Comments on Patient's Results: Acute Pulmonary Edema Paper Example

Introduction

After doing the chest edema, such results show that the patient is experiencing an acute pulmonary edema (Mayoclinic, 2018). His blood pressure and heart rates are very high which portrays a high risk of experiencing a heart attack (NICE, 2011). From the results, his oxygen saturation is low as well which means that he has hypoxemia; below normal level oxygen saturation in the blood. Accompanied by the wheezing and the atrial fibrillation, the results show a problem with the patient's lungs functionality.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

From the blood results that were done: Na 128 mmol/L is a test that measures the amount of sodium in a patient's blood. The results show that the patient has hyponatremia; he has low levels of sodium in his blood. K 3.5 mmol/L was used to measure the levels of potassium in the patient's blood and the results indicated that his levels were moderate. The Creatinine test that was used to determine the patient's kidney functionality. The results, Cr 67 micromole/L showed that the patient has more than enough creatinine in his blood, therefore, his kidneys were not functioning normally. The patient's blood sugar level was Ur 3.9 mmol/L after the glucose level test was done. This meant that his sugar level was normal (Ananya, 2018). Hb 11.2 g/dl were the results gotten after measuring the patient's hemoglobin level count, the results indicated a low-level count for hemoglobin. The combination of these results means that the patient has a serious heart condition which is affecting his breathing and overall respiratory system's functionality.

Drug class and their rationale for usage

Aspirin belongs to a class of drugs known as the nonsteroidal anti-inflammatory drugs (NSAID). It is mostly used to relieve pains like toothaches, muscle aches, swelling and headaches to name a few. The patient underwent a coronary bypass in 2015 and prescribed aspirin in small doses to use as a blood thinner to prevent blood clots which could cause a stroke or heart attack.

Simvastatin drug belongs to a group of drugs called statins. The drug is often combined with proper dieting and has main functions in the body; first, it helps reduce the amount of cholesterol made by the liver, lowering the amount of "bad" cholesterol made by the body and helps raise "good" cholesterol from the body. Basically, the drug reduces the rates of suffering a heart disease, stroke or heart attack (Nayor, M. and Vasan, 2015). The patient in this case, is certainly overweight and therefore has a lot of cholesterol in his body. Simvastatin drug was prescribed so that it can reduce his chances of experiencing a heart attack as he did in 2015 and 2017.

Bisoprolol is an oral drug belonging to a class of beta blockers. It is used to manage and treat hypertension by lowering the blood pressure, heart rate and strain of the heart hence preventing stroke, heart attack and kidney problems. In this case, the results indicated that the patient had high blood pressure and heart rate. Thus, Bisoprolol was used to help reduce his high blood pressure and his heart rate.

Ramipril is an oral drug and belongs to a class of ACE inhibitors. Ramipril's primary goal is to relax the blood vessels for the blood to flow more easily in the body. It helps manage and treat high blood pressure by lowering it hence preventing stroke, heart attack or kidney problems (NICE, 2018). From the case, the patient has a heart disease causing his heart to fail and suffer two heart attacks, Ramipril was being used to prevent him from suffering additional heart attacks and strokes as well as improving his heart's survival rates.

Furosemide belongs to a group of drugs called diuretics (NICE, 2018). They are all used to treat high blood pressure/hypertension as well as edema. Basically, their function is to get rid of the excess salt and sugar in a patient's body making it produce more urine to be excreted hence reducing the blood pressure and swelling in the body. In this case, the patient's results indicated that his blood pressure and heart rate were higher than normal which caused the chest edema. Therefore, Furosemide was meant for reducing the blood pressure and managing the patient's pulmonary edema condition.

Comment on using Tolvaptan

The drug belongs to a class of drugs called vasopressin receptor antagonists which are used to treat low sodium (salt) levels in the blood. The drugs basically assist the body in increasing the amount of urine production hence increases the extraction of more water from the body (NICE clinical guideline, 2015). This effect leads to an increase in the salt concentration in the blood. Some of the effects associated with the drug are possible heart failure or hormonal imbalance. In this case, the patient is already suffering from a heart failure which is as a result of contribution by his low levels of sodium in the blood. Therefore, tolvaptan can be an effective drug to raise his sodium levels which in return may lower his heart failure. However, the patient must be under frequent and close monitoring to mitigate the risk of another heart problem or even liver failure. He simply has a number of issues that are directly connected or caused by low sodium levels in the blood, therefore, using the drug would be better than not using it; the benefits that will accrue to tolvaptan's use are greater than the negative effects it may cause. Therefore, yes, I would recommend the use of tolvaptan drug.

Pharmaceutical Care comment

Based on his health history, the drug prescriptions that the patient had been using must have been helpful. They all centered on preventing heart problems (attacks, strain, and failure), stroke and high blood pressure. However, all these are conditions that are often attributed to his current heart problem considering his chest edema and blood tests. After the current diagnosis, pharmaceutical care should also be effective to treat his heart failure and severe edema. Besides recommending the use of tolvaptan, I would suggest that the patient to be prescribed iron supplementing drugs which will facilitate the increase of his sodium level in the blood. The implementation of these two suggestions will not only help reduce heart conditions (indirectly) but also help raise the patient's sodium level.

Additional advice

I would advise the patient to reduce his stress levels and reduce heavy working but concentrate on simple and healthy physical body exercising activities. This will contribute to reducing his blood pressure levels. Also, I would advise the patient to eat a more healthy diet by decreasing the consumption fatty foods which will reduce the amount of excess and bad cholesterol in his body. The patient should also consider consuming foods rich in iron e.g. eggs, spinach, beans, seafood etc., to increase his hemoglobin level count to normal. Furthermore, he should reduce his smoking rates and reduce.

References

Ananya Mandal, MD. 2018, August. News Medical Life Sciences. Defining hypoglycemia. Retrieved from: https://www.news-medical.net/health/Defining-Hypoglycemia.aspxMayo Clinic. 2018, August 8. Pulmonary Edema. [Online] Available at: https://www.mayoclinic.org/diseases-conditions/pulmonary-edema/symptoms-causes/syc-20377009

Nayor, M. and Vasan, R.S., 2015. Preventing heart failure: the role of physical activity. Current opinion in cardiology, 30(5), p.543.

NICE Clinic Guidelines. Chronic heart failure in adults: Diagnosis and management. 2018, Sept. [Online] Available at: https://www.nice.org.uk/guidance/ng106/chapter/recommendations.

NICE Clinical Guideline: Hypertension in adults: diagnosis and management. 2011, Aug. Clinical guide (CG127). Retrieved from: https://www.nice.org.uk/guidance/cg127/chapter/1-Guidance#measuring-blood-pressure

NICE Clinical Guideline. Tolvaptan for treating autosomal dominant polycystic kidney disease. Technology appraisal guidance: NICE Guidance (TA358). 2015, Oct 28. Retrieved from: https://www.nice.org.uk/guidance/ta358/chapter/2-The-technology