Overview of Patient
Jeremy, age 55 white male, has come in for his annual physical. He has hypertension and type 2 diabetes mellitus. His blood pressure is controlled with lisinopril 20 mg daily and amlodipine 5 mg daily. He has no known allegies and denied any hx of smoking. His most recent HbA1c was 7.2% while taking metformin 500 mg twice a day. His father died at age 55 of a myocardial infarction, and his brother, age 57, just underwent angioplasty. Jeremy eats fast food at least five times a week because of his work schedule. He weighs 245 lb and stands 5-foot-11. His fasting blood sugar is 213. His blood pressure is 134/80. His total cholesterol is 237 (LDL, 162; HDL, 35; triglycerides, 200).
You should now have all of the patient information necessary to complete your case study assignment.
- Does Jeremy fall into any of the statin risk categories? If so, which one?
- What drug therapy and dose would you prescribe, and why?
- What are the parameters for monitoring the success of the therapy?
- List one or two adverse reactions for the drug therapy that you prescribed for Jeremy that would cause you to change therapy. Provide rationale for your answer.
- When rechecked, Jeremy’s total cholesterol is 174 (LDL, 100; HDL, 38), but he is complaining of muscle pain. How would you manage Jeremy’s treatment? Provide rationale for your answer.
- When would you have patient follow up?
- What labs would you order and why?
