NU641: Advanced Clinical Pharmacology
Case Study Week 2 – Hypertension
Instructions
Review the patient case study and answer the questions provided. You are expected to include two
evidence-based practice articles to support your work. Additionally, you will need to include the national
guidelines for any treatment plans/options. All papers must conform to the most recent APA standards.
Case Study
Darius, a 65-year-old black man, was referred to the clinic for evaluation of high blood pressure noted
on an initial screening. He reports having headaches and nocturia. He states that he has gained 8 pounds
over the last year.
Past medical history:
ppendectomy 30 years ago
eptic ulcer disease 10 years ago
ype 2 diabetes mellitus for 10 years
out
Family history:
ather had hypertension; died of myocardial infarction at age 55.

other had diabetes mellitus and hypertension; died of cerebrovascular accident at age 60.
Physical examination:
eight 69 in, weight 90 kg
P: 140/89 mm Hg (left arm), 138/82 mm Hg (right arm)
ulse: 84 beats/minute, regular
unduscopic examination: mild arterial narrowing, sharp discs, no exudates or hemorrhages
Laboratory findings:
lood urea nitrogen: 24 mg/dL
erum creatinine: 1.1 mg/dL
lucose: 95 mg/dL
otassium: 4.0 mEq/L
otal cholesterol: 201 mg/dL
igh-density lipoprotein cholesterol: 30 mg/dL
riglycerides: 167 mg/dL
rinalysis: within normal limit (no proteinuria)
lectrocardiogram and chest radiograph: mild left ventricular hypertrophy
Social history:
obacco: 35 pack years
lcohol: 1 pint of vodka/week
offee: 2 cups/day
Diagnosis: Stage 1 Hypertension
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List specific goals for treating Darius(ypertension.
What drug therapy would you prescribe? Why?
What are the parameters for monitoring success of the therapy?
Discuss specific patient education based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause you to change
therapy.
What would be the choice for second-line therapy?
What over-the-counter and/or alternative medications would be appropriate for Darius?
What lifestyle changes would you recommend to Darius?
Describe one or two drug2ug or drug¯od interaction for the selected agent.

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