Pharmacology>Adr Prediction Practice Test

A 58-year-old man with hypertension and diabetic nephropathy was started on lisinopril 10 mg daily two weeks ago. Since then, his home blood pressures have improved to the 120s/70s, but he reports a new, persistent dry cough that is worse at night. He denies fever, sputum production, rhinorrhea, or exposure to sick contacts. He has never smoked. His medications include metformin, atorvastatin, and aspirin. Physical exam is normal, and his lungs are clear. Serum potassium is 4.7 mEq/L and creatinine increased from 1.0 to 1.2 mg/dL. The prescriber suspects the cough is related to the new medication and considers switching therapy.

A 54-year-old man with hypertension is started on lisinopril 10 mg daily at a routine visit. Two weeks later he reports a persistent, dry, tickling cough that is worse at night and interrupts his sleep. He denies fever, sore throat, wheezing, or sputum production. His blood pressure has improved from 156/94 to 128/78. He continues hydrochlorothiazide 25 mg daily and takes no over-the-counter cold medicines. He is a nonsmoker and has no history of asthma or chronic lung disease. Physical exam is unremarkable, and lungs are clear to auscultation. Baseline and current labs show creatinine 1.0 mg/dL and potassium 4.4 mEq/L. His clinician suspects the new medication is responsible.