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Patient FD (male, 71 years old) has been diagnosed with Park…

Patient FD (male, 71 years old) has been diagnosed with Parkinson’s Disease. He is a retired chef but now volunteers 4 days per week working in the gardens of a local historical property giving guided tours. In his spare time, he likes to golf and does this at least twice per week. When discussing how his symptoms are impacting on his life he describes how he is becoming very upset about the impact of the motor symptoms on his ability to work and play golf. He has no significant past medical history and no drug allergies. Which is the MOST SUITABLE pharmacological treatment to initiate?

Patient AD (male, 70 years old) has type 2 diabetes and chro…

Patient AD (male, 70 years old) has type 2 diabetes and chronic kidney disease. They take metformin 1 g twice daily, gliclazide 160 mg twice daily and lisinopril 10 mg once daily and take them all as prescribed. They have come to the GP surgery for a diabetes review. Their blood results are: eGFR 51 ml/min/1.73m2 (last year 55 ml/min/1.73m2) Urine albumin:creatinine ratio (ACR) 32 mg/mmol (6 months ago 28 mg/mmol) HbA1c 67 mmol/mol (3 months ago 62 mmol/mol)   Which is the MOST APPROPRIATE next step?

Patient GC (female, 78 years old) has a diagnosis of heart f…

Patient GC (female, 78 years old) has a diagnosis of heart failure with reduced ejection fraction. They are prescribed the following:   Lisinopril 40 mg once daily Bisoprolol 2.5 mg once daily Furosemide 40 mg once in the morning Spironolactone 25 mg once daily   Blood results are as follows: eGFR 75 ml/min/1.73m2 Sodium 141 (137-144 mmol/L) Potassium 4.6 (3.5-5.3 mmol/L) Creatinine 75 (60-110 micromol/L) Blood pressure is 115/71 mmHg They are clinically stable and have attended the heart failure clinic for a routine review. Which action would be MOST APPROPRIATE to optimise their treatment?

Patient JQ (male, 56 years old) has type 1 diabetes and has…

Patient JQ (male, 56 years old) has type 1 diabetes and has been in hospital for the last 3 days with a chest infection. This has cleared up significantly and he is now on oral antibiotics and looking forward to being discharged soon. This afternoon, however, he has complained of feeling sweaty, dizzy and ‘just awful’. It is 1.30 pm, just after lunch. His capillary blood glucose is tested and found to be 3.10 mmol/L. It was noted that the previous two days post-lunch blood glucose readings were 3.90 mmol/L and 3.50 mmol/L respectively. Other blood glucose readings have been within range. The list of medication he is currently prescribed in hospital is shown below.   Tresiba FlexTouch 100 units/ml                 20 units twice daily (8 am and 6 pm) NovoRapid FlexPen 100 units/ml              10 units three times daily with meals Co-amoxiclav 625 mg tablets                     three times daily for 4 more days to complete 7 day course (Intravenous co-amoxiclav 1.2 g now finished)   What is the MOST APPROPRIATE course of action?