Based on his CF history, he will require an additional antihypertensive medication. He is now taking a diuretic combination, Maxzide 37.5/25mg once daily, and will require the addition of a beta blocker cocktail. As a result, I shall recommend HCT 50mg/25mg to be taken once day. The beta blocker in the medication prevents diuretics from increasing plasma renin levels by balancing their tendency to retain water (Kjeldsen et al., 2014).
In the treatment of diabetes, I will prescribe 500mg of metformin twice day and 30mg of Actos (Pioglitazone) once daily. This is a combination of a biguanide and thiazolidinediones that are essential for overweight or obese patients since it does not cause increase in weight and works to reduce the risk of hypoglycemia (George et al., 2015). The patient will be advised to take metformin with meals to reduce the gastrointestinal side effects. Also, the thiazolidinediones do not affect the renal function with the patient taking antihypertensives since they are highly metabolized by the liver and excreted in feces (George et al., 2015).
On the other hand, the patient has a BMI of 32 which indicates that he is obese. A combination of nutrition therapy, pharmacological and use of exercise will, therefore, be part of the recommendation that the patient receives during discharge (American Diabetes Association, 2014). First, since the patient is elderly, advice on the right diet will be given to the caregivers. The patient's diet will be required to have a reduced amount of carbohydrates, proteins and much of the food should contain fruits and vegetables (George et al., 2015). The patient will then be encouraged to take walks every day as the best way of exercising about his age. Additionally, he will be encouraged to attend the outpatient clinics one every month for follow up to ensure that progress is using the prescriptions.
References
American Diabetes Association. (2014). Executive summary: standards of medical care in diabetes-2014.
George, C. M., Bruijn, L. L., Will, K., & Howard-Thompson, A. (2015). Management of Blood Glucose with Noninsulin Therapies in Type 2 Diabetes. American family physician, 92(1).
Kjeldsen, S., Feldman, R. D., Lisheng, L., Mourad, J. J., Chiang, C. E., Zhang, W., ... & Williams, B. (2014). Updated national and international hypertension guidelines: a review of current recommendations. Drugs, 74(17), 2033-2051.
