Jorge did not have any constipation episodes this year. He experienced one episode of diarrhea on 6/8/17 that required the administrator of Immodium 2 mg cap PO once; Miralax was held, then restarted on 09/25/17. NO other GI related symptoms were reported or documented. His bowel elimination at present being treated with Miralax 17 gram orally, High fiber diet, and 2 tbsp. Ground Flaxseeds mixed with food at lunch. Jorge’s last lipid panel test shoed ↓Cholesterol 78 L [112-200] and ↓HDL 35 [>39]. He is currently taking Lovaza 2 gram oral cap twice a day for Dyslipidemia and a statin Lipitor 10 mg PO tab daily at bedtime for ↑ASCVD risk (Atherosclerotic Cardiovascular Disease). His last EKG on 7/20/17 indicated NRS with no acute changes, QTC
Read the posted case study about Benita Vasquez and discuss the following questions: 1. What are the clinical causes of death in the story? a. Senora Vasquez died because of uncontrolled diabetes, Infected wound and diffusing kidneys. With not well-controlled diabetes and acquiring an infected burn wound makes it harder for the patient to get treatment. Thus with the condition of the patient and her current social status, she is unable to afford the treatment and medications needed to alleviate her suffering.
A 46-year-old Hispanic man presented to the clinic for a routine physical and a review of his recent laboratory studies. His medical history was significant for high cholesterol. His daily medication regimen included a multivitamin, aspirin 81 mg, and simvastatin (Zocor) 40 mg for high cholesterol. His family history was remarkable for type 2 diabetes, hypertension, and hyperlipidemia in his mother, maternal grandmother, maternal aunt, and maternal uncle. Physical examination revealed a height of 69 inches, weight of 199 pounds, body mass index (BMI) of 29.4 kg/m2, waist circumference of 36 inches and blood pressure of 125/72 mm Hg. Initial laboratory results were: total cholesterol 195 mg/dL; triglycerides 136 mg/dL; low-density lipoprotein cholesterol (LDL), 124 mg/dL; high-density lipoprotein cholesterol (HDL), 44 mg/dL; and fasting plasma glucose (FPG), 119 mg/dL. Complete blood count, renal function and liver function tests were all normal. Additional studies included an oral glucose tolerance test (OGTT) of 157 mg/dL and hemoglobin A1c (HbA1c) of 5.9%. The patient’s physical exam was unremarkable with no abnormalities noted.
According to my Diet Analysis my cholesterol intake was over by 148.44 mg when compared to recommend of less than 300mg per
CAD is a leading cause of morbidity and mortality throughout the worldwide. The prevalence of biological and metabolic risk factors were also found to be high in development of coronary artery disease. Patients with hypercholesterolemia are at increased risk to experience cardiovascular events and to die from vascular disease [2]. .Statins, among the most commonly prescribed drugs worldwide, are cholesterol let downing agents used to manage cardiovascular and coronary heart diseases and to treat hypercholesterolemia. Statin’s therapy ...
1) Coronary Artery Disease (CAD)/Coronary Heart Disease (CHD): In the United States, CAD accounts for one death every minute making it a leading cause of death (Kones, 2011). Individuals at risk for CAD include those with modifiable and non-modifiable risk factors. Non-modifiable risk factors for CAD include: age, race, family history. Modifiable risk factors include: hypertension, obesity, smoking, hyperlipidemia, diabetes, and minimal to no physical exercise. If untreated, CAD can lead to heart failure (Kones, 2011). Individuals with CAD may present to their primary care providers with symptoms such as: angina, shortness of breath, indigestion/heartburn, and dyspnea on exertion. Individuals develop CAD when plaque obstructs the coronary arteries
If symptoms are mild then they may not require specific treatment as the symptoms can clear up by itself. Certain foods may trigger diarrhoea and bloating. They should be given lifestyle and dietary advice. They should be advised to drink plenty of fluids and eat small amounts of food throughout the day. Patients should avoid high fibre foods such as bran, beans and nuts. They may also limit their intake of milk products if they are lactose intolerant. Finally they should avoi...
Being presented with the problems in the implementation of the SAP ERP system, it is evident that Novartis Pharmaceuticals requires a comprehensive action plan that resolves key issues and the underlying problem. Refer to Exhibit A for a graphical representation of the action plan.
Lipid altering drugs include several classes of medications each of which have their own mechanism of action. Statins inhibit HMG CoA reductase (hydroxymethylglutaryl CoA reductase), which is the rate-limiting enzyme for the production of cholesterol in the liver. Statins competitively inhibit this enzyme and induce an increased expression of LDL receptors in the liver. Which in turn increases the uptake catabolism of serum LDL into the liver resulting in decreased serum cholesterol level. This reduction in serum LDL and cholesterol levels has resulted in reduction of 10-year CHD and stroke risk. Pitavastatin was approved in Japan since 2003 and was granted FDA approval in 2009 and is marketed under the name of Livalo. Several phase III and IV trials have shown that Pitavastatin is both safe and efficacious in lowering both serum LDL and Triglycerides (TG) by 29.1% and 22.7% respectively from baseline levels which was significant. These studies showed that only 10% of Pitavastatin treated patients had adverse events (AE) in which 84% of these events were mild and about 1% were serious adverse events (SAE)6, 12, 14, 16-26, 28-31. Atorvastatin is the most commonly used statin in clinical practice; the F...
