Cardiovascular Case Study: Analyzing Mary's Medication Plan - CSB601

This case study examines the medication plan of a patient named Mary, focusing on her treatment for Type II Diabetes, hypertension, and heart failure. Mary is prescribed Metformin, Perindopril, Metoprolol, Furosemide, and Diclofenac. The analysis reveals that despite taking Perindopril, her blood pressure remains elevated. The use of Metformin for patients with cardiovascular problems is questioned, and the presence of fluid build-up despite Metoprolol use is noted. The study highlights the importance of patient adherence to medication, as Mary's discontinuation of Furosemide due to frequent urination is linked to fluid retention. The medication plan is evaluated in accordance with the Australian Government Department of Health's guidelines on the Quality Use of Medicines. The assignment incorporates references to support the analysis, focusing on the effectiveness of the prescribed drugs and the overall management of Mary's health conditions.

CSB601 2018 Group assignment
Group Name, Case Patient Chosen (Mary)
Workshop Day, Workshop Time, Group #
Group Leader Name, Student Number
Team Member 2 Name, Student Number
Team Member 3 Name, Student Number
Team Member 4 Name, Student Number
Team Member 5 Name, Student Number
Team Member 6 Name, Student Number

ASE-C-POP
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The drugs that are prescribed to Mary includes
Metformin CR 2g daily : In order to control Type II Diabetes
Perindopril 5mg daily (started 2 years ago) : In order to control the hypertension
Metoprolol CR 47.5mg daily (started several months ago): To control chest pain common
during heart attack
Furosemide 40mg daily (started several months ago) : To cure fluid build-up
Diclofenac 50 mg 1 tablet three times daily (started last week): It acts as pain relief while
reducing inflammation
[1]
 On studying the current medication that is being administered to the patient, it can be
said that the patient is regularly taking Perindropil but the elevated blood pressure is still
not under control as evident from the cardiac complications
 The administration of Metformin for Type 2 Diabetes mellitus has long been treated as
obsolete specifically to patients who have a cardio-vascular problems like Mary
 It should also be noted that despite taking Metoprolol for a several months, Mary has
fluid build up as evident from swelling of her ankles. The case study highlights that
Mary was prescribed fluid tablet (diuretics) following her heart failure. However, since
she was facing problems with her frequent urge to urinate, she has stopped taking
medication during weekdays. Cessation of medication might be the problem underlying
fluid retention
The medication plan of Mary is in accordance to the Australian Government Department of
Health (2011), Quality Use of Medicines (QUM) [2]

References
1. Vetter I, Zimmermann K, Lewis RJ. Ciguatera toxins: pharmacology, toxicology and detection.
2. Australian Government Department of Health (2011). Quality Use of Medicines (QUM). Access
date: 14th September 2018. Retrieved from:
http://www.health.gov.au/internet/main/publishing.nsf/content/nmp-quality.htm
3. Romero SP, Andrey JL, Garcia-Egido A, Escobar MA, Perez V, Corzo R, Garcia-Domiguez GJ,
Gomez F. Metformin therapy and prognosis of patients with heart failure and new-onset diabetes
mellitus. A propensity-matched study in the community. International journal of cardiology. 2013
Jun 20;166(2):404-12.
4. Patel BM, Bhadada SV. Type 2 diabetes-induced cardiovascular complications: comparative
evaluation of spironolactone, atenolol, metoprolol, ramipril and perindopril. Clinical and
Experimental Hypertension. 2014 Aug 1;36(5):340-7
5. Jung O, Gechter JL, Wunder C, Paulke A, Bartel C, Geiger H, Toennes SW. Resistant hypertension?
Assessment of adherence by toxicological urine analysis. Journal of hypertension. 2013 Apr
1;31(4):766-74.
6. Garber A, Abrahamson M, Barzilay J, Blonde L, Bloomgarden Z, Bush M, Dagogo-Jack S,
Davidson M, Einhorn D, Garvey W, Grunberger G. American Association of Clinical
Endocrinologists' comprehensive diabetes management algorithm 2013 consensus statement.
Endocrine practice. 2013 May 1;19(Supplement 2):1-48.