We always need diagnosis and more information, but I like to analyze a medication list as an educational tool. The med list review with some possible concerns to investigate:
- Cilostazol 100 mg twice daily
- Aspirin 81 mg daily
- Propranolol 80 mg twice daily
- Captopril 25 mg three times daily
- Pantoprazole 40 mg daily
- Ropinirole 0.5 mg daily
- Alendronate 70 mg weekly
The first thing that jumps out to me is that propranolol and captopril are not used all that often for hypertension. Captopril is an ACE Inhibitor but it really isn’t used very often as there are numerous ACE Inhibitors that don’t need to be dosed multiple times per day. It would be interesting to know why this patient is on it versus another one?
Propranolol is kind of a jack of all trades in that it can have a bunch of different indications. I would be looking to identify what indication it is being used for.
Remember that cilostazol is recommended to be given on an empty stomach (30 minutes before or 2 hours after meals), which can be a little bit of a challenge sometimes as it is dosed twice daily. The day alendronate is administered it may be even more challenging 🙂
One last question I would like to investigate; With the assumption that alednronate is being used for osteoporosis, why isn’t this patient on vitamin D supplementation and/or calcium?
Based upon your experience, what else should we investigate?
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