Drug Therapy for 76-Year-Old Man - Case Study Example

? Graded Discussion-Case Study 76-Year-Old Man Hypertension describes high blood pressure in the body that is beyond the recommended healthy levels in the body. This condition of the body is a chronic elevation of the arterial blood pressure, which forces the heart to work extra hard to circulate blood through the body. Normal blood pressure exists within the ranges of 100-140mmHg which is the systolic top reading and 60-90mmHg for the diastole bottom reading. High blood pressure is characterized by consistent and persistent readings at or above 140/90mmHg. Asthma is a chronic disease that is characterized by panting or wheezing due to protracted inflammation f the airways. Bronchospasm and reversible airflow are the common symptoms characterized by coughing, shortness of breath and wheezing. Asthma is caused by both genetic and environmental factors like genetically being allergic to certain substances and environmental allergens like pollen that trigger asthmatic attacks. Glycaemia is a term used to describe impaired fasting glucose levels in the blood stream, which means that there are elevated levels of glucose in the blood stream during starvation. Glycaemia is the condition where the fasting blood glucose levels are elevated but do not qualify to be termed as diabetes mellitus thus, the term pre-diabetes is used. This paper is a graded discussion of a case study of 76-year-old man with the above-mentioned conditions. The 76-year-old man has a blood sugar of 13mmol/L during routine blood test, hypertension and asthma. His medications include atenolol 50mg daily and Flixotide (fluticasone) 250mcg and Vetolin (salbutamol) 100mcg prn. His BMI is 21Kg/m? and hid creatinine is 0.11 mmol/L. Research studies have established that high blood pressure is a primary result of poor glycemic control in insulin dependent diabetes (Brands & Hopkins, 1996). This aspect could be attributed to the man’s hypertensive nature due to his elevated levels of fasting glucose, which stands at 13mmol/L way above the recommended American Diabetes Association (ADA) standards of 5.6mmol/L to 6.9mmol/L (Tracy & Clegg, 2007). The old man is experiencing kidney problems because of the creatinine levels in his blood, which is abnormally high, an indication of renal trouble. The old man’s glycaemia could be due to other factors other than insulin related diabetes, and in this case, his medication could be a probable cause. This is because it is an established fact that taking steroids to treat rheumatoid arthritis or asthma can cause a temporary increase in blood glucose levels. Albuterol is a key ingredient in Ventolin that is used as an inhaler, which acts as a vasodilator of airways during pulmonary constrictions (McNamee & Cruickshank, 2012). Ventolin effects blood sugar, inhaled has little effect, his GFR (glomeruli filtration rate) is 60ml/min/1.73m? (110 micro mol/l) this shows renal failure. The recommended GFR for individuals over the age of 70 years is 75 mL/min/1.73 m?. GFR is calculated by using creatinine methods calibrated to be isotope mass spectrometry (IDMS) traceable (National Kidney Disease Education Program, 2013). The IDMS-traceable version of the Modification of Diet in Renal Disease (MDRD) study equation is used as a conversion for creatinine levels in a patient’s blood serum. This medication is not recommended for individuals with hypertension and diabetes patients because it affects both by altering blood pressure and glucose levels in the body (Wai et al, 2012). It increases blood pressure and the levels of circulating blood glucose by interfering with the actions of insulin. Atenolol is excreted via kidneys some effects on atenolol clearance normal range is 100-150ml/min/1.73m2. Atenolol has increase in airway resistance and may occur in asthmatic patients. Pharmacotherapy treatment of glycaemia in the old man with asthma and hypertension should be based on the careful consideration of all the pre-existing conditions (Schwanstecher, 2011). This is to ensure that all pharmaceuticals used work to improve the overall health of the patient with minimum exacerbation of existing conditions or the introduction of new ones (Marinangeli & Jones, 2010). Metformin SHOULD NOT be used because his renal clearance is Read More