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A man of 65-year-old male weighing 65 kg recovering stroke patient. Past Health history (+) Hypertension...

A man of 65-year-old male weighing 65 kg recovering stroke patient.

Past Health history (+) Hypertension since 2000 (+) CAD since 2015 (+) history of asthma (-) DM

Home Medications:

Aspirin 80 mg/tab 1 tab once a day

Atorvastatin 80 mg/tab 1 tab at bedtime

Budesonide/Formoterol (Symbicort) 160/4.5 mcg 1 puff twice a day

Digoxin 0.5 mcg/tab 1 tab once a day

Metoprolol 25 mg/tab 1 tab twice a day Furosemide 20 mg/tab twice a day

Lactulose 30 ml at once a day, hold if BM >2/day

He was brought to the local community hospital due to difficulty of breathing and expiratory wheezes; diagnostic exams show Chest X-ray is clear and CBC shows platelet count= 145,000 and WBC= 5.0. Blood chemistry further shows SGPT=80 and CBG= 160 mg/dL. Additional orders were made as follows:

Salbutamol nebulization, 1 nebule every 8 hours Prednisone 40mg/tab twice a day

Esomeprazole 40mg once a day Monitor CBG every 4 hours Start Regular Insulin using the following sliding scale: <180= none 181-200= 2 units/SC 201-220= 4 units/SC 221-240= 6 units/SC 241-260= 8 units/SC >280=refer

State the case/patient-specific indications only

Medications

Purpose/Indication/s

Aspirin 80 mg/tab 1 tab once a day

Atorvastatin 80 mg/tab 1 tab at bedtime

Budesonide/Formoterol (Symbicort) 160/4.5 mcg 1 puff twice a day

Digoxin 0.5 mcg/tab 1 tab once a day

Metoprolol 25 mg/tab 1 tab twice a day

Furosemide 20 mg/tab twice a day

Lactulose 30 ml at once a day, hold if BM >2/day

Salbutamol nebulization

Prednisone 40mg/tab twice a day

Esomeprazole 40mg once a day

Expert Solution

Case study

A. Condition of the patient

A man of 65-year-old male weighing 65 kg recovering stroke patient.

B. History of present ILLNESS

He was brought to the local community hospital due to difficulty of breathing and expiratory wheeze

C.Past History

Past Health history (+) Hypertension since 2000 (+) CAD since 2015 (+) history of asthma (-) DM

D. Medication

1.Aspirin 80 mg/tab 1 tab once a day

2.Atorvastatin 80 mg/tab 1 tab at bedtime

3. Budesonide/Formoterol (Symbicort) 160/4.5 mcg 1 puff twice a day

4.Digoxin 0.5 mcg/tab 1 tab once a day

5. Metoprolol 25 mg/tab 1 tab twice a day Furosemide 20 mg/tab twice a day

6.Lactulose 30 ml at once a day, hold if BM >2/day

E.Diagnostic formulation

Diagnostic exams show Chest X-ray is clear and CBC shows platelet count= 145,000 and WBC= 5.0.

Blood chemistry further shows SGPT=80 and CBG= 160 mg/dL

F.Management plan

Salbutamol nebulization, 1 nebule every 8 hours Prednisone 40mg/tab twice a day

Esomeprazole 40mg once a day Monitor CBG every 4 hours Start Regular Insulin using the following sliding scale: <180= none 181-200= 2 units/SC 201-220= 4 units/SC 221-240= 6 units/SC 241-260= 8 units/SC >280

Nightingale answered 2 years ago

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