Replies for peers. Need ONE Response Per Each Discussion Total 2 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion

Juana Rosa Izquierdo

Based on the condition of the patient, Lipitor 10 mg/ once daily will be prescribed to the patient to prevent the risk of primary Arteriosclerotic Cardiovascular Disease. Statins lower the level of bad cholesterol or LDL in the body. The effectiveness of Statins has been proven by research. It reduces fatal and nonfatal coronary heart disease. Evidence also shows that Statins also reduce the risk of mortality by 14 percent (Karmali, et al, 2016). Lipitor is a synthetic lipid-lowering drug. Atorvastatin inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. The conversion of HMG-CoA to mevalonate is catalyzed by this enzyme. This process limits cholesterol biosynthesis (Lipitor (Atorvastatin Calcium). She should continue to take Tylenol for arthritis pain. 

The patient has a history of MI. Patient’s father and brother also suffered from MI. It implies that the condition is genetic. Studies have demonstrated the Statins help in the long-term management of MI. Therefore, no other medication needs to be prescribed (McCoy, et al, 2013). 

References:

Karmali, K. N., Lloyd-Jones, D. M., Berendsen, M. A., Goff, D. C., Jr, Sanghavi, D. M., Brown, N. C., Korenovska, L., & Huffman, M. D. (2016). Drugs for Primary Prevention of Atherosclerotic Cardiovascular Disease: An Overview of Systematic Reviews. JAMA cardiology, 1(3), 341–349. https://doi.org/10.1001/jamacardio.2016.0218

Lipitor (Atorvastatin Calcium). (n.d). Lipitor (Atorvastatin Calcium)_ Uses, Dosage, Side Effects, Interactions, Warning. https://www.rxlist.com/lipitor-drug.htm#description

McCoy, S. S., Crowson, C. S., Maradit-Kremers, H., Therneau, T. M., Roger, V. L., Matteson, E. L., & Gabriel, S. E. (2013). Longterm outcomes and treatment after myocardial infarction in patients with rheumatoid arthritis. The Journal of rheumatology, 40(5), 605–610. https://doi.org/10.3899/jrheum.120941

Tatiana Davalos Sarria

 

Medications this Patient should be Prescribed

           Several possibilities among the current medications used in congestive heart failure (CHF) exist including angiotensin-converting enzyme inhibitors (ACEs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRA), and angiotensin receptor–neprilysin inhibitors (ARNI). In a head-to-head study of these various types of medications, Burnett, et al. (2017) of Circulation: Heart Failure, a journal of the American Heart Association, found that ARNIs in conjunction with β-blockers and MRAs or ACEs plus β-blockers and MRAs are the most effective treatment combinations for reducing all-cause mortality in people with CHF (Burnett et al., 2017). Common ARNIs include Entresto and sacubitril/valsartan. Common β-blockers are atenolol, bisoprolol, metoprolol, and propranolol. Common MRAs include spironolactone and eplerenone. ACEs include benazepril, captopril, enalapril, fosinopril, lisinopril, and quinapril. Some combination that fits the two possibilities recommended should be prescribed for this patient (Burnett et al.,2017).

           Some disagree with this combination, who say that after an MI, a patient with CHF should be treated with reperfusion and ACEs and MRAs and not the β-blockers until after the CHF has been resolved (Bahit et al., 2018). Since this patients MI was a year ago, the CHF has probably developed because of that especially if she has not been taking her medications as prescribed.

Does the Patient Need Medication(s) Based on her History?

The patient definitely needs medications. Malik, et al. (2021) of Stat Pearls explains that a person with CHF has decreased functional capacity, and this patient is no exception. She also has an increased mortality risk. Medications would improve her quality of life and should be prescribed for that reason alone. She also needs to be educated about her disease and the medications that are prescribed for her (Malik et al., 2021). The medications will make her more comfortable and give her more time to live. 

        References

Bahit, M., Kochar, A., & Granger, C. (2018). Post-Myocardial Infarction Heart Failure. JACC: Journal of the American College of Cardiology, 6(3), 179-186. Retrieved from https://reader.elsevier.com/reader/sd/pii/S2213177917306789

Burnett, H., Early, A., Voors, A., Senni, M., MacMurray, J., Deschaseaux, C., & Cope, S. (2017). Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction: A Network Meta-Analysis. Circulation: Heart Failure, 10(1), 1-13. Retrieved from https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.116.003529

Malik, A., Brito, D., & Chhabra, L. (2021). Congestive Heart Failure;. Treasure Island: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430873/#article-22661.s4