In the above case study, the patient is suffering from Hypertension, Hyperlipidemia, and Angina. Therefore, the clinical recommendation will involve therapies to help manage the condition. First statins such as Lovastatin, Simvastatin, Atorvastatin, and Rosuvastatin would deal with abnormal lipid levels and lower coronary artery conditions. According to Vamvakis et al. (2017), the dose must undergo titration and be monitored by a registered nurse. Any abnormal reaction will indicate hypertension in the patient’s lipid profile. This will indicate that the patient has tested positive for hypertension and hence the onset of medication. Thus, Diuretics and Beta-adrenergic blockers must be included in the medication. Some components, such as Nitrates Glyceryl trinitrate, Isosorbide dinitrate, offer symptomatic relief from the thorax region (angina pectoris) (Campbell et al., 2006). Some Platelet inhibitors, such as aspirin or Clopidogrel, are essential long-term applications to curb the risk of re-infection and coronary artery disease.
The immediate action when handling the patient is to prevent the excess loss of water. Since the patient is under medication with hydrochlorothiazide, the possibility of duress would be high. Other potential adverse effects of hydrochlorothiazide are hyponatremia, dehydration, high blood pressure, hypokalemia, hyperglycemia, hyperuricemia, an increase in LDL cholesterol, and a decrease in HDL cholesterol. According to Burchum and Rosenthal (2019), the therapies expected to manage the side effects consist of Digoxin, lithium, antihypertensive agents, NSAIDs, and potassium-sparing diuretics. These drugs will prevent dieresis by countering the effects of hypokalemia in hydrochlorothiazide. For patient safety, the potassium level will require keen observation after ingesting Digoxin spontaneously as it might cause ventricular dysrhythmias.
Moreover, some side effects are associated with the intake of statins, such as myopathy and rhabdomyolysis, hepatotoxicity, and a mild form of diabetes. This trace of diabetes is rare among most patients, and only appears in elderly people. Moreover, the doctor’s role is to ensure proper monitoring of the prescription as statin can cause liver and muscle defects. However, combining a statin with fibrates (gemfibrozil) will increase the risk of some drug responses and raise the possibility of injuring the body due to statin’s high reactivity with other medications, antifungals, and some antibiotics (Antihypertensives, 2015). Lastly, it is not advisable to prescribe a statin to pregnant women as it produces teratogenic effects that can lead to miscarriages.
Nonpharmacological interventions will include natural additives, diet, and aerobics. Most importantly, the patient should get involved in regular exercises for around 20-30minutes daily. Physical exercises will help maintain body weight and prevent abrupt weight gain that can interfere with the body mass index. Burchum and Rosenthal (2019) assert that diet is crucial when one suffers from high blood pressure. Therefore, I recommend the patient to use foods with low sodium content, low-fat content, and low sugary diet. Additionally, drinking much water and heavy fruit intake is essential for maintaining a healthy body. Avoiding alcohol would also be advisable as it risks increasing blood pressure and affecting the electrolyte level in the body.
I would educate patients to maintain healthy lifestyles by balancing their diet, regular exercise, and drinking much water daily. Physical exercise will help in controlling their weight and guarantee proper blood circulation in the body. Water will allow optimal metabolic reactions, remove waste, and excess drugs in the patient’s body (Vamvakis et al., 2017). Further, the patients need to minimize alcohol intake as it may react with some prescribed drugs and interfere with the body’s electrolytes balance. It is important to pay close attention to the doctor’s advice and follow the therapies as instructed. Patients should not buy drugs over the counter unless under a unique prescription from the doctor. Lastly, I would also recommend do seek medical advice in case of any ambiguity during the medication.
References
Burchum, J. & Rosenthal, L. (2019). Lehne’s Pharmacology for Nursing Care (10th ed.) St. Louis: Elsevier.
Campbell, N., Semchuk, W., & Lewanczuk, R. (2006). Pharmacotherapy of Hypertension: Pharmacists Can Play a Greater Role in Improving Management. Canadian Pharmacists Journal / Revue Des Pharmaciens Du Canada, 139(3_suppl), S5-S19. Web.
Vamvakis, A., Gkaliagkousi, E., Triantafyllou, A., Gavriilaki, E., & Douma, S. (2017). Beneficial effects of nonpharmacological interventions in the management of essential hypertension. JRSM Cardiovascular disease, 6, 2048004016683891.