History of Present Illness
FR is a 67-year-old Hispanic male who presents to see the cardiologist, Dr. B, for a follow-up visit. FR was last seen in clinic on 1/20/12, at which time the simvastatin dose was increased to 80 mg daily to better control his dyslipidemia. The patient has no new complaints today and states that he is feeling "great." FR requests refills on his medications. You are the newly hired PharmD in this clinic, and the cardiologist asks your opinion regarding this patient's case.
Past Medical History
Type 2 diabetes mellitus × 4 years
Hypertension × 6 years
Dyslipidemia × 2 years
Constipation
Medication List
Lantus 10 units QHS (started 3/18/11)
Glipizide XL 7.5 mg (started 9/24/10)
ASA 81 mg (started 9/24/10)
Lisinopril 10 mg (started 7/22/09)
Hydrochlorothiazide 12.5 mg (started 7/12/11)
Simvastatin 80 mg (started 1/20/12)
Docusate 100 mg PRN (started 2/15/08)
Allergies
No known drug allergies
Family and Social History
Father died at age 82 from myocardial infarction
Mother died at age 61; medical history unknown
Patient is married with two children
Denies current alcohol and tobacco use
Fasting lipid profile rechecked today at 8 AM
Total cholesterol: 248 mg/dL
Triglycerides: 320 mg/dL
HDL: 66 mg/dL
LDL: 143 mg/dL
Liver function tests from 8/11/11 are within normal limits.
Vital Signs
BP: 124/76, P: 89, RR: 18, T: 37.2°C,
Wt: 94 kg, Ht: 5'8"
What is your recommendation for Dr. B regarding this patient's dyslipidemia management?
Anna Markel Vaysman, PharmD, BCPS
Clinical Pharmacist, Clinical Assistant Professor
College of Pharmacy
University of Illinois at Chicago
Chicago, Illinois
Case taken from:http://www.uspharmacist.com/case_study
FR is a 67-year-old Hispanic male who presents to see the cardiologist, Dr. B, for a follow-up visit. FR was last seen in clinic on 1/20/12, at which time the simvastatin dose was increased to 80 mg daily to better control his dyslipidemia. The patient has no new complaints today and states that he is feeling "great." FR requests refills on his medications. You are the newly hired PharmD in this clinic, and the cardiologist asks your opinion regarding this patient's case.
Past Medical History
Type 2 diabetes mellitus × 4 years
Hypertension × 6 years
Dyslipidemia × 2 years
Constipation
Medication List
Lantus 10 units QHS (started 3/18/11)
Glipizide XL 7.5 mg (started 9/24/10)
ASA 81 mg (started 9/24/10)
Lisinopril 10 mg (started 7/22/09)
Hydrochlorothiazide 12.5 mg (started 7/12/11)
Simvastatin 80 mg (started 1/20/12)
Docusate 100 mg PRN (started 2/15/08)
Allergies
No known drug allergies
Family and Social History
Father died at age 82 from myocardial infarction
Mother died at age 61; medical history unknown
Patient is married with two children
Denies current alcohol and tobacco use
Fasting lipid profile rechecked today at 8 AM
Total cholesterol: 248 mg/dL
Triglycerides: 320 mg/dL
HDL: 66 mg/dL
LDL: 143 mg/dL
Liver function tests from 8/11/11 are within normal limits.
Vital Signs
BP: 124/76, P: 89, RR: 18, T: 37.2°C,
Wt: 94 kg, Ht: 5'8"
What is your recommendation for Dr. B regarding this patient's dyslipidemia management?
Anna Markel Vaysman, PharmD, BCPS
Clinical Pharmacist, Clinical Assistant Professor
College of Pharmacy
University of Illinois at Chicago
Chicago, Illinois
Case taken from:http://www.uspharmacist.com/case_study