CEA Nursing Practice Exam

Which medication is most likely the cause of lower extremity edema and constipation in a patient prescribed multiple agents including amlodipine?

1. Ezetimibe (Zetia)

2. Bupropion (Wellbutrin)

3. Amlodipine (Norvasc)

4. Lisinopril (Zestril)

The correct answer is: Amlodipine (Norvasc)

Amlodipine is a calcium channel blocker commonly used for hypertension and angina. One of its well-documented side effects is peripheral edema, particularly in the lower extremities. This occurs because amlodipine causes relaxation of vascular smooth muscle, leading to vasodilation which can increase capillary permeability and fluid accumulation in surrounding tissues. Additionally, patients taking amlodipine may experience gastrointestinal issues, including constipation. While constipation is not as commonly associated with amlodipine as lower extremity edema, it can occur as a result of decreased gastrointestinal motility related to vascular relaxation and the effect of calcium channel blocking on smooth muscle function throughout the body. In this scenario, the combination of these two side effects—lower extremity edema and potential constipation—aligns specifically with amlodipine's known pharmacological effects, establishing it as the most likely cause among the listed medications. Other medications like ezetimibe, bupropion, and lisinopril have different primary uses and side effect profiles that do not typically include these specific symptoms, thus making them less likely to be responsible for the patient's symptoms.