Joycelyn Echano

Case digest

1. is the class of drug assigned to your group the best drug to start on the patient and why

- no,

2. if yes, give the best drug and dose, if no, explain why

a. consider iv nitrates such as isoket drip or nitroglyecerin drip if available, as initial therapy for the
admitted patient, (with titration)to reach the goal bp of less than 140/100

-----insert source from jinesh

b. iv beta blockers can also be considered as initial theraphy

https://onlinelibrary.wiley.com/doi/10.1111/jch.14335?
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3. give a brief summary of your management of the case

Problem

1. ACS
2. HPN
3. DM
4. CHEST PAIN
5. IN DISTRESS

Management

Admission;

DIET- NPO for now until stable

IVF- PLR

Diagnostics- 12lead ecg stat, cbc, urinalysis, trop I, cxr, cbg, fbs and lipid profile( if stable)

Treatment- insert IFC (to prevent valsalva when urinating)

02 via nasal cannula since patient is in distress

Start ACS regimen

Start antidiabetic drugs such as metformin, also depends on the lab results

Complete bed rest without bathroom privileges

WOF persistentchest pain, decrease sensorium, DOB

Refer PRN

*if target bp is reach, discontinue isoket drip and shift to oral bet blockers like metoprolol

*if patient is for discharge, start combination theraphy with monopill such as-ace/arb plus beta blocker
(d ko alam if merong monopill neto, pharmacist pls help hahahaha) or ace/arb plus ccb like amlife
( amlodipine +losartan) 5/50 OD,

* continue antidiabetic drug such as metformin

*continue acs regimen drugs

*health teaching about lifestyle modification

1. smoking cessation

2. control blood glucose and lipids

3. reduce sodium intake to no more than 2,400 mg/day

4. encourage physical activity