Clinical scenario help?

Question

A 79year old lady with a history of congestive heart failure and angina receives this prescription: Aspirin 70mg, one tablet in the morning. Imdur 60mg, one tablet in the morning. GTN tablets, one tablet for chest pain. Any comments?

Answer 1

A much more detailed history is needed to assess if she is on the right treatment. Like, does she have other medical conditions, is she intolerant to particular medication, how bad is the heart failure and agnina?

Generally, people with angina should be on a beta-blocker as this is the one medication that improves their prognosis.
Patients with heart failure should be on an ACE-inhibitor as this is one of the main medication that slows down the progression of the ventricular impairment.
She should also be prescribed a cholesterol-lowering tablet such as a Statin or alternative.
And the usual dose of Aspirin is 75mg.

Ofcourse, there are many factors that affect the above treatment and her doctor would have taken all of those into account.

Answer 2

What do you need to know? The asprin is generally prescribed for it's antithrombotic effect (prevents platelets from coagulating therefore leading to a blockage in an artery). Imdur is a vasodilator and assists the blood vessels to widen, therefore allowing more blood to get to the heart. GTN is usually used as required and only when suffering chest pain. These medications are used to assist to prevent/treat Angina or myocardial infaction ("heart attack"). Hope this helps

Answer 3

This is a standard treatment for someone with this condition. By the way GTN should be NTG This is Nitroglycerin tablet.

Answer 4

so long as this lady is stable, she doesn't need any additional tablets. i agree giving statins and/or ACE or a B-blocker. Any additional medical condition?DM, renal impairment, HTN? If she's bleeding from ASA, may use clopidogrel. Ask your cardiologist for further comments. Cheers.