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Assignment Scenario:
On 5th of March at 1800 hours, Mr. Michael Coleman, aged 56 years, was admitted to the acute care ward with chest pain for investigation. He was transferred from the emergency department where he presented with mild chest pain and shortness of breath. Mr. Coleman has a past medical history of hypertension, hyperlipidemia (managed with diet), and ischaemic heart disease. He usually takes atenolol, ramipril, aspirin and sublingual glyceryl trinitrate (GTN), but doesn’t always adhere to his medication regime. He has been charted for enoxaparin. Mr. Coleman has chest pain on exertion, which is relieved with sublingual GTN. It is now 6th March at 0730 hours.
Mr. Coleman had vital signs taken two hours ago:
HR 62 bpm (regular)
BP 105/62 mmHg
RR 24 breaths per minute
SpO2 93% on 2L nasal prongs
Temp 37.4 (tympanic)
Mr. Coleman’s12-lead ECG shows changes from his previous one. He is booked to have an angiogram today for potential angioplasty. He weighs 90kg and his serum troponin is 9.92 μg/L (normal < 0.03 μg/L).
Q1. Assess Mr. Coleman’s medication chart and identify and explain two (2) significant risks that may be associated with the use of these medicines. (Expect approximately 400 words)
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