Question

JM, a 50 year old male returns to the clinic for a follow up visit. On his last visit BP was 136/90, HR 86, RR 18- weighs 220 lbs- at that time he was advised to limit salt intake and consume low fat diet- New visit - VS are as follows: BP 150/92, HR 88, RR 20 and weight 235 lbs.

1. JM has a strong family history for cardiac disease, his father passed away at age 60 from an MI and his 2 older brothers have had MI’s and stent placement. Does JM need any additional medication based on his own history and his family history? (2 Points)

2. Please devise a medication regimen for JM and provide a rationale for each medication recommended- additionally, please note all the non pharmacologic interventions as well. (4 points)

Answer 1

1. He need medication in order to control blood pressure. Because during his first visit bp-136/90 second visit it raised to 150/92 even he restricted salt intake.

During his first visit it will be in prehypertension stage, in second visit it will become stage1 high blood pressure stage. Later it will result heart attack and stroke. In order to prevent that he should take medication. Based on his family history he will be alert about his health and practice exercise and diet modification to control weight and blood pressure

2.

Diuretics _diuretic remove excess water and sodium from the body. So there's less fluid flow through veins and arteries .this reduce pressure on the wall of blood vessels. Eg:bumetanide,chlorothizide

Angiotensin converting enzyme inhibitors _these help relax blood vessels by preventing formation of angiotensin, a chemical in your body that narrows blood vessels. Eg:enalapril,ramipril.

Calcium channel blockers _these medications prevent calcium entering the cells of your heart and arteries allowing it relaxesand open. Eg:diltiazem,nifidipine

Beta blockers _these drug work by blocking the effects of hormone epinephrine also called adrenaline eg:metaprolol,atenolol