(SOLVED) DL is a 48-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day

SCENARIO 4

 
DL is a 48-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day. He is currently on losartan 50 mg po daily, linagliptin (Tradjenta) 5 mg PO daily and red yeast rice supplement. Fasting lipid profile shows Total Cholesterol 245 mg/dL, LDL 165 mg/dL, HDL 41 mg/dL, and Triglycerides 175 mg/dL. He is 5’10” and weighs 223 lbs. What treatment plan would you implement for DL? Include a complete medication order. What are GOAL Total Cholesterol, LDL, HDL, and Triglyceride levels? What is DL’s BMI per Medscape calculator? What patient monitoring and education would you provide? How many risk factors for Coronary Artery Disease (CAD) does DL have? Identify them specifically.
 

Scenario 4

The treatment plan I would implement for 48-year-old patient DL would take care of his type II diabetes, the risk of kidney disease, hypertension, hypercholesterolemia, and the risk of heart disease (Jameson et al., 2022). The complete medication order will be as follows:

Acetyl salicylic acid (Aspirin) 81 mg tablets 1 (one) tablet PO daily, #30, RF 2

Atorvastatin (Lipitor) 20 mg tablets 1 (one) tablet PO daily, #30, RF 2

Linagliptin (Tradjenta) 5 mg tablets 1 (one) tablet PO daily, #30, RF 2

Losartan (Cozaar) 50 mg tablets 1 (one) tablet PO daily, #30, RF 2

Zestoretic (lisinopril/hydrochlorothiazide) 10/12.5 mg tablets 1 (one) tablet PO daily, #30, RF 2

The GOAL total cholesterol is below 200 mg/dL, LDL cholesterol is below 100 mg/dL, HDL cholesterol is above 60 mg/dL and triglycerides are below 150 mg/dL (Jameson et al., 2022). According to the Medscape calculator, patient DL’s body mass index (BMI) is 32 kg/m
2
 (Medscape, 2025e). This means that he is obese (obesity class 1).

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The patient monitoring for this patient would include at-home random blood sugar checks, HbA1c checks every three months, three-monthly EKG, daily at-home blood pressure checks, three-monthly cholesterol checks, and three-monthly BMI calculation. The education that I would provide include smoking cessation, commencement of routine isotonic aerobic exercise such as walking for 30 minutes every day, and taking a diet low in fat and carbohydrates, but rich fresh fruits and vegetables. Finally, the risk factors for coronary artery disease (CAD) that this patient has includes:

Cigarette smoking.

A sedentary lifestyle.

Elevated LDL cholesterol and triglycerides.

References

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Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2022).
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https://reference.medscape.com/calculator/28/bmi-and-bsa-mosteller

OSCEstop Education (2024).
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https://oscestop.education/learning/outpatient-prescriptions/

Rosenthal, L.D., & Burchum, J.R. (2020).
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