04-26-2009, 12:33 PM
An 80-year-old man is evaluated for a routine examination. He has a history of hypertension and was diagnosed with chronic osteoarthritis 20 years ago. Medications are atenolol, 50 mg/d, and hydrochlorothiazide, 25 mg/d. One year ago, he began ibuprofen, 250 mg four times daily.
On physical examination, pulse rate is 60/min and blood pressure is 180/90 mm Hg without orthostatic changes. There is trace peripheral edema.
Laboratory Studies
Blood urea nitrogen 40 mg/dL
Creatinine 1.5 mg/dL
Sodium 134 meq/L
Potassium 4.9 meq/L
Which of the following treatment strategies is indicated for this patient?
a.ncrease the atenolol dose
b. Increase the hydrochlorothiazide dose
c.Add lisinopril
d.Discontinue ibuprofen
On physical examination, pulse rate is 60/min and blood pressure is 180/90 mm Hg without orthostatic changes. There is trace peripheral edema.
Laboratory Studies
Blood urea nitrogen 40 mg/dL
Creatinine 1.5 mg/dL
Sodium 134 meq/L
Potassium 4.9 meq/L
Which of the following treatment strategies is indicated for this patient?
a.ncrease the atenolol dose
b. Increase the hydrochlorothiazide dose
c.Add lisinopril
d.Discontinue ibuprofen