Let’s do a med list review, it’s been a while… Remember with these cases, I really try to highlight the most important things I want you to think about. There are multiple things to monitor in these case reviews, as well as multiple patient specific factors that can really effect the way you prioritize your items to address.
Hydralazine and Imdur doses are pretty substantial, leading me to believe that this individual has significant cardiac/hypertension issues. Also on amiodarone, Norvasc, Aspirin, Plavix, Lipitor, doxazosin. Blood pressure monitoring will be very important. Remember that Amiodarone has some funky side effects to monitor for.
Appears they have diabetes with the glyburide Rx. I’d investigate why they aren’t on an ACE or ARB especially since they most likely have significant issues with blood pressure. If they haven’t been on an ACE or ARB for some odd reason(allergy or ADR), I’d maybe look at a transition from the doxazosin, unless using doxazosin for BPH/HTN.
Some pain issues with scheduled Tylenol (and likely gabapentin at a decent sized dose), and would suspect gout with allopurinol Rx.
I’d try to investigate why Norvasc is BID – but some providers prefer twice daily especially if having variable BP’s
Sound off if you’ve got something to add!
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