Patient HH has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and
hyperlipidemia.
Drugs currently prescribed include the following:

Metformin 500 mg po daily
HCTZ 25 mg daily
Atenolol 25 mg po daily
Hydralazine 25 mg qid
Simvastatin 80 mg daily
Verapamil 180 mg CD daily
Case study need to be presented with advanced pharmacology in focus.
Facilitator/Professor help:
INFORMATION AS SHORT PARAGRAPHS, READABLE. All information & presentation have to be at
advanced clinician level.
1. Discuss pharmacology of existing agents briefly, molecular mechanism of action, therapeutic & adverse
effects, & relevant kinetics, all as a short paragraph, readable, for each drug.
2. Talk about what modifications are needed, what drugs are not at the best interest.
3. Follow a guideline, preferably JNC 8 and its current modifications (ACC/AHA 2019 guidelines).
4. Talk about the drugs you have substituted or added, & their key pharmacology.
5. Address any specific questions that you are asked for in this case.
Example, here are some questions you may want to address in your assignment:
Does this patient need both verapamil & atenolol at the same time, since both have similar actions? 
6/8/2021 Order 346722098
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Recent guidelines do not recommend beta blockers for hypertension. But it was possibly added for the best
therapeutic outcome? Why beta blockers? (example, protect him from strokes? Does he have any cardiac
arrhythmias).
Is there a drug to be added for stroke prevention?
What are the major adverse effects of statins (muscle related), hydralazine (many, lupus like syndrome),
glipizide (hypoglycemia) HCTZ (hypokalemia) etc