WHO Guide to Good Prescribing Chapter 3: Example of selecting a P-drug: angina pectoris
Chapter 3:
Example of selecting a P-drug: angina pectoris
Example: patient 2 You are a young doctor, and one of your first patients is a 60-year old man, with no previous medical history. During the last month he has had several attacks of suffocating chest pain, which began during physical labour and disappeared quickly after he stopped. He has not smoked for four years. His father and brother died of a heart attack. Apart from occasionally taking some aspirin he has not used any medication in the past year. Auscultation reveals a murmur over the right carotid artery and the right femoral artery. Physical examination reveals no other abnormalities. Blood pressure is 130/85, pulse 78 regular, and body weight is normal. You are fairly sure of the diagnosis, angina pectoris, and explain the nature of this disease to him. The patient listens carefully and asks: But, what can be done about it?. You explain that the attacks are usually self-limiting, but that they can also be stopped by drugs. He responds Well, that's exactly what I need. You tend to agree that he might need a drug, but which? Atenolol, glyceryl trinitrate, furosemide, metoprolol, verapamil, haloperidol (no, no that's something else) all cross your mind. What to do now? You consider prescribing Cordacor® , because you have read something about it in an advertisement. But which dose? You have to admit that you are not very sure. Later at home you think about the case, and about your problem in finding the right drug for the patient. Angina pectoris is a common condition, and you decide to choose a P-drug to help you in the treatment of future cases. | |
|
