Summary
Joint pain, which is a widespread side effect of the statin class of drugs, occurs because of the use of rosuvastatin. The pain is often severe in people with myopathies, liver, and renal diseases (Lehne, 2013). Joint pains arise due to the incomplete metabolism of the drug by the liver. Subsequently, poor kidney excretion of the drug causes it to build up in the body.
Rhabdomyolysis
Rhabdomyolysis is a life-threatening syndrome, which is associated with drugs that treat high blood lipid levels. The condition often leads to a rapid disintegration of the skeletal muscles, which causes the muscle tissues to circulate in the blood (myoglobinemia). The presence of muscle tissue in urine (myoglobinuria) causes damage to the kidneys. Rhabdomyolysis has numerous other causes apart from the adverse effects of some drugs.
These causes include skeletal muscle trauma, overexertion, and the presence of poisonous substances in the blood (O’Connor & Deuster, 2012). Certain genetic diseases, for example, McArdle’s disease elevate the possibility of having the condition. Symptoms of the disorder include a decrease in urine output, lethargy, stiffness of the muscles, and joint pain.
Cardiac Implications of the Prescribed Drugs
Despite possessing therapeutic effects, the patient’s prescription drugs have unintended effects on cardiac functions. For instance, the administration of 0.25mg of alprazolam twice a day causes rapid and erratic heartbeats in some patients. The drug is also associated with hypotension and tachycardia (Aronson, 2009). Lisinopril at a daily dose of 20mg acts as an angiotensin-converting enzyme (ACE) inhibitor that improves cardiac function by lowering blood pressure (Lehne, 2013).
By inhibiting ACE, the drug lowers blood plasma levels of angiotensin II, which then stimulates aldosterone secretion. Consequently, blood volume and pressure decrease thereby improving cardiac function by reducing vasoconstriction. Rosuvastatin at a dosage of 20mg has tendencies of causing palpitations and cardiac arrhythmias. Sildenafil, which is a Viagra, alters cardiac function leading to irregular heartbeats.
Current Concerns on the Use of Ambien
Ambien has widespread uses including the treatment of insomnia in some patients. However, the rising frequencies of tragic incidences associated with the drug are causes for concern. The use of Ambien causes patients to sleepwalk hence the term ‘Ambien zombies.’ The drug leads to other bizarre behaviors such as eating and shopping while asleep. Sleep driving is an extreme case, which often leads to tragic accidents. The patients report doing odd activities unconsciously and blame the drug for erasing their memories. Ambien is also associated with hip fractures in patients above 50 years. In addition, the chances of cancer are fourfold higher in people who take ambient than in those who do not take the drug (Ambien blog news & updates, n.d.).
Recommendations to Reduce the Effects of Ambien
The patient’s fatigue is a consequence of mild hypertension due to lisinopril tolerance. To increase the efficacy of lisinopril, I would suggest a gradual increase of the dosage from 20mg to a maximum of 80mg in a day. Another alternative is administering lisinopril with a diuretic to reduce blood pressure. I would also recommend combining 20mg rosuvastatin with a fibrate to reduce the levels of low-density lipoprotein (LDL) from 140mg/dl to less than 100 mg/dl. Consequently, the levels of high-density lipoproteins (HDL) would increase from 35mg/dl to more than 40mg/dl. High HDL levels would protect the patient from cardiac diseases leading to efficient peripheral circulation and less exhaustion (Lehne, 2013).
Significance of Grape Juice
Grapefruit has bergamottin that alters the functions of enzymes responsible for the breakdown of statins and other drugs. The consumption of grapefruit juice before taking statins and other drugs that are metabolized in the liver causes the drugs to accumulate in the body (Li, 2011). Health problems occur leading to liver damage and rhabdomyolysis in rare circumstances. Therefore, the patient’s consumption of grape juice is significant because it interferes with liver enzymes and other metabolic functions.
References
Ambien blog news & updates. (n.d.). Web.
Aronson, K. L. (2009). Meyler’s side effects of cardiovascular drugs. New York: Elsevier Health Sciences.
Lehne, R. A. (2013). Pharmacology for nursing care. New York: Elsevier Health Sciences.
Li, X. (2011). Oral Bioavailability: Basic principles, advanced concepts, and applications. Hoboken: John Wiley & Sons.
O’Connor, F. G., & Deuster, P. A. (2012). Rhabdomyolysis. In Goldman, L., & Schafer, L., A. (Eds.), Goldman’s Cecil medicine (pp. 700-701). New York: Elsevier Health Sciences.