Final answer:
The pharmacist should advise against initiating nesiritide therapy if the patient has a history of severe allergic reactions, is on medications that interact with nesiritide, or has normal blood pressure. Nesiritide is beneficial for lowering blood pressure and treating heart failure symptoms but must be used with caution due to its potent effects.
Step-by-step explanation:
The pharmacist should recommend that nesiritide therapy NOT be initiated if the patient has a history of severe allergic reactions to nesiritide. Nesiritide should also be avoided in patients currently taking other medications that interact with nesiritide, as there could be potential for harmful drug interactions. In addition, because nesiritide is used to lower blood pressure, initiating therapy in a patient with normal blood pressure may not be appropriate and could risk hypotension.
Nesiritide binds to receptors that affect heart function and blood pressure regulation. It is particularly useful in urgent situations like hypertensive crises or in cases of heart failure where other medications like ACE inhibitors and diuretics are not effective. However, as a potent agent, it can have significant effects on blood pressure and heart rate, necessitating cautious use. In patients with a history of congestive heart failure, nesiritide can be used to relieve heart failure symptoms, but careful monitoring is essential due to the patient's delicate condition and the drug's potent effects.