Lucy is a 32 year old patient who comes to your medical clinic for primary care. She is on hormonal contraceptives for years, even though she's just been married and has stopped her medication in hopes of her becoming pregnant. Her primary medical history includes hypertension that was diagnosed 3 years ago, familial hypercholesterolemia, PCOS, and obesity. She is currently on the following meds: Metformin 2000 mg every day, Lisinopril 10 mg PO daily, rosuvastatin 5 mg PO daily, and a multivitamin tablet.
Her friend Gerry is an 82-year-old patient and is taking 2 mg of terazosin for BPH comes in complaining of dizziness and generalized muscle weakness and persistent LUTS.
What would you recommend and how should you advise these patients and manage her medications? What was the process you went through to assess her current medications and to recommend an updated regimen? Minimum 150 words APA (If you need to take three questions away from me for this one that is fine.) Thank you
1.Recommendations to Luci
Luci is suffering from multiple health disorders like PCOS, Hypertension, Hyperlipidemia.So her health is in a complex state.even though she is taking medicines for each of these health disorders .I would recommend her to moddify her daily routine by incorporating exercise,healthy diet,reduced stress,8 hours of sleep which will regularise iher hormones and will treat her better .
Luci should focus her diet on whole food other than processed foods.PCOS is caused by reduced insulin sensitivity which causes higher blood sugar levels and hunger craving which results in binge eating and obesity.so a recommended calorie intake of 1200 to 1400 kcal should be followed consisting of fresh fruits, Vegetables,whole grains,meat.She should focus on low carbohydrates high protein diet.She should also avoid fats instead snack on nuts which are a source for omega fat she should also avoid canned food,pickles which contains increased sodium now since she has stopped contraceptive pills in a hope of conception.i would recommend her go through clomid cycles along with metmorphin .clomid with metmorphin combined is known to increase the fertility rates .clomid will help in ovulation induction and get good quality eggs.Luci should also spend around 30 minutes for moderate to intense exercise regimen or a simple brisk walk for 40 minitues will be enough to burn enough calories which will help maintain a normal cholesterol levels.All these life style changes will help Luci to have a healthy life
2.Recomendation for Gerry
Gerry is suffering from benign prostate hypertrophy which is a condition occuring in older men when the prostate gland enlarges causing restricted urine flow,abdomen pain,urinary tract infection.Terazosin is the medication of choice it acts by relaxing the blood vessels of prostate this reduces the size thus ease symptoms.gerry complains of dizziness this is because if the drug terazosin which causes sudden drop in blood pressure leading to dizziness.so I would recommend Gerry to take tablet only at bedtime.Advise not to keep bladder full for long time which increases the discomfort.advise to void after 2-3 hours.advise to avoid alcohol which will cause discomfort for bladder and to a kid liquids just before or one hour before bedtime this will reduce the urge to washroom in the midnight.this can help Gerry to have a peaceful sleep .
I went through a detailed history,past present medical history,family history for various disease.
Medication history asked them the frequency and timing of each drug.
Physical assessment.
All these methods helped me to assess the medication history
Lucy is a 32 year old patient who comes to your medical clinic for primary care....
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