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NBME 20 Answers

nbme20/Block 2/Question#27

A 38-year-old African American man with recently ...

It should play a role because the efficacy of certain classes of medications varies among different ethnicities

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submitted by drw(2),

According to UTD, it is said that for the young patient, ACEI, ARB, beta-blocker are of better efficacy for primary hypertension as a monotherapy, however, CCB and thiazide are better for the elderly and the black patients.

"only pharmacokinetic processes which are biologically or biochemically mediated have the potential to exhibit differences between racial or ethnic groups. Thus, the pharmacokinetic factors which can be expected to potentially exhibit racial differences are (1) bioavailability for drugs which undergo gut or hepatic first-pass metabolism, (2) protein binding, (3) volume of distribution, (4) hepatic metabolism, and (5) renal tubular secretion. Absorption (unless active), filtration at the glomerulus, and passive tubular reabsorption would not be expected to exhibit racial differences. "

via: https://www.ncbi.nlm.nih.gov/pubmed/9423140