A nursing student is reviewing medications used to treat a patient with Peripheral Artery Disease (PAD). Which of the following medications should the nurse identify as commonly prescribed for this condition? (Select all that apply)
Cilostazol (Pletal)
Ramipril (Altace)
Metoprolol (Lopressor)
Aspirin
Clopidogrel (Plavix)
Correct Answer : A,D,E
Choice A reason: Cilostazol inhibits phosphodiesterase III, increasing cyclic AMP, which dilates arteries and reduces platelet aggregation. This improves blood flow and reduces intermittent claudication in PAD, directly targeting vascular symptoms by enhancing circulation and preventing thrombosis, making it a primary treatment option.
Choice B reason: Ramipril, an ACE inhibitor, lowers blood pressure and protects vascular endothelium, benefiting PAD indirectly. It reduces cardiovascular strain but doesn’t directly improve limb perfusion or claudication, so it’s not a primary PAD medication despite its role in managing comorbidities like hypertension.
Choice C reason: Metoprolol, a beta-blocker, slows heart rate and reduces myocardial oxygen demand, useful in heart disease. In PAD, it may worsen claudication by reducing peripheral blood flow via vasoconstriction, making it less commonly prescribed specifically for PAD management.
Choice D reason: Aspirin inhibits cyclooxygenase, reducing thromboxane A2 and platelet aggregation. This antiplatelet action prevents clot formation in narrowed PAD arteries, improving outcomes by reducing thrombotic events, making it a standard, evidence-based therapy for symptom relief and risk reduction.
Choice E reason: Clopidogrel blocks ADP receptors on platelets, preventing aggregation and thrombus formation. In PAD, it reduces ischemic events and improves patency, often used alone or with aspirin, making it a key medication for managing vascular complications and symptoms.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: Daily alcohol use may amplify propranolol’s CNS depression, but it’s not a contraindication. It warrants monitoring for sedation, yet hypertension treatment proceeds, as no direct physiologic conflict exists with beta-blockade.
Choice B reason: Asthma contraindicates propranolol, a non-selective beta-blocker, as it blocks β2 receptors, causing bronchoconstriction. This risks severe airway obstruction in asthmatics, prompting consultation for a cardioselective alternative like atenolol.
Choice C reason: Peptic ulcer disease isn’t affected by propranolol directly; beta-blockers don’t alter gastric acid. It’s not a contraindication, though stress-related hypertension management might consider other factors, not this drug.
Choice D reason: Post-MI, propranolol reduces myocardial demand, aiding recovery. It’s beneficial, not contraindicated, lowering reinfarction risk via β1 blockade, so no consultation is needed unless acute decompensation occurs.
Correct Answer is C
Explanation
Choice A reason: A cardiac diet (low sodium, low fat) supports blood pressure control long-term by reducing vascular strain. However, it’s less immediate than addressing adherence, as dietary change alone won’t correct current medication misuse driving the elevation.
Choice B reason: Cardiac assessment identifies complications like hypertrophy, useful for monitoring. It’s reactive, not proactive, and doesn’t address the root issue of inconsistent adherence, which directly impacts blood pressure control and outcomes now.
Choice C reason: Medication education tackles adherence, the primary cause of uncontrolled hypertension here. Teaching proper use ensures therapeutic levels, reducing pressure via vasodilation or fluid control, directly improving outcomes with evidence-based efficacy.
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