THERAPEUTICS 1 CASE PRESENTATION HYPERLIPIDEMIA WITH HYPERTENSION Scenario

THERAPEUTICS -1 CASE PRESENTATION

HYPERLIPIDEMIA WITH HYPERTENSION

• Scenario: Here is a 5 o years old female patient hospitalized for four days. • Chief complaints: c/o chest pain since 2 hours. • History of present illness: The patient was apparently alright 2 hours back but developed chest pain, which is non radiating, not associated with sweating. • Past medical history: k/c/o hypertension since 2 years.

• Personal history: Smoking for past 15 years. • Family history: Father- MI LABORATORY DATA: DATE B. P. LIPID PROFILE: Cholestetrol 254 VLDL 64. 6 LDL 157 TGS 323 P. R. 1|3 150/100 90 2|3 140/90 78 3|3 140/80 74 4|3 120/80 76

SOAP NOTE SUBJECTIVE: Here is a female patient present with complaint of chest pain since 2 hours. OBJECTIVE: BP- increased- due to hypertension. CHOLESTEROL- INCREASED VLDL, LDL , TGS are increased and thus these indicate hyperlipidemia. Echocardiograph : shows mild concentric left ventricular hypertrophy.

Assessment: Chest pain: This occurs due to reduced blood supply to the heart and thus this leads to chest pain. Hyperlipidemia: It is an elevation in one or more of the following: cholesterol, cholesterol esters, phospholipids or triglycerides. This results in predisposition in the coronary artery.

• STANDARD THERAPY: PROBLEM GOALS OF TREATMENT Hyperlipidemia • To lower LDL and Cholesterol. DRUGS AND MOA • HMG-COAREDUCTASE: They inhibit conversion of HMG-COA to mevalonate. • Reduce risk of They also reduce synthesis recurrent events such of LDL and enhance as MI and angina, catebolism. ischemic heart disease. • BILE ACID RESINS: They bind to bile acids in the intestinal lumen and stimulate hepatic syntesis of bile acid from cholesterol. • FIBRIC ACID DERIVATIVES: Reduce synthesis of VLDL DOSAGE Atorvastatin 10 mg Rosuvastatin 5 -10 mg Cholestyramine 8 mg TID Colestipol 10 mg. BID Fenofibrate 54 -67 mg