Select one of the two questions from the discussion questions listed below.
Discussion Question 1
CF is a sixty-year-old African American male who presents as a new patient for initial evaluation and follow-up. He has been diagnosed with hypertension for the last twelve years and Type 2 diabetes for the same period of time. His current blood pressure is 162/90, with a pulse of 76. His body mass index (BMI) is 32. He is currently taking Maxzide 37.5/25 mg every morning. This is the only antihypertensive medication he has taken.
For this question, focus on the treatment of hypertension. Discuss the influences of his age, gender, and ethnicity on hypertensive medications. On the basis of an analysis of those factors, provide one option for improvement of his blood pressure and provide a clear and specific justification for that choice. Be sure to include dosage and scheduling. Include highlights of patient teaching and/or recommendations for any lifestyle changes. Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication.
Discussion Question 2
MT is a fifty-six-year-old obese (BMI 31.5) Caucasian female with a significant family history of cardiovascular disease. She has uncontrolled hypertension and is currently taking metoprolol 50 mg twice daily. She has dyslipidemia and is taking exetimibe 10 mg daily and garlic. Her current cholesterol is 240 mg/dL, HDL is 41 mg/dL, LDL is 163 mg/dL, and triglycerides are 183 mg/dL. Her blood pressure today is 174/94, and her pulse is 90.
Review the medications she is taking for hypertension and dyslipidemia. Evaluate the efficacy of these medications. Review them in terms of her age, gender, and ethnicity. Suggest any changes you would recommend, with clear justification for those choices. For medications, include dosages and schedules. Include highlights of patient teaching and/or lifestyle alterations. Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication.