In the beginning Chucks DX were hypercholesterolemia, stage I hypertension and his risk for heart disease was significant. At that time I would have recommended the following medications: 1) Red Yeast Rice capsules (1 po qd to help decrease his cholesterol level, 2) Omega 3 Fish Oil 3 gms/day to help lower his blood pressure, reduce triglyceride level, slow the development of plaque in the arteries & reduce the likelihood of heart attack or stroke. My rationale behind this is these herbs are way less expensive and at this stage in his disease process I believe coupled with the modification of his lifestyle including diet, exercise, stress level and tobacco intake it would have been an effective way to maintain a healthy lifestyle and significantly lower his risk for heart disease. Teaching would include diet modification to decrease his cholesterol to 300mg/day. Reduce Saturated Fats to less than 7% of total intake, encourage him to drink a glass of red wine a day, increase his daily fiber intake and also increase his sterol intake which is found in green leafy vegetables and other plants. Aerobic exercise 3x's/wk, weight control, eliminate tobacco if applicable, and minimize stress. Pricing for meds: 60 caps of Red Yeast Rice is available for around $15 according to the woman on Tegrity. Lol. Omega 3 Fish Oil can be found online at vitaminshoppe.com for $36.93. That's (180) 1000 mg soft gels or a 3 mth supply.
By the end of the lectures Chuck appears to be in bad shape. He's had a recent MI, CHF, CAD, Angina, Stage II Hypertension, Atrial Fibrillation, Dyslipidemia, Decreased Peripheral Vascular Resistance, and Hypercholesterolemia. At this stage in his disease process I would prescribe the following: 1) Enteric Coated Low Dose Baby Aspirin 81mg PO QD
2) Propranolol hydrochloride 180mg PO QID
3) Simvastatin 40mg PO QD in AM
4) Plavix 75mg PO QD
5) Spironolactone 100mg PO QD with breakfast.
Rationalization: ASA decreases risk of MI, treats...
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