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George Smith is a 52 year-old white man with a history of hypertension for which he takes lisinopril 10 mg orally each day. Over the past several years he has experienced increasing stiffness and pain in his knees. After careful assessment, he is found to have osteoarthritis. What would you prescribe for him? Factors to consider are that he is employed in a job that he must stand most of the day, he has health insurance but no coverage for medication and he has a family history of coronary artery disease and stroke.
You may wish to review the following article:
Trelle S, Reichenbach S, Wandel S, Hildebrand P, Tschannen B, Villiger P, Egger M & Juni P. (2011). Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ, 342, c7086.
(ATTACHED if needed)
In no more than two pages, write your prescription (3 points), provide the rationale for your choice (3 points) and describe any implications for treatment of his hypertension based on what you have prescribed for the arthritis and your plan for managing both (4 points).
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