Session #1

D.S. is a 65-year-old white woman, who implemented lifestyle modifications for her dyslipidemia 6 months prior to her follow-up clinic visit last December. She has a Hx of gout, chronic nonischemic HF (LVEF 28%), and diabetes (diet controlled) as well as a 20 pack-year smoking history (quit 5 years ago).
Her medications included lisinopril, furosemide, metoprolol succinate 25 mg Once Daily.

Her vital signs included BP 124/80 mm Hg, and HR 75 beats/minute. Her laboratory results were as follows: HDL-C 64 mg/dL, LDL-C 101 mg/dL, TG 98 mg/dL, and TC 185 mg/dL.

Discuss the appropriate next step for pharmacologic management of D.S’. dyslipidemia, along with pharmacologic agents for her comorbidities.

• Please briefly justify/explain your choice/s of pharmacologic agent/s (Please include the complete regimen).

 

Today (4/7/2020), four months later, D.S. is admitted to the hospital with atrial fibrillation, which she said began 1 week ago “occurring off and on several times daily”. On physical examination, she was found to have rales; her extremities have 2+ pitting edema. ECG showed a ventricular heart rate of 140 beats/min.

Discuss the pharmacologic management of A. Fib, along with pharmacologic agents for her comorbidities.

• Please briefly justify/explain your choice of pharmacologic agent/s (Please include the complete regimen).