A 64 year old male has a current medication regimen of:
- Garlic 200 mg daily
- Chromium 500 mg daily
- Omega 3 fish oil 1,000 mg daily
- Magnesium 500 mg daily
- Cinnamon 500 mg daily
- Red Yeast rice 1 table daily
- Aspirin 81 mg daily
- HCTZ 25 mg daily
- Morbid obesity
His most recent Labs:
Blood pressure – 156/78
In review of this medication list, there’s a few obvious questions that come to my mind.
- Medication omissions based on guidelines. Statin therapy, as well as an ACE or ARB would likely be appropriate with hypertension and diabetes history. I would need to look at past history further with this patient, but I think those would be initial strong considerations.
- Another significant concern is the A1C. From the medication list, this patient obviously doesn’t have concerns with taking supplements. I would try to get the source of the reason for why he is taking multiple supplements to treat his chronic disease (i.e. fish oil – likely lipid control, cinnamon – often used for diabetes, red yeast rice – often used for lipid control).
Going a little further on this idea, patients will often not agree with standard medication therapy for various reasons. They may be fearful, uneducated, or simply have tried standard therapy and haven’t tolerated it. Whatever the reason may be, as a pharmacist, its your job to figure it out and help our patient get to the goals that will help them live their happiest, healthiest, life they can!
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Well, that’s taking it lightly. I won’t trust a lowering of A1C by these items unless a stringent diet and exercise regimen is in place. Get the brand names and check how good these supplements are.
This guys diabetes and hypertension are not being managed adequately and going by his labs he is not doing very well on the so called supplements.
I would say he needs proper diabetes and HTN consult
This is Not so good. The indicators for efficacy of his drugs, tell this much. He is also close to being considered a Geriatric,which means strict disease control following standard guidelines should be adopted. Also, Supplements only assist a stable case of a disease, and should not be a substitute for medications.