Psychiatric-Mental Health Nurse Practitioner Exam

Which two types of blood pressure medications should not be used together?

1. Beta-blockers and Calcium Channel Blockers

2. ACE inhibitors and ARBs

3. Thiazide diuretics and Beta-blockers

4. Calcium Channel Blockers and ACE inhibitors

The correct answer is: ACE inhibitors and ARBs

The combination of ACE inhibitors and ARBs (Angiotensin II Receptor Blockers) should not be used together due to the increased risk of adverse side effects and complications. Both classes of medications work to lower blood pressure by affecting the renin-angiotensin-aldosterone system, but they do so through different mechanisms. Using them in conjunction can lead to excessive blockade of this system, resulting in potentially harmful outcomes such as acute kidney injury, hyperkalemia (elevated potassium levels), and hypotension (low blood pressure). Research and clinical guidelines recommend against this combination, especially in patients with certain risk factors, to prevent these adverse effects while managing hypertension. Therefore, prescribing either an ACE inhibitor or an ARB separately is encouraged, but combining them is not considered safe or effective.