Patient SD: 67 y. O. Female arrives for a medication review of cardiovascular medications and to fill a new prescription for Ibuprofen 800 mg written by PCP for chronic knee pain.
Past Medical History: Depression, hypercholesterolemia, heart failure, allergiesHPI: Chronic Heart Failure due to ischemic cardiomyopathy
CC: Compliance with multiply daily dosing, significant light-headedness and dizziness, knee pain
Medications: Captopril 12.5mg Carvedilol 12.5 mg Furosemide 40 mg Digoxin 0.125 mg Spironolactone 25 mg Simvastatin 40 mg Citalopram 20 mg Potassium Cl 20 mEq Fluticasone Prop 50mcg/inhaltion
She needs to take less than 3200 mg daily
Naproxen might be more effective in controlling knee pain
Ibuprofen and NSAIDs are contraindicated in patients with heart failure
She should avoid activity
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Discontinue captopril
Switch captopril to BID dosing instead of TID dosing
Switch captopril to lisinopril
Change captopril to losartan
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Acetaminophen
Ibuprofen as prescribed currently
Naproxen 220mg BID
Celecoxib 100 mg BID
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