King Abdulaziz University College of Pharmacy Clinical Pharmacy
King Abdulaziz University College of Pharmacy Clinical Pharmacy
King Abdulaziz University College of Pharmacy Clinical Pharmacy
Therapeutics II
November 2007
J.P.,a 62-year-old retired dairy farmer, is hospitalized for evaluation of chest pain.
About 3 weeks before admission, he noted substernal chest pain brought on by lifting
heavy objects or walking uphill. He describes a crushing pain that never occurs at rest
and is not associated with meals, emotional stress, or a particular time of day. When
J.P. stops working, the pain subsides in about 5 minutes.
Family History:
His mother & brother died of a heart attack; his father, who alive at age 86,has
survived one heart attack and one stroke. His family history is negative for DM.
Social History:
He drinks two or three beers per day and does not smoke or chew tobacco.
Medication History:
Atenolol 50mg QD
Glipizide 5mg BID
Losartan 50mg QD
-He rarely use OTC medications
-He has a history of an allergic reaction to sulfa drugs
Physical Examination:
VS: BP 164/98 mm Hg HR=73 beats/min RR=12 breath/min Ht=160 cm
Wt=60kg
Gen: On admission to the cardiac ward,J.P.appears his stated age and is in no
apparent distress
HEENT: WNL
CVS: Regular rate & rhythm with a normal S1 &S2;Third or fourth heart sounds and
murmurs are not noted.
Chest: Clear to auscultation and percussion
ABD: Unremarkable
Ext: No peripheral edema
Neuro: Oriented to time, place, and person; cranial nerves intact; normal deep tendon
reflexes(OX3)
Question:
# Answer the following questions by true or false and correct the false one
1- Most episodes of exertional angina last several minutes in-duration and are relived
with rest ( T )
2- J.P.’s symptoms can be classified as typical chest pain. However, symptoms don't
occur at rest, so they can be classified as Unstable angina ( F ) STABLE
3- ECG during an anginal episode would confirm CHD &angina if T-wave inversion,
ST-segment depression are noted ( T )
4- Nitrates are effective in treating all forms of angina because they decrease arterial
return to the heart &therefore decrease cardiac workload ( F )VENOUS
5- During anginal episodes the patient can take a maximum of five tablets over 15
min of NTG tablet ( F ) THREE
# Comment on drug list, suggest any modification (add or delete drugs)? Why
should J.P., continue his Atenolol therapy?
Prepared by: Dr/Ohoud Al-juhani
Clinical pharmacy department
Prepared by: Dr/Ohoud Al-juhani
Clinical pharmacy department