Thiazide Case Study

Life expectancy has grown over the last 100 years. This leads to a variety of health issues and problems that affect these elder generations quality of life. According to the United States CDC, one in three American adults suffers from hypertension. With so many Americans having high blood pressure it is no surprise that hypertension is one of the most dangerous conditions, leading to death, in the elderly. Doctors often skip directly to subscription, medications to help control elevated blood pressures, but other problems can arise from these medications, like dementia. The earlier the hypertension is diagnosed, the faster doctors can help create a treatment plan individually tailored to help the sufferer.

The concern on whether anti-hypertensive’s should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure.

According to JNC 8 guidelines, close monitoring is essential when patients start on new hypertensive medication. Therefore, Mr. Hightower will require frequent visits to the clinic to ensure improvement in his health condition. His blood pressure will be monitored at each visit and blood work will be done to monitor his kidney and liver functions and to determine his adherence to treatment. In case of noncompliance, a third category of antihypertensive must be added to improve hypertension outcomes and prevent cardiovascular disease.

Hypertension is exceedingly common in the United States and can lead to heart attack, stroke, kidney disease, and eye disease. Given the importance of this condition, it is critical for patients to recognize its causes, diagnosis, and treatment. By the end of this article, you will know the

Surprisingly, Chaz has little to no systemic risk factors. Answering yes to only two medical conditions on his health history, high blood pressure and thyroid disease, he is taking two medications to combat these diseases. The first medication is Micardis. This is an angiotensin receptor blocker (ARB) used to treat hypertension. ARBs work by preventing the hormone, Angiotensin II, from having an effect on our body. When Angiotensin II is released into the blood stream it causes vasoconstriction and water retention, in turn raising blood pressure; if we prevent the effects of Angiotensin II the result will be vasodilation and less water retention, leading to a lower blood pressure. (Angiotensin receptor blockers (ARBs) – blood pressure medication,

My mother, Nanci, my uncle, Mike, and my aunt Kim have all been diagnosed with hypertension. Hypertension, also known as high blood pressure is the most common cardiovascular disease and leads to over 326,000 deaths in the United States every year (Adams & Urban, 2013). Hypertension is consistent increased systemic arterial blood pressure, and can be divided into two categories, primary and secondary. Primary hypertension has no identifiable cause, and according to Adams and Urban is responsible for almost 90% of all cases of diagnosed hypertension (Adams & Urban, 2013). Secondary hypertension on the other hand is related to an underlying disease process or condition, such as hyperthyroidism or the use of corticosteroids. Hypertension can systemic issue, which means that the blood pressure of the entire body is affected, or it can be a localized issue where only certain tissues are affected, such as the liver. Hypertension is usually an asymptomatic issue, however, when symptoms do appear, they have been caused by the long-term existence of the disorder, over years or decades. Over time, the elevation of the blood pressure begins to wear on the arteries and the organs of

One of the diagnosis included hypertension also known as high blood pressure. If not treated over time hypertension can cause heart disease and stroke. In order, to lower blood pressure a person can consume a healthy diet with less salt, exercise daily and take their medication. Usually, if a person’s blood pressure is above 140/90 mmHg they are considered to have high blood pressure. My patient takes Lisinopril, it decreases blood pressure in hypertension, decrease preload, and afterload in cognitive heart failure. The only use for this is when a person has mild to moderate hypertension. Precautions for those who should not take this if you are pregnant, breastfeeding, or have renal disease. An adult can take this by mouth 10-40 mg/day and may be increased to 80

Mancia G, Omboni S, Parati G. Assessment of anti-hypertensive treatment by ABP. J Hypertens 1997, 15 (Suppl.2): 543-50.

Elliot will be educated on the new medications. He will learn that Atrovent is a long-acting puffer versus Ventolin is a short-acting puffer. He will be advised to take Atrovent as directed and make sure he is compliant on taking it daily in order to assist in controlling his symptoms in the long run. He would be informed that Atrovent will not help with shortness of breath on exertion. Therefore, if he feels like he needs quick relief of his symptoms, he needs to use the Ventolin puffer as a rescue puffer for shortness of breath.

Mancia G, Omboni S, Parati G. Assessment of anti-hypertensive treatment by ABP. J Hypertens 1997, 15 (Suppl.2): 543-50.

Lisinopril and levofloxacin were prescribed for Mr. P. Lisinopril was prescribed to treat Mr. P’s new found hypertension. Lisinopril is considered an angiotensin converting enzyme inhibitor (ACE inhibitor). ACE inhibitors are designed to block the vasoconstrictive properties by angiotensin II (Gutierrez, 2008, p712). By blocking this action, and dilating the arteries, the increased workload of the heart is once again decreased, causing decreased blood pressures again (Gutierrez, 2008, p712). ACE inhibitors also help the kidneys excrete sodium and water, thus decreasing the blood volume and decreasing the workload of the heart (Gutierrez, 2008, p712). ACE inhibitors “are biotransformed in the liver” (Gutierrez, 2008, p713, para 5). Excretion occurs through the urine and stool (Gutierrez, 2008, p713).

There are many methods of treatment for hypertension. This includes exercise, a healthy diet, quitting smoking, and medications. Some medications that might be prescribed to a hypertension patient are thiazide diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and renin inhibitors. Thiazide diuretics, also known as water pills, help improve the kidneys. They eliminate the sodium (salt) and excess water which reduces the blood volume. Thiazide diuretics are most commonly the first drug that is prescribed to a hypertension patient. These types of drugs include hydrochlorothiazide (Microzide), chlorthalidone, and many others. Beta

The tests also concluded that Vicki is suffering from Congestive Heart Failure (CHF) and will be supplemented with Lozol (Thiazide diuretic) to remove excess fluid and is also used to help lower hypertension levels. Frequent monitoring of body systems is important to prevent serious side effects from prolonged hypertension and the use of the drug therapy. There are still other alternative treatment therapies available, namely a lifestyle change.

However, loop diuretics can initiate or further exacerbate thiamin deficiency. This relationship was first described in 1980 when the administration of loop diuretics in rats increased urinary excretion of thiamin after 4 weeks, suggesting that long-term therapy promotes deficiency (Yiu, Itokawa & Kuwai, 1980). The renal excretion of thiamin is directly dependent on urine flow, which is increased with diuretic medication (Wooley, 2009). Further, thiamin is not protein-bound, and is therefore easily filtered at the site of the glomerulus. A particular diuretic called furosemide decreases thiamin uptake by cardiac myocytes A particular diuretic called furosemide not only hyper-excretes thiamin, but it also minimizes thiamin’s entry into heart cells (Dinicolantonio et al., 2013). Therefore, administration of this medication may further affect heart contractility since myocardial cells are deprived of thiamin, preventing the decarboxylation reaction necessary in pyruvate’s conversion to acetyl CoA and slowing energy

Potassium-sparing diuretics combine and block the intracellular aldosterone receptor, which then reduce the expression of gene that code for epithelial sodium ion channel (ENaC) and Na+/K+ ATPase (Katzung & Trevor, 2015).