Case Study for Pharmacology
Chris is a 40-year-old male with a history of asthma, diagnosed by his previous PCP, that had previously been well controlled by a low-dose inhaled corticosteroid (ICS) and a short-acting inhaled β-agonist as needed. He presents in clinic with symptoms of shortness of breath, chest tightness, and wheezing. Chris states that the symptoms are worse at night and wake him a few times per week. He also reports that he has had some limitations in normal activities of daily living and work performance. He has been using rescue therapy almost every day. In fact, he is at clinic today because he is tired of using his inhaler so often simply to function during the day at work. Chris's job requires physical activity, and he often has trouble performing his work due to his asthma. Chris reports smoking roughly 10 cigarettes per day, but states that he plans to take up vaping because he heard it was "better for me than cigarettes."
Chris also complains of nasal congestion, sneezing, and itchy eyes. The patient reports that his nasal symptoms and asthma began to worsen a few months ago after a bout with bronchitis that was successfully treated with antibiotics.
No lung function tests/records available.
Ht: 5 ft. 11 in., Wt: 130 kg, Allergies: NKDA
CXR: clear
BP: 118/78 mm Hg; HR 110 BPM
Temp: 98.2 F
Lung/Thorax: Expiratory wheezes bilaterally
PMH: Hypertension: dx at 19 y/o; Hypercholesterolemia: dx at 23 y/o
SH: smokes 10 cigarettes per day. About to switch to vaping. No pets. Lives alone.
FH: Hypertension: Father/Mother; Hypercholesterolemia: Mother.
Medications: lisinopril/HCTZ 20/25 mg po daily, atorvastatin 10 mg po daily, albuterol HFA 1-2 puffs q 4-6 hours prn, fluticasone HFA 44 mcg, two puffs BID
Please answer the question thoroughly and site references.
1. What would be the goals of therapy and preferred pharmacological treatment(s) for Chris? Be SPECIFIC in your recommendations and justify your answer.