Reference no: EM133571572

Case Study: L.B. is a 55-year-old white female who presents to her family physician's office for a yearly routine physical. Her husband passed away 5 months ago after a 2-year battle with lung cancer. She has three children, two of whom are still in college. Her daughter accompanies her to the doctor's office and says she is concerned about her mother's recent behavior. She explains that her mother has been "sleeping all the time" and has lost 25 lb in the past 2 months without being on a diet. When the doctor examines L.B., she explains that she has become increasingly fatigued and complains of a lack of energy. She no longer has any desire to participate in her lifelong hobbies of painting and photography because of frequent feelings of sadness. L.B.'s medical history is significant for hypothyroidism, hypercholesterolemia, and recently diagnosed hypertension. Her medications are levothyroxine 0.075 mg daily, simvastatin 20 mg daily, hydrochlorothiazide 25 mg daily, lisinopril 10 mg daily, multivitamins 1 tab daily, and aspirin 81 mg daily. In the office today, L.B.'s blood pressure is 138/88 mm Hg.

Questions:

1. What would you consider first-line pharmacological treatment for the patient and why? Please write the order for the treatment as a prescription. Please provide rationale for your choice of treatment.
2. List adverse effects to the therapy you recommended in question #1.
3. Are there any adverse effects that would cause you to change therapy, if so, please explain?
4. If your first-line agent were unsuccessful or a significant adverse drug event occurred, what would be your second-line pharmacological treatment for the patient and why? Please write the order for the treatment as a prescription. Please provide rationale for your choice of treatment.
5. Discuss specific patient education based on both your first- and second-line choices.