins (pravastatin, atorvastatin and simvastatin) after co-
administration with ritonavir compared with treatment with the statin
alone. What is the most likely interpretation of this graph? *

Metabolism of atorvastatin is impaired by ritonavir

Ritonavir increases pravastatin clearance
Simvastatin is the most resistant to the effects of ritonavir
Ritonavir would not influence blood concentrations of any of the statins
Older individuals can often demonstrate a decreased response to
beta blockers. Why might this be the case? *
Reduced plasma proteins.
Elderly can have reduced hepatic metabolism
Kidney can have impaired renal clearance
Elderly may have a reduced number of beta-adrenergic receptors
Mr E’s presenting symptoms were dry mouth, light sensitivity and
problems with emptying his bladder and sweating – symptoms
associated with the autonomic nervous system. Which of these
symptoms could be caused by either inhibiting the sympathetic
nervous system or treating the patient with a muscarinic receptor
antagonist? *
Reduced sweating
Light sensitivity
Problems with bladder emptying
Dry mouth