What second drug should the clinician add

Reference no: EM133731282

Assignment:

Discussion

Patient With Benign Prostatic Hyperplasia

JK is a 63-year-old male who presents with complaints of difficulty starting his urine stream and that he has to get up to urinate at night at least three times. He states there are times when he does not think he will be able to go.

Past Medical History

Controlled hypertension

Hypercholesteremia
Type 2 diabetes controlled by diet
Medications

Zestril, 5 mg once daily

Simvastatin, 40 mg
Niacin, 1,000 mg
Baby aspirin, daily
Social History

A six-pack of beer on weekends

Nonsmoker
Active in Lions club
Physical Examination

Well-developed male

Chest: clear to auscultation
Heart: regular rhythm; no gallops, thrills, or murmurs
Digital rectal exam: enlarged prostate
Labs and Imaging

Liver enzymes: normal

Prostate specific antigen (PSA): 2.5 ng/mL
Hemoglobin A1C: 6.9
Office-based ultrasound: prostate enlargement approximately 41 cm3 • Postvoid residual urine volume: 300 mL

Discussion Questions

1. The clinician prescribes dutasteride. What patient teaching should be included?

2. In addition to taking the prescribed medication, the clinician suggests JK keep a voiding diary. What information should JK track in this diary, and what value does this information provide?

3. JK fails to respond to the initial therapy. What second drug should the clinician add? What is the method of action of this drug and what advantage does this drug provide? What patient teaching should be included?

Reference no: EM133731282

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