Which are effective ways to help prevent medication errors? (Select all that apply)

Choice A reason: ACE inhibitors cause dry cough by inhibiting bradykinin breakdown, which accumulates and irritates the airways. ARBs block angiotensin II receptors without affecting bradykinin, eliminating this side effect. This makes ARBs a suitable alternative for patients experiencing cough, confirming this as the correct choice.

Choice B reason: Hyperkalemia occurs with both ACE inhibitors and ARBs due to reduced aldosterone production, which decreases potassium excretion. Both drug classes affect the renin-angiotensin-aldosterone system similarly, so switching to an ARB does not eliminate this risk, making this choice incorrect for the question.

Choice C reason: Hypotension is a shared side effect of ACE inhibitors and ARBs, as both reduce blood pressure by inhibiting the renin-angiotensin system. ARBs block angiotensin II receptors, causing vasodilation similar to ACE inhibitors, so this side effect persists, making this choice incorrect.

Choice D reason: Angioedema, though rare, can occur with both ACE inhibitors and ARBs. While less common with ARBs, it’s not eliminated, as it may result from mechanisms beyond bradykinin accumulation. Switching to an ARB doesn’t guarantee avoidance of angioedema, making this choice incorrect.

Choice A reason: Beta 1-adrenergic drugs, like dobutamine, stimulate beta-1 receptors in the heart, increasing cyclic AMP and calcium influx, enhancing myocardial contractility. This increases stroke volume by strengthening heart contractions, directly improving cardiac output, making this the correct choice for the drug’s mechanism of action.

Choice B reason: Cardiac afterload is the resistance the heart pumps against. Beta 1-adrenergic drugs don’t directly reduce afterload; they increase contractility. Increasing afterload would decrease stroke volume, opposing the drug’s purpose, making this choice incorrect for the drug’s effect on stroke volume.

Choice C reason: Venous return affects preload, not directly influenced by beta 1-adrenergic drugs. These drugs enhance contractility, increasing stroke volume independently of venous return. While preload impacts output, it’s not the primary mechanism of beta-1 stimulation, making this choice incorrect.

Choice D reason: Cardiac preload is the initial stretch of the heart, influenced by venous return. Beta 1-adrenergic drugs increase contractility, not preload, to boost stroke volume. Preload changes are secondary and not the primary action of these drugs, making this choice incorrect.