Professional Documents
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Hypertension
B. What are the basis of the problem using the history, physical examinations and
laboratory examinations?
65 years old, woman
History of Hypertension for 10 years
Family history of hypertension (noted on her mother and 1 sister)
(+) tobacco history 1 ppd x 30 years, quit 5 years ago
medications: Lisinopril 20mg PO
ROS: occasional headaches relieved with acetaminophen
PE: 101.4 kg and 165 cm
C. Enumerate the therapeutic objectives.
Promoting healthy lifestyle modification
Maintain BP w/in normal limits
Prevent further complications
D. Identify the non-pharmacological and pharmacological regimen
Non-pharmacological treatment
LIFESTYLE MODIFICATIONS:
Diet modification: reduction in NaCl intake to <6g (100meq), low-fat dairy
products, address diabetic diet
Encourage the patient to have a regular physical activity such as brisk
walking.
Reduction of alcohol consumption
E. For the pharmacological regimen, identify the different drug class and then the
drug class of choice
Drug Class:
I. Agents that block production or action of Angiotensin
II. Diuretics
III. Direct Vasodilators
IV. Sympathoplegic agents
II. Diuretics
i) Thiazides
ii) Loop diuretics
iii) Carbonic Anhydrase Inhibitors
iv) Potassium sparing diuretics
v) Osmotic diuretics
vi) Vasopressin antagonists
Drowsiness
Weakness
Abnormal taste
(metallic or
salty taste)
Rash
Cost + ++++ ++ ++
ARBs Inhibitor
Personal DOC: Irbesartan
Drug Study: Irbesartan (Aprovel)
Indication
- for the treatment of essential HTN and treatment of renal disease in patients with HTN anf type 2 diabetes mellitus ,
as part as antihypertensive regimen.
Dosage
- 150mg daily. Maybe increased to 300mg or combined with other antihypertensive agents if patient is
notsufficiently resolved.
CI
- Pregnancy , 2nd or 3rd trimester lactation
SP
- Intravascular vol. depletion, renovascular HTN, renal impairment and kidney transplantatiom, hyperkalemia,
aortic and mitral valve stenosis, Hypertensive patient with type 2 NIDDM and renal diseases
Adverse Reaction
- Musckulotskletal trauma and flushing
- Preg. Safety ;: D
1,064 pesos