Week 3 discussion post

Margaret is a 59-year-old Caucasian female who presents to the clinic for follow-up of her hypertension. She reports that she has a worsening of a tremor in her hand over the last few months. She was seen by a neurologist previously and was diagnosed with an essential tremor but opted to not take medication because it wasn’t particularly bothersome. She reports now that she has difficulty pouring a drink, drinking from a cup, using utensils to eat, and writing or drawing. Margaret also reports that since you started her on Clonidine last month for her blood pressure, she has been having some difficulties with headaches, dizziness, dry mouth and difficulty urinating. You plan to discontinue the clonidine. Past Medical History: Hypertension, essential tremor and seasonal allergies. Surgical History: Tonsillectomy. Family History: Mother HTN & essential tremor, Father Diabetes, Sister Diabetes all deceased. Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week. Allergies: NKA Current medications: Multivitamin with Iron 1 tab PO daily, Claritin 10mg daily PO prn for allergies, Clonidine 0.1mg PO BID All vaccines up to date. Vitals: Height 57 inches, Weight 145 pounds, BP 156/85, P 70, R 16. Physical exam is normal. Dr. Paarlberg and Class, What are your treatment goals for Margaret today? The treatment plan for Margaret is to discontinue her current medication Clonidine and replace this medication with an hypertension therapy. What is your pharmacological plan and rationale? (cite with appropriate clinical practice guidelines or scholarly peer-reviewed articles and always include medication name, strength, dosage form, route, frequency and duration when making recommendations) Clonidine is a alpha-agonist such are generally selected a second or third line drug choice to treat mild to moderate hypertension. In the geriatric population, clonidine should be avoided or if used use with extreme caution due to decrease in sympathetic tone, peripheral resistance, heart rete and renal vascular resistance while also increasing the parasympathetic stimulation (Woo & Robinson, 2016). As seen above Margaret is presenting with some of the common adverse effects of Clonidine including dry mouth and urinary retention. Urinary retention is a more severe adverse effect concerning the potential for creating further additional issues, this adverse effect individually is a reason to discontinue this medication. Nonetheless, Clonidine is not a medication that should be discontinued suddenly since the lack of alpha2 receptors impair