Whether it is Lipitor being used to lower cholesterol or aspirin to lower blood pressure, until the present, cardiovascular and heart diseases have been tackled by a variety of medications that address its various risk factors. However, this strategy focuses on secondary and tertiary prevention instead of heart diseases’ underlying causes. Yes, diabetes mellitus and hypertension have a concrete proven link to heart disease, but addressing them with medication only masks them and does not address the root of the problem.
(Novo 2012) In 2005, it was found that CVDs are responsible for the deaths of more than 17 million people each year, almost a third of total mortality rates, reported by the World Health Organisation (1, 2). The majority of these deaths were strongly related to Coronary Artery Disease of approximately 7.6 million. However, in the latter 15 years mortality rates in relation to CVD’s have significantly reduced according to age in develo...
Liao, J. K., (2007). Safety and efficacy of statins in Asians. American Journal of Cardiology, 99(3), 410-414. doi: 10.1016/j.amjcard.2006.08.051
It can be prevented naturally by practicing vegetarianism which refers to those who practice a diet low in meat and fish or may not consume meat products at all. Vegetarianism diet offers an advantage because people who practice or change their lifestyle to no meat consumption have lower body mass index (BMI), and can reverse the effects of atherosclerosis. (reducing, 2010). However, people have to be careful while practicing it because a poorly vegetarian diet can cause anemia, fatigue, decreased zinc, decreased vitamin C. Also it can decrease B12 and this may cause neural tube defects, congenital heart defects, dementia, and Alzheimer’s disease. It is very important to educate vegetarians to have a vitamin B supplementation to prevent another type of conditions. (reducing, 2010). There is another way to prevent or reverse heart disease by consuming seven heart nutrients which are fiber, fish oil, magnesium, vitamin D, vitamin K, zinc, and COQ10. Also, there are statin drugs such as Crestor (rosuvastatin) and Lipitor (atorvastatin) that are being prescribe to cholesterol-lowering but there is a concern about their safety and effectiveness. There is an alternative to these types of drugs. The statin alternatives are Niacin (B3) known to be effective in lowering blood cholesterol and triglyceride levels, and citrus flavones that work blocking the enzymes in the liver
Currently, John Martin is at high risk for a heart attack within the next 10 years. His blood pressure is high, HDL is low, and he is a smoker. While it has been determined that Mr. Martin does not have metabolic syndrome, it is imperative that he make the following changes in order to ensure a long, healthy life.
Six moths ago I scheduled a physical and blood work, a month later I was diagnosed with high cholesterol. My total cholesterol levels were at 250, with and LDL of 150, which puts me at a higher risk of cardiovascular illness. I was given the option of changing my eating habits with a combination of exercise to manage and lower my cholesterol levels, thus avoiding the need for medication. The dr. was very supportive, he had many helpful suggestions and showed me several ways in which I could lower my cholesterol by making simple food choices. After a long discussion I decided this was the way to go, I hate taking medication. When I reviewed the analysis report and saw that my cholesterol continues to be above the recommended range I let out a huge sigh, it took a few seconds to compose myself before I continued to look over it. This whole time I thought I had maintained my cholesterol under control, the analysis report proved that I was wrong. It is important that I make changes on how I eat. High cholesterol is indicative of cardiovascular illnesses that possibly result in serious chronic diseases. Diseases that are linked to high cholesterol are Coronary heart disease, peripheral vascular disease, diabetes and high blood pressure. The main risk from cholesterol is heart attacks. If the cholesterol remains high, it can build up overtime in the walls of the arteries forming a build up known as plaque. This plaque will cause the arteries
A healthy 64-year-old male was seen at the College of Southern Nevada’s Dental Hygiene Clinic on April 13, 2016 for a health history assessment, vitals and screening. The patient stated he was “feeling good.” The major reason for his coming to the clinic is to get a cleaning. His last dental visit was in 2014, and his last doctor visit was in March of 2016. He has no health problems and no allergies. He drinks one beer a day. He stated that he has one dental implant since 2000, although, no implants are present in his mouth. He is currently taking the following medications: a multivitamin, Omega 3, flaxseed oil, Aspirin, and coenzyme Q10. The patients vital signs are as follows: BPRA 116/74 mmHg, RCP 60 BPM, and R 14 RPM. The patient was classified as an ASA II and is case typed as