Lisinopril Case Study

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1. The 48 years old Native American women presenting to the Indian Hospital is taking Lisinopril because of hypertension as one of the conditions documented in her past medical history. Hypertension is supported by the current measurements of the blood pressure readings of 165/100. Lisinopril is an angiotensin –converting enzyme inhibitor (ACE) considered as one of the first line treatment option for hypertension. The pharmacological mechanism of action for Lisinopril is to inhibit the action of angiotensin- converting enzyme by preventing conversion of angiotensin I to angiotensin II which will result in decreased vasoconstriction of the vessels and water reabsorption. More than that Lisinopril will prevent the bradykinin to breakdown …show more content…
This patient is taking acetaminophen with hydrocodone in order to relief the pain caused by the osteoarthritis. Hydrocodone is an opioid that acts on the central nervous system and smooth muscle and help with the pain relief in the joints. In contrast analgesic effect of acetaminophen implies the peripheral nerves system. ( NIH,2015). Both components act in reducing the patient’s moderate to severe pain involving hands and knees.
3. The patient in this case study is taking omeprazole for a presumably gastrointestinal reflux disease (GERD). Omeprazole is a proton pump inhibitor producing a decrease in the gastric acid secretion, therefore it is used as first treatment option in the gastrointestinal reflux disease( May and Rao,2014)
4. It would be reasonable to suspect that constipation in this patient’s case is induced by the aosteoarthritis therapy and anticholinergic effect of loratadine used for the treatment of seasonal allergic rhinitis. Moreover, constipation is also association with diabetes mellitus type II with neuropathy and the signs of dehydration (Fabel and Shealy,2014).Docusate is a stool softener and it is used by this patient for the treatment of constipation, condition highlighted in her past medical
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Loratidine is an H1 histamine antagonist drug used by this patient to relief the symptoms of the seasonal allergic rhinitis that the patient is suffering for almost 28 years (AAAAI,2015).
6. The blood pressure of 165/100 and the weight of 203lbs are the two clinical signs that arouse most concerns for this patient. According to the Joint National Committee a patient with a blood pressure above 160/100 it is classified as stage 2 hypertension, presenting an increased risk for complications like myocardial infarction and stroke. Moreover, weight of 203 lbs with a height of 63 inches is a risk factor not only for the hypertension but also for diabetes mellitus type II ( James et al.,2014).
7. Upon completion of the physical examination it is evident that the two bruits auscultated in the neck and abdomen reveal a blood flow disturbances more at the carotid than abdomen level which could relate to the stenosis of that vessel as result of atherosclerosis (Kurtz,1990). Atherosclerosis can be explained by the patients increased serum lipids and the consumption of a diet rich in fats. A closer examination by ultrasound or imaging it is recommended to confirm a possible stenosis or other structural

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