In a patient presenting with multiple symptoms that point to different possible health conditions, such as in the case study, prescription of drugs takes into consideration outcomes of thorough diagnosis. The primary function of diagnosis is to confirm the presence or absence of the suspected health condition. For the patient in the case, it is critical to establish the underlying cause of the complaints of hot flushing, night sweats, genitourinary symptoms, and the high blood pressure (150/90). Based on the patient’s health history, the possibility of breast cancer, menopause related problems, or side effects and contraindications from HTN medications being the cause of the symptoms must be confirmed or ruled out. Screening for the BRCA gene harmful mutations and hormonal changes is also recommended.
The symptoms presented by the patient may manifest menopause transition, which according to Roberts and Hickey (2016), is characterized by vasomotor symptoms and genito-urinary problems. Menopause is a major cause of night sweats and flushes. The elevated blood pressure, despite a history of HTN and related medications, may also be an outcome of menopause. Weight gain triggered by hormonal changes during menopause cause blood pressure sensitivity to dietary salts. The patient is also at risk of increased body mass index, a common problem in menopause considered to lead to high blood pressure. Early and asymptomatic cancer is also known to cause night sweats and flushes, which makes it a problem of concern for the patient in the case. The observations on the patient’s medical issues are made based on the understanding that at 46 years of age, and being a woman, the patient is at a higher risk of developing menopausal problems and breast cancer.
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Based on the patient condition, it is commendable to maintain the HTN medications, Amlodipine (Norvasc) and hydrochlorothiazide (HCTZ). Upon confirmation of menopause or cancer to be the cause of the symptoms, appropriate drugs would be recommended. For menopause, therapy will be informed by the severity of the symptoms. Low doses of estrogen within short time frames are recommended for hot flushes; vaginal estrogen for genito-urinary problems; antidepressants for hot flushes; and Clonidine (Catapres, Kapvay) for blood pressure and hot flushes. In the case of breast cancer, the recommended prescription is Tamoxifen (Nolvadex and Soltamox), used for preventative purposes for women before and after menopause.
The health management regimen for the patient in the case would revolve around maintaining a healthy lifestyle. The patient must maintain a healthy weight through diet and exercise, manage stress, and avoid consumptions of foods or drugs with possible exacerbating outcomes. Screening for breast cancer is also necessary.
References
Roberts, H., & Hickey, M. (2016). Managing the menopause: an update. Maturitas , 86 , 53-58.
