Patient Information
Introductory Summary
Patient A is a 55 year old Hispanic female with a chief complaint of having swollen legs. She is currently taking Chlorthalidone 50 mg for management of her swollen legs and Pravastatin 80 mg for high cholesterol. She has a blood pressure of 149/95 and a pulse rate of 69 bpm. Her respiratory rate is 14 and body temperature is 36.6oC. She does not have any allergy to any drug or food substance. She also complains of having had drowsiness, nausea, fatigue, headache, and feeling lightheaded over the past one week.
Medical Conditions
The patient has the following medical conditions: High blood pressure, pitting edema, headache, and high blood cholesterol.
Consultations
To the cardiologist: please provide detailed information about this patient including venous return and electrocardiogram.
To the pharmacist: Kindly provide a detailed information on pravastatin and chlorthalidone that the patient currently uses, including comprehensive information on the interactions of each drug with other drugs, food or chemicals, and side effects of each drug.
To the Nephrologist: Please assess the current state of the patient’s renal system and determine whether Chlorthalidone 50 mg has effectively managed her condition.
To the laboratory: measure the patient’s blood cholesterol levels including HDL and LDL.
The response from the pharmacist indicates that Chlorthalidone has such side effects as dizziness, nausea, fatigue, lightheadedness and drowsiness. The drug also causes erratic blood glucose level, low potassium, and high levels of calcium ions (Chobanian, p96). Headache that the patient complained about could be as a result of the drug. The pharmacist advised that the patient could be put on spironolactone, a potassium-sparing diuretic. The laboratory report indicated that the LDL levels were still very high. Hence the patient needs to continue using pravastatin.
Treatment Summary
The patient shall continue using pravastatin for her high cholesterol levels. To alleviate dizziness and headache, the patient shall terminate Chlorthalidone 50 mg and instead be put on spironolactone.
Discussion of Medical Conditions
The rationale for changing diuretic is that Chlorthalidone presents with several side effects such as low potassium, headache, drowsiness, and lightheadedness. Spironolactone, is a potassium-sparing diuretic which will restore normal levels of potassium and prevent the side effects of Chlorthalidone. Her slightly advanced age makes it difficult to put her on combination therapy hence she shall continue using only two drugs.
Work Cited
Chobanian, Aram V. “Current Use of Diuretics in the Management of Hypertension.” Hypertension 2.4 (2016): 181-182.
