Advanced Pharmacology

Advanced Pharmacology

Advanced Pharmacology 150 150 Peter

Advanced Pharmacology

Download the LDL-C Manager app by the American College of Cardiology – the URL is: https://www.acc.org/LDLCmanager

For the initial post provide data that correlates with the following case:

52 y/o African American male with ST-elevation myocardial infarction (STEMI) 6 months ago

Strong fam hx of heart disease

Patient went to cardiac rehab for the first 3 months after his MI but has just been going to the gym to ride the bike two to three times a week now. He denies unilateral weakness, numbness/tingling, or changes in vision. He denies CP and only has SOB if he really pedals hard on the bike for longer than 15 minutes. He denies changes in bowel or urinary habits. He denies any lower extremity edema.

MEDICATION LIST:

Carvedilol 25mg po bid

Atorvastatin 80mg po qd

aspirin 81mg po qd

Plogridolel 75 mg PO once daily

Lisinopril 40 mg po qd

Clothalidone 25mg po qd

BP 136/85, P 64, RR 18, T 38.2°C; Wt 102.3 kg, Ht 6′0″

Total Cholesterol 190; HDL 40; LDL 121; triglycerides 145

PE: normal heart, lung and abdomen. Liver enzymes WNL

Calculated patient risk of a cardiovascular event
What are the patients CV risk factors (consider med list)
Change at least one data parameter (LDL, HDL, smoking cessation, et. al) and provide the new CV risk calculation
Discuss what resources were most helpful in this tool – Lowering LDL-C booklet – and how it can be used in the clinic setting

Sample Paper

Calculated patients risk of cardiovascular event

The CVD risk calculation involved the use of the ASCVD risk estimator and ASCVD risk estimator to depict the rate at which the patient was at risk. The risk breakdown on the 53-year-old African American was capped at 11.3% risk for ten years and a 50% rate lifetime. Calculation figure displayed (Reference figure 1)

Patient’s risk factor

Based on the NHS UK, the risk factor for cardiovascular disease comes from high blood pressure, intense smoking, diabetes and family history of CVD, among others, such as alcohol consumption. Therefore, the patients need the medicinal prescription administered and enhanced health promotion activities to balance their health. The patient is over 50 years old, the ethical background and family history of the hx heart disease showcase chances of CV risk. Again, the BMI (30) directly exposes the patients to risk factors resulting in CV.

Change of parameter and provision of new CV risk calculation

In the figure below, there was a change in the smoking part, and the results are 18.7% for ten years and 69% lifetime. (Reference figure 2)

Most helpful resources in the tool (Lowering LDL-C booklet) and how it can be used in a clinical setting

According to my analysis, the most valuable part of the tool (LDL-C Manager) is the LDL-C-Lowering Therapy part. The LDL-C-Lowering Therapy is useful in assessing the effectiveness of the current medication and therapy (Yeang et al., 2015). Additionally, the LDL-C-Lowering Therapy is valuable in ASCVD Risk Estimation whereby it adds on the calculated risk percentage and at the same time gives guidelines on the various ways to manage the condition at hand as directed by the healthcare practitioner.

Figure 1

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Figure 2

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Reference

Yeang, C., Witztum, J. L., & Tsimikas, S. (2015). ‘LDL-C’= LDL-C+ Lp (a)-C: implications of achieved ultra-low LDL-C levels in the proprotein convertase subtilisin/kexin type 9 era of potent LDL-C lowering. Current Opinion in Lipidology26(3), 169-178.