I selected case study 1, whereby we have a patient by the name AO who has been diagnosed with hypertension and hyperlipidemia. In addition to having obesity history, the patient has gained approximately 9 pounds in the recent past. She has been prescribed with several drugs, namely:
1. Atenolol 12.5 mg daily. Being a beta blocker, this drug impacts the patient’s circulation and heart. Administered orally, its rate of absorption is rapid and at between 100mg and the maximum dosage, systolic pressure reduction could be achieved in less than one hour. In essence, a dose of 200 mg is the maximum allowable dose in a day. This, therefore, effectively means that our patient’s dose is largely minimized.
2. Doxazosin 8 mg daily. In this case, the patient has been prescribed with the maximum dosage of this drug which is, in essence, an alpha-adrenergic blocker. It functions by relaxing a patient’s arteries and veins, and one of the reasons the patient may have been prescribed with the maximum dosage is to treat benign prostatic hyperplasia.
3. Hydralazine 10 mg qid. A peripheral arterial vasodilator, the usual start dose is often 10 mg qid and the maximum daily dosage ought not to exceed 300mg.
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It is important to note that amongst uremic patients, the elimination rate of hydralazine happens to be significantly slower. This could in most cases be attributed to hepatic metabolism that happens to be impaired.
4. Sertraline 25 mg daily. A selective serotonin reuptake inhibitor, sertraline comes in handy in the treatment of depression. It effectively facilitates and promotes serotoninergic transmission (Burton, Shaw, Schentag, Evans, 2006). As the author further points out, this is one property that clarifies this SSSI’s antidepressant properties. The maximum dosage within a 24 hour period is usually 200mg. This effectively means that the patient is within dosage limits. In essence, “depression, a common disease among the adult population, is also accepted as a risk factor for cardiovascular diseases” (Kesim, Tiryaki, Kidioglu, Muci, Kalyoncu, and Yaris, 2011, p. 1525).
5. Simvastatin 80 mg daily. Simvastatin, in the words of Burton, Shaw, Schentag, Evans (2006), “is an oral antilipemic agent which inhibits HMG-CoA reductase.” The patient has in this case been prescribed with double the usual starting dose, which is usually lower than 40 mg daily.
The one factor that has been taken into consideration….....
Burton, M.E., Shaw, L.M., Schentag, J.J., Evans, W.E. (2006). Applied Pharmacokinetics & Pharmacodynamics: Principles of Therapeutic Drug Monitoring. New York, NY: Lippincott Williams & Wilkins
Kesim, M., Tiryaki, A., Kidioglu, M., Muci, E., Kalyoncu, N.I. & Yaris, E. (2011). The Effects of Sertraline on Blood Lipids, Glucose, Insulin and HBA1C Levels: A Prospective Clinical Trial on Depressive Patients. J Res Med Sci, 16(12), 1523-1531.
Ortega, L.M., Sedki, E. & Nayer, A. (2015). Hypertension in the African American Population: A Succinct Look at Its Epidemiology, Pathogenesis, and Therapy. Nefrologia, 35(2), 139-145.
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