Blood pressure and thiazide diuretic
You are caring for a 53-year-old obese woman in the telemetry unit with chest pain with exertion. She is doing well on Isosorbide and will be placed on it orally to go home. Her blood pressure has been the problem. She is taking a thiazide diuretic.
- What is other blood pressure medicine good for angina and blood pressure? Describe its mechanism of action in this situation.
She has also had high cholesterol for a long time. This has been managed well with atorvastatin 80 mg every day. However, she now has triglycerides of 340 mg/dl.
- What medication can be added to her atorvastatin to lower triglycerides? Describe the mechanism of action in this situation.
She takes metformin and canagliflozin for her diabetes. She is controlled with an A1C of 7.2. However, her weight is uncontrolled and she gains 10-15 pounds a year, despite “eating all of the right things.”
- What is an injectable medication that the patient can be started on that will lower her A1c further and is known to help with weight reduction? Describe the mechanism of action in this situation
Now take all of her drugs that she will be on and put them into a drug interaction checker
- identify any serious interactions (“monitor closely”). Based on these interactions what symptoms will you tell the patient to report immediately to her prescriber?
