Question

Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following:

Glipizide 10 mg po daily

HCTZ 25 mg daily

Atenolol 25 mg po daily

Hydralazine 25 mg qid

Simvastatin 80 mg daily

Verapamil 180 mg CD daily

Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Answer 1

As patient has history of strokes, i would like to add antiplatelet agents like clopidogrel, aspirin etc.

Pt has also risk factors of developing coronary artery disease. So antiplatelet agents must be added.

Also hypertensive drugs are more numbers in the prescribed regimen. But patients monitoring data not available but i would like to regulate anti hypertensives to 1-2 tablets according to his blood pressure. Also fasting blood glucose level to be analyse to check hypoglycemic agents are adequate or not.

Also high dose cholesterol lowering drugs not recommended.because new studied showing it will enhance the possibility of diabetes

The major changes are to add T ecospirin 150 /clopidogrel 75mg daily or double antiplatelet regimen

Simvastatin 40mg may be adequate instead of 80mg

Exercise regimen and good food practicess to be entertained .

.