Pharmacology Answers-14

(C) The combination of an ACE inhibitor and a
diuretic is rational for this patient with hypertension
and mild heart failure as both drugs are
effective for both conditions. Furthermore, ACE
inhibitors have been shown to slow or stop the
progression of heart failure and thiazide diuretics
have been shown to be among the cheapest
and most effective agents for hypertension. If
this combination is not sufficiently active to
control the heart failure, a loop diuretic might
be substituted for the thiazide. Dobutamine
(choice A) is a parenteral drug for acute failure.
Hydralazine (choices B, E) is a vasodilator that
causes tachycardia and usually requires concurrent
administration of a beta blocker. Use of
two diuretics (choice D) is probably unnecessary
in this early stage of failure and is not the
most effective therapy for hypertension.

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