Posted: September 22nd, 2016

Outline the mechanism of action of the drug chosen and any side effects of concern.

Case Study-Diuretics
A 70 year old man with a history of myocardial infarction presents to the ER with shortness of breath and chest pain. Over the past 2 weeks he has developed increasing dyspnea with exertion and swelling in the limbs. Over the past 3 days he has found the need to elevate his head while sleeping to reduce the incidence of coughing and shortness of breath. At the moment he uses 4 pillows.
In the ER while sitting upright he seems to be in respiratory distress and is tachycardic with a blood pressure of 195/112. JVD is predominant. Upon auscultation of the lungs rales are heard bilaterally and he has pitting edema of both lower legs up to his knees.
Chest x-ray confirms pulmonary edema and he is immediately place on oxygen.
He is currently on hydrochlorothiazide, metoprolol and enalapril.

What would be the typical diagnosis and why?
How would you ideally treat this patient in terms of first line management and why?
Outline the mechanism of action of the drug chosen and any side effects of concern.
Are there any potential interactions?

Instructions: Please prepare and submit a paper 3-4 pages [total] in length (not including APA format) answering the questions below. Please support your position with examples.