Need ONE Response for the Discussion One Reference

Neida

Case Study

Q1: According to the ACC/AHA guidelines, what medications should this patient be prescribed?

           Atherosclerotic cardiovascular disease is a non-communicable disease that is mainly caused by lipid disorders such as cholesterol. The goal of the medication is to reduce morbidity and prevent complications related to Atherosclerotic cardiovascular disease. Pharmacotherapy aims to prevent and treat further complications in the patient through treatment of secondary diagnosis, which is atherosclerosis and osteoarthritis, and the risk factor controls that include the treatment of hypertension (Hadaegh, Asgari, Moosaie, Orangi, Sarvghadi, Khalili, & Azizi, 2021). As a future FNP, the medications that would be recommended to the patient would be statins and cholesterol medications that would lower the patient's low-density lipoprotein cholesterol, which is referred to as the bad cholesterol, and reverse the build-up of fatty deposits in the arteries of the patient. Statins would be recommended to the patient to lower the cholesterol levels and improve his artery health and prevent further progression of atherosclerosis. The most common and available cholesterol absorption inhibitor approved by the FDA is ezetimibe (Arnett, Blumenthal, Albert, Buroker, Goldberger, Hahn & Ziaeian, 2019). The patient would also be recommended another medication along with the cholesterol medication, such as simvastatin. The patient can also be recommended blood thinners such as aspirin to reduce the risk of platelets clumping in them narrowed arteries and form clots which can be grave to the patient due to further blockage of the arteries. As a future FNP, I would recommend apixaban. I would also recommend the patient with blood pressure medication to lower her hypertension which would reverse the arteriosclerosis and prevent further complications that are related to Atherosclerotic cardiovascular disease. Some of the blood pressure medications that can be recommended to the patient include ACE inhibitors such as lisinopril.

Q2: Does he need medication(s) given his history of MI?

           Given his history of myocardial infarction, he needs the medication. This is because MI is the culmination of a long and complex process that results in the formation of occlusive thrombus within coronary arteries resulting in cardiac ischemia and infarction since atherosclerosis is the primary underlying condition that begins in adulthood and is caused by lipid-related conditions that causes in the arterial wall and inflammation (Palasubramaniam, Wang & Peter, 2019). As the progression of atherosclerosis continues, the lipid plaques would eventually evolve to more unable phenotypes, which would cause a greater degree of inflammation on the arteries. The plaques will eventually rupture, causing blood contact with the subendothelial matrix causing occlusive thrombi. The prevalence and cycle of the events when the patient does not take medication would result in myocardial infarction coupled with angina pectoris and eventually cause cardiac impairment and function. Hence the patient would need the medication considering the history that he had experienced myocardial infarction previously. Considering that the patient had Left Anterior Descending (LAD) cardiac stent placement the patient there is a need for optimal management of myocardial infarction by focusing on the improvement of cardiac health. The patient should therefore be administered aspirin at a dosage of 162 mg-325 mg daily, and the medication continued at a dosage of 162 mg when there are no signs of MI (Mercado, Smith & Mcconnon, 2013). The patient should also be given clopidogrel, maintenance dosage 75 mg taken once per day, in combination with aspirin for the next six months for the prevention of bare-metal stents. The patient should also be given ACE inhibitors considering that she had a cardiac stent in the last twelve months, further Lasix 20 mg daily helps with diuretic effect.