Medical case study report Essay Example | Topics and Well Written Essays - 750 words

Medical case study report - Essay slipFrequent monitoring of the blood sugar at least after every 4 hours is also important to ensure the episodes of hypoglycaemia do non occur (1). The second scenario could be if Dooleys creatinine clearance 50-60 ml/min or higher, it is recommended that metformin be administered at a reduced dose patch increasing as tolerated to a highest of 1G daily. The third scenario is if Mr. Dooley had comfortably used Gliclazide 60mg for a long time, it may be continued. However, this should be taken with food followed by closing curtain monitoring of blood glucose to avert any episode of hypoglycaemia (2). Therapeutics issues Clarithromycin has the capability of interacting with simvastatin thus may lead to the increase in the simvastatins blood levels because clarithromycin is CYP 3A4 inhibitor and Simvastatin mainly metabolised by CYP3A4 administration with drugs that inhibit these enzymes may increase its concentration which increase risk of myopathy and rhabdomyolysis (Paravastatin are not metabolised by CYP enzyme and then it had reduce risk) (3). Also verapamil interact with simvastatin which could increase in simvastatin level which increase risk of liver damage. Heart rate may also be lowered by combining verapamil and clarithromycin since this combination reduces blood pressure and may cause dizziness and headaches. The patient is also talk over to cease use verapamil because it has potential for side effects such as constipation. Suggested use of CCB (lercanidipin) 10mg daily which can be increased in a two weeks time depending on the therapeutic response exhibited by the patient. Long term use of coloxy and Senna is not recommended since they stimulate laxatives in long term preaching of constipation. It should therefore be withdrawn gradually within two to four weeks and the bowel condition checked regularly. The use of high doses of Fosinopril dose is not well-grounded for the elderly patient since it could also c ontribute to dizziness and lightheadness. The