1. A 65-year-old man with a history of hypertension, diabetes, and chronic

kidney disease is prescribed lisinopril, a type of angiotensin-converting

enzyme (ACE) inhibitor, to lower his blood pressure. What is the main

mechanism of action of lisinopril and why is it beneficial for this patient?

a) It blocks the production of angiotensin II, a potent vasoconstrictor, and

reduces the workload on the heart and kidneys.

b) It inhibits the breakdown of bradykinin, a vasodilator, and enhances the

effects of nitric oxide and prostaglandins on the blood vessels.

c) It antagonizes the effects of angiotensin II on the angiotensin II type 1

(AT1) receptors, and prevents vasoconstriction, sodium retention, and

aldosterone secretion.

d) It stimulates the production of renin, a hormone that activates the reninangiotensin-aldosterone system (RAAS), and increases blood volume and

pressure.

*Answer: A. Rationale: Lisinopril is an ACE inhibitor that blocks the

conversion of angiotensin I to angiotensin II, which is a powerful

vasoconstrictor that increases blood pressure and causes damage to the

heart and kidneys. By lowering angiotensin II levels, lisinopril reduces the

workload on these organs and protects them from further deterioration.*

2. A 25-year-old woman with a history of asthma is experiencing an acute

exacerbation of her symptoms. She uses a metered-dose inhaler (MDI)

containing albuterol, a type of beta-2 adrenergic agonist, to relieve her

bronchospasm. What is the main pharmacodynamic effect of albuterol and

what are some possible adverse effects of this drug?

a) It activates the beta-2 receptors in the smooth muscle cells of the

bronchi, causing bronchodilation and increased airflow. Some possible

adverse effects are tachycardia, palpitations, tremors, and nervousness.

b) It inhibits the release of histamine and leukotrienes from the mast cells

in the airways, reducing inflammation and mucus secretion. Some

possible adverse effects are dry mouth, headache, drowsiness, and fatigue.

c) It blocks the muscarinic receptors in the parasympathetic nervous

system, preventing bronchoconstriction and mucus production. Some

possible adverse effects are blurred vision, urinary retention, constipation,

and confusion.

d) It stimulates the production of cyclic adenosine monophosphate