For this week, please answer all the below. Please state which antihypertensive (if any) you would prescribe each patient. Please state a specific medication, dosage and frequency for each, along with a sentence or two rationale.
A. 200 lb 65 yo male who is already on max dose Zestoretic (lisinopril/HCTZ). Brings in home BP log, which shows average of 160/92. Last GFR of 60. Hepatic enzymes fine. Comorbidities: chronic headaches – stress induced. (1 point)
B. A newly-diagnosed type 2 diabetic. 43 yo female. Smoker. Asthmatic. BP’s consistently 140s/90s. GFR of 80 and hepatic enzymes mildly elevated. (1 point)
C. 37 yo male. BP’s are well-controlled on 20 mg of lisinopril, however, he has developed a dry cough since starting this medication. Feels there is a correlation. (1 point)
D. 45 yo African American. BPs 150s/90s. Also suffers from gout. (1 point)
E. 78 yo male currently on ACE inhibitor and beta blocker for congestive heart failure, stage 3. Has chronic pitting ankle edema. Last potassium high-end normal. Last GFR of 40. Hepatic enzymes mildly elevated. (1 point)
F. 27 yo male. BPs 150s/90s. No significant comorbidities. (1 point)
G. You inherit a male, 55-year-old, diabetic patient with comorbid obesity, cigarette use and diabetes mellitus. His recent low density lipoprotein (LDL) is 150 mg/dL. Using the guidelines of the American Heart Association mentioned in your lecture, what is your prescribed treatment plan for this patient to lower his LDL (provide a specific medication and dose, please)? (1 point)
He calls in two weeks stating he has developed myalgias since starting the medication. What do you do for this patient? (1 point)