Posted: February 27th, 2022

Management of Coronary Artery Disease

Management of Coronary Artery Disease

Drug to add to the Prescription
Enalapril which is an ACE inhibitor. Angiotensin converting enzyme that has to be addressed pharmacologically when managing Coronary Artery Disease and it causes narrowing of blood vessels hence increasing blood pressure, and in the case of coronary artery disease, it could lead to heart failure and stroke.
I would discontinue Lisinopril prescription because the prescription also has a statin; Simvastatin, they have the same pharmacology and mode of action; thus, they do not need to be used with the same treatment. Simvastatin has a better pharmacologic action; hence; the dosage of Lisinopril should be reduced but should not be left out in the prescription.
The diagnosis of stage 3 chronic kidney disease would affect the type of medications I prescribe because kidneys are critical in drug pharmacokinetics in the body (Patel, Guzman, Lin, Pence, Reichman, John, & Siddiqui, 2018). Severe kidney failure also stimulates the risk of coronary artery disease symptoms. I would consider doing ambulatory blood pressure monitoring to assess for hypertension which, in this case, have a high mortality rate. I would prescribe Angiotensin Converting Enzymes inhibitor; Benazepril to reduce the excessive release of renin into the bloodstream hence lowering the cases of heart failure. I would also reduce the dosage of lisinopril.
The patient was prescribed more two antihypertensives to increase the antihypertensive action as monotherapy is at time unsatisfactory in treatment (Thomas, Divakaran, Nasir, Shah, Slim, & Cheezum, 2015). It also cuts off the long-term dosage requirement if one drug was to be prescribed.

There are such critical reasons for inclusion of aspirin in the as,
It counters the action of enzyme cyclooxygenase. This makes the body less likely to produce chemicals that can help induce inflammation. It helps prevent blood clots from developing. Any chemicals in the blood cause blood clot-causing events, and therefore prescribing aspirin is very important.
It is very important in the management of hypertension as combination therapy with other antihypertensives.
Question 2
Drugs acting on blood and circulatory system;
Drugs that promote RBC development are known as erythropoietic drugs, those that generate WBCs are colony-stimulating factors, and those that increase platelets contain special interleukin.
Anticoagulants are medications that increase the time it takes for clotting factor to have a full effect. They are generally referred to as blood thinners. Heparin helps in atrial fibrillation. These drugs suppress the action of clotting factors in the blood hence preventing coagulation.
Antiplatelet drugs prevent the risk or treat blood clotting and are also known as blood thinners (Assimes, & Roberts 2016). They irreversibly inhibit prostaglandin H synthase (cyclooxygenase-1) in platelets and megakaryocytes and thereby prevents the production of thromboxane A2 (TXA2; potent vasoconstrictor and platelet aggregate).
Erythropoietic drugs are used in the management of anemia. Anemia is a condition where there is not enough erythropoietin production and therefore finding a stimulating factor for the process is fundamental. Peginesatide an erythropoietic drug which has an extended acting mechanism and is commonly used to treat anemias.
When managing a patient with anemia, various lab procedures need to be highly observed to prevent blood component imbalance or coagulation.
Total blood count;
The test monitors your level of hemoglobin and hematocrit. Lymphocytes are important components of blood as they help in transportation of oxygen as oxyhemoglobin (Gyberg, De Bacquer, De Backer, Jennings, Kotseva, Mellbin & Amouyel, 2015). Hematocrit counts the availability of space to occupy hemoglobin in blood. Low hemoglobin or hematocrit levels are a symptom of anemia. A full blood count should be done regularly after completing a dose of erythropoietic drugs.
The electrophoresis of hemoglobin.
This test is for the various kinds of hemoglobin in your blood. The examination will help determine the form of iron deficiency a patient might have.
The count of the reticulocyte. The test checks the amount of juvenile red blood cells in your blood (Kitkungvan, Johnson, Roby, Patel, Kirkeeide, & Gould, 2017). The examination shows when your bone marrow contains the right number of red blood cells.
Bone marrow tests and tests for kidney failure are also essential to assess for any underlying causes of anemia. After succeeding in the management of anemia, patients should be given regular check-up appointments for labs assessment.

References
Patel, S. S., Guzman, L. A., Lin, F. P., Pence, T., Reichman, T., John, B., … & Siddiqui, M. S. (2018). Utilization of aspirin and statin in management of coronary artery disease in patients with cirrhosis undergoing liver transplant evaluation. Liver Transplantation, 24(7), 872-880.
Assimes, T. L., & Roberts, R. (2016). Genetics: implications for prevention and management of coronary artery disease. Journal of the American College of Cardiology, 68(25), 2797-2818.
Thomas, D. M., Divakaran, S., Villines, T. C., Nasir, K., Shah, N. R., Slim, A. M., … & Cheezum, M. K. (2015). Management of coronary artery calcium and coronary CTA findings. Current cardiovascular imaging reports, 8(6), 1-14.
Gyberg, V., De Bacquer, D., De Backer, G., Jennings, C., Kotseva, K., Mellbin, L., … & Amouyel, P. (2015). Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology. Cardiovascular diabetology, 14(1), 1-11.
Kitkungvan, D., Johnson, N. P., Roby, A. E., Patel, M. B., Kirkeeide, R., & Gould, K. L. (2017). Routine clinical quantitative rest stress myocardial perfusion for managing coronary artery disease: clinical relevance of test-retest variability. JACC: Cardiovascular Imaging, 10(5), 565-577.

Order | Check Discount

Tags: Management of Coronary Artery Disease