Question

The patient's history for update purposes

Patient A age 70. He is obese and 100% sedentary. He needs to do physical exercises, to lose weight, to decrease stress and to eat better (but he does not do that). He has diabetes: 25 years ago, he was diagnosed with diabetes type 2 and he has to take insulin.

Diet: He eats meat 3 times a day and does not eat dietary fiber.

Emotional: He is stressed and anxious, and works hard.

Parents: The mother and father died young because of complications of diabetes. Father: died at age 53 of myocardial infarction.

Symptoms now: shortness of breath, chest pain due to physical exertion (angina).

Has high blood pressure: 140/90. Never had hypertension before. His doctor prescribed for hypertension: Vasotec (enalapril).

He must take the following exams:

FSC: red blood cells, white blood cells and platelets

Lipid profile

Creatinine test

Uremia test (urine in the blood)

Electrolytes test (usually sodium or potassium or an acid-base imbalance)

Clearance of creatinine test

HbA1c test (also called glycated hemoglobin test, and glycohemoglobin)

Stress ECG test

Urine analysis

3 weeks later, the results:

Clearance of creatinine test show to us the GFR (Glomerular Filtration Rate) results:
GFR 55mL/min (normal: 90-125mL/min)

Lipid profile: low level HDL, high level LDL

Plasma creatinine level (creatinine test): 150 mmol/L (normal: 50-110 umol/L)

Uremia test : 8 mmol/L (N : 3 - 6,5 mmol/L)

Urine analysis: 120 mg/L of proteins (normal: < 80 mg/L)

Stress ECG test: Anomalies related to unstable angina

Doctor's conclusion: chronic renal insufficiency (CRI), unstable angina. Needs to do an emergency angiography.

Angiography test results: several atheroma plaques in the coronary arteries. He had to put four stents during the procedure.

He had to take these medicaments:

Clopidogrel (Plavix), Aspirine (acide salicylique, for 1 year), and Crestor (is a statine). And also, the insulin and Vasotec (énalapril).

Question A: Search for in the medication guide the family and the mechanisms of action of used medications.

Answer 1

Obesity: It is a serious, chronic disease that can have a negative effect on many systems in your body. Overweight and obesity may increase the risk of many health problems, including diabetes, heart disease, certain cancers, bone and joint disease.

Weight loss drugs are otherwise termed as anti-obesdy drugs, play a key role in the regulation of the body weight. The basic mechanism through whch these drugs act is by decreasing appetite or absorbing the calories within the body. Apart-from the uses these drugs have many side effects which are lethal to the individual This is the reason for banning such drugs in the market

Some weight loss drugs with major side effects are listed below:

Fenfluramine: This drug is associated with heart and lung side effects, this no more available in the market .

Sibutramine: this drug is banned by the US government due its side effects in heat attack and stroke.

Alli and Xanical: these are de two lipase inhilartors that are responsible for the liver injury. this drug also results in the excretion of brown colored urine due to the presence of excess of bilurubin in the urine.