Ian Mutava Kioko

 Wk5 discussion Student name Institution Course Instructor Due date Wk5 discussion Application of Course Knowledge The 55-year-old Mexican man, Emiliano Jiménez, appears for a post-hospitalization visit after having a myocardial infarction (MI) and receiving a stent. His past medical history includes hyperlipidemia, confirmed coronary artery disease, diabetes mellitus type II, and latest MI. The present medications include metformin (500mg PO BID), aspirin, atorvastatin, and clopidogrel (75mg PO daily). A full physical examination on the patient shows normal vital signs, good healing of the PCI access site and no complications as seen. With regards to Emiliano’s presentation, the clinical practice guidelines suggest controlling his cardiovascular danger by addressing both diabetes and atherosclerotic disease. The 2021 American Diabetes Association and the American College of Cardiology guidelines recommend GLP-1 receptor agonists such as liraglutide in predominantly asymptomatic patients with diabetes type II and ASCVD to further reduce the risk of recurrent cardiac events. Liraglutide, according to Verma et al. (2019), can contribute to a decrease in the risk of MI, stroke, and cardiovascular death in such patients, that is why it is prescribed to Emiliano. His level of glycosylated hemoglobin A1c is 7% which shows that additional efforts to control glucose levels are required with liraglutide to help in achieving better glycemic control. In the pharmacological approach, liraglutide also reciprocally improves Emiliano’s disease profile besides enhancing glycemic control. A follow-up appointment in one week will evaluate perseverance before escalating the dose. I would also analyze areas of possible problems, for instance, about how well the patient is compliant with his medications and his knowledge regarding the management of other chronic conditions like diet and exercise. Subsequent laboratories on future labs should incorporate monitoring hemoglobin lipid panels, and renal operation to combat response to therapy. Integration of Evidence Liraglutide has been associated with significant reduction in cardiovascular risks in patients with diabetes and ASCVD (American Diabetes Association, 2021). It is also essential in reducing blood glucose levels and inhibiting future cardiac incidences (Rosenthal & Burchum, 2020). A review is needed after one week to check for the side effects and to revisit the dose if necessary. References American Diabetes Association. (2021). 10. Cardiovascular disease and risk management: standards of medical care in diabetes—2021. Diabetes care, 44(Supplement_1), S125-S150. https://diabetesjournals.org/care/article-abstract/44/Supplement_1/S125/30445 Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=IPm9DwAAQBAJ&oi=fnd&pg=PP1&dq=Rosenthal,+L.+D.,+%26+Burchum,+J.+R.+(2021).+Lehne%E2%80%99s+pharmacotherapeutics+for+advanced+practice+nurses+and+physician+assistants+(2nd+ed.).+Elsevier&ots=rQW9lmCuQM&sig=8ysRKBNy5uUR-UWltynJJ5o586s Verma, S., Poulter, N. R., Bhatt, D. L., Bain, S. C., Buse, J. B., Leiter, L. A., Nauck, M. A., Pratley, R. E., Zinman, B., Ørsted, D. D., Monk Fries, T., Rasmussen, S., & Marso, S. P. (2019). Effects of Liraglutide on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus With or Without History of Myocardial Infarction or Stroke. Circulation, 138(25),-. https://doi.org/10.1161/circulationaha-