An 80-year-old man came to the pharmacy to renew his prescription medications, which he had been taking for years. These were prazosin, metoprolol, diltiazem and ramipril. He was happy with these medications because his blood pressure reading at the hospital was usually around 120/60 mm Hg. However, he revealed that he was frequently waken up by nightmares, and felt faint when he got out of bed to go to the toilet. He also coughed terribly in the night.

a) For what disease did he take these medications? (1 mark)

B) Was 120/60 mm Hg and appropriate blood pressure for him? (3 marks)

c) To which drug class does prazosin belong? What adverse effect might it cause in this patient? What could be done to reduce this adverse effects? (4 marks)

d) To which drug class does metoprolol belong? Which TWO adverse effects might it cause in this patience? (3 marks)

e) Which drug is an alternative to metoprolol with less adverse effect? (1 mark)

f) To which drug class does diltiazem belong? Name TWO common adverse effects. With which of the other drug might it interact? (4 marks) 

g) To which drug class does ramipril belong? Which TWO adverse effects might its cause in this patient? What alternative drug might reduce these adverse affects? (4 marks)