CASE ST'UDY
5
HYPERTENSION
PATIENT CASE
HPI
B.W. is a 40-year-old African American male, who has had difficulty controlling his HTN lately. He is visiting his primary care provider for a thorough physical examination and to renew a prescription to continue his blood pressure medication.
PMH
.. .. .. ..
II
Chronic sinus infections Hypertension for approximately 11 years Pneumonia 6 years ago that resolved with antibiotic therapy One major episode of major depressive illness caused by the suicide of his wife of 15 years, 5 years ago No surgeries
FH
., .. .. " Father died at age 4Q P:~ JtMI; had HTN Mother has DM and HTN Brother died at age 20 from complications of CF Two younger sisters are A&W
SH
The patient is a widower and lives alone. He has a 15-year-old son who lives with a mater nal aunt. He has not spoken with his son for four years. The patient is an air traffic con troller at the local airport. He smoked cigarettes for approximately 10 years but stopped smoking when he was diagnosed with HTN. He drinks "several beers every evening to relax"
and does not pay particular attention to the sodium, fat, or carbohydrate content of the foods that he eats. He admits to "salting almost everything he eats, sometimes even before tasting it." He denies ever having dieted. He takes an occasional walk but has no regular daily exercise program.
Patient Case Question 1. Identify six risk factors for hypertension in this patient's history.
Meds
" Hydrochlorothiazide 50 mg po OD .. Pseudoephedrine hydrochloride 60 mg po q6h PRN .. Beclomethasone dipropionate 1 spray into each nostril q6h PRN
Patient Case Question 2. Why is the patient taking hydrochlorothiazide and what is the primary pharmacologic mechanism of action of the drug? Patient Case Question 3. Why is the patient taking pseudoephedrine hydrochloride and what is the primary pharmacologic mechanism of action of the drug? Patient Case Question 4. Why is the patient...
