Advance Pharmacology in Nursing case study
You have a 58 year old African American male that is coming in for a follow-up visit after recently having a Myocardial infarction which was successfully treated via angioplasty. He was started on Metoprolol for his consistently elevated high blood pressure during his hospital stay.
His primary diagnoses include:
Coronary Artery Disease
Type 2 diabetes controlled with Metformin 1,000 mg BID and HgA1C of 6.7.
Asthma- Mild Intermittent- with no recent episodes of wheezing. Albuterol INH as needed.
All other pertinent labs Within Normal Limits
First consider what clinical guidelines noted below can help choose the best medication treatment for this patient with diabetes, CAD, Asthma and Hypertension.
Joint National Committee JNC 8 – https://thepafp.org/website/wp-content/uploads/2017/05/2014-JNC-8-Hypertension.pdf
National Center for Biotechnology Information – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092891/table/T1/?report=objectonly
American Heart Association – https://www.ahajournals.org/doi/epub/10.1161/HYPERTENSIONAHA.120.15026
IHS Division of Diabetes https://www.ihs.gov/sites/diabetes/themes/responsive2017/display_objects/documents/algorithms/AlgorithmHypertension.pdf
Answer each questions citing your response from evidence based clinical guidelines.
Reference:
Unger T;Borghi C;Charchar F;Khan NA;Poulter NR;Prabhakaran D;Ramirez A;Schlaich M;Stergiou GS;Tomaszewski M;Wainford RD;Williams B;Schutte AE; (n.d.). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension (Dallas, Tex. : 1979). Retrieved August 1, 2022, from https://pubmed.ncbi.nlm.nih.gov/32370572/
Metoprolol is selective for which adrenoceptor? ( pharmacodynamics)
What effects do agents such as metoprolol have on the cardiovascular system? ( pharmacodynamics)
In which organ is metoprolol primarily metabolized? (Pharmacokinetics)
Why would a provider be cautious when ordering a Beta Blocker in a patient with Asthma?
