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Ashfiya, Shafna Raudlatul - CaseAnalysisPharmacology

Case Analysis, Pharmacology Virtual Exchange Program (MMSU, Philippines)

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Shafna Raudlatul Ashfiya
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51 views2 pages

Ashfiya, Shafna Raudlatul - CaseAnalysisPharmacology

Case Analysis, Pharmacology Virtual Exchange Program (MMSU, Philippines)

Uploaded by

Shafna Raudlatul Ashfiya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Hyperlipidemia

Introduction
Hypercholesterolemia, elevated low-density lipoprotein (LDL) levels, and low high-density
lipoprotein (HDL) levels are unequivocally linked to increased risk for coronary heart disease
and cerebrovascular morbidity and mortality. LDL is the primary target.

Multiple genetic abnormalities and environmental factors are involved in clinical lipid
abnormalities, and routinely used clinical laboratory measurements do not define the
underlying abnormalities.

Initial therapy for any lipoprotein disorder is therapeutic lifestyle changes with restricted
intake of total and saturated fat and cholesterol and a modest increase in polyunsaturated
fat intake along with a program of regular exercise and weight reduction if needed.

If pharmacologic therapy is insufficient after therapeutic lifestyle changes, lipid-lowering


agents should be chosen based on the specific lipoprotein disorder presentation and the
severity of the lipid abnormality.

Objective
In this activity, you should be able to analyze the case and answer each question precisely.

Instruction
Analyze the case carefully.
Mr. CD is a 43-year-old man who has been relatively fit and well for the past 20 years during
which he has rarely visited his primary care doctor. Two weeks ago he was admitted to the
hospital having suffered a myocardial infarction. On questioning it was revealed that his
brother had died in a road traffic accident at the age of 19 and his father had died from CHD
aged 54 years.
Examination of Mr. CD revealed a corneal arcus and tendon xanthomas. Blood drawn within
2 h of the onset of his myocardial infarction revealed TC 7.8 mmol/L, HDL-C 0.9 mmol/L and
triglycerides 2.3 mmol/L.

Questions
1. What is the likely diagnosis of Mr. CD?
2. What are the treatment options?
3. Mr. CD wants to know why he was not identified as being at high risk of CHD before he
suffered his myocardial infarction.

You will be graded using a rubric based on the following elements:


1. Depth of answer: demonstrates a thorough and conscious understanding of the case
and subject matter.

Pharmacology: Hyperlipidemia
2. Development of examples, evidence: uses specific and convincing examples to
support ideas and make insightful connections.

Output
1. Mr. CD is diagnosed Familial Hypercholesterolemia, that can be happen because his
father had died form CHD at 54 years old. Familial Hypercholesterolemia and
hyperlipoproteinemia can be caused by inherited changes (mutations) in a few genes.
This diagnose is more reinforced because of Mr. CD has low HDL level (0,9 mmol/L) or
<39 mg/dL and high triglyceride level (2,3 mmol/L) normal triglyceride: <1,7 mmol/L,
which is very high level. So we get the LDL level is 6,45 mmol/L (Normally 3,4-4,1
mmol/L) if we converted in mg/dL, LDL level at 248,13 mg/dL. So, according TLCs the risk
category is 0-1 risk factor.
A family history positive for CHD has elevated triglycerides, Mr. CD is associated
abnormally is probably a contributing factor to CHD and should be treated.
Examination of Mr. CD revealed a corneal arcus and tendon xanthomas. That happen
because in the setting of elevated LDL. The elevation of LDL can be either as a primary
elevation of cholesterol.
2. Elevate the HDL level should be required, because low HDL is a strong independent risk
predictor of CHD. The treatment options for Mr. CD is treated with BARs, statins, niacin,
or ezetimibe. But for familial combined hyperlipidemia may respond better to a fibrate
and BAR.
3. Myocardial Infarction (ie, heart attack) is caused by decreased or complete cessation of
blood flow to a portion of myocardium. Definitely, Mr. CD can present with chest
discomfort or pressure that can radiate to the neck, jaw, shoulder or arm. MI is closely
associated with coronary artery disease which caused by plaque build up in the wall of
arteries that supply blood to the heart (Coronary arteries). Plaque build up of cholesterol
deposits on the lining of the blood vessels, eventually producing degenerative changes
and obstruction of blood flow (Atherosclerosis). That’s why it develop the heart disease
(e.g, DHC). Mr. CD supposed to do medical check up routine even he don’t feel
discomfort because myocardial infraction may be “silent” and suddenly happen and he
doesn’t know he has risk of CHD until he get myocardial infarction. According to Mr. CD,
those fact is reinforced by the evidence that her father had died because of CHD before
(inherited genetic risk fact)

Name: Shafna Raudlatul Ashfiya


Student Number: 1804015287

Pharmacology: Hyperlipidemia

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