The patient is a 57 year-old woman followed by Dr. Haggard in the IWAKE HEALTHCARE Clinic for problems related to obesity, depression and poorly controlled hypertension. In March of 1995, she had a palpable indurated area at 12:00 on the right breast and was seen by Dr. Noguchi in the Surgery Clinic and scheduled for a right breast biopsy. She was admitted to the General Medical Service and given more aggressive hypertensive medications including increasing her ACE inhibitor to Lisinopril 40 mg p.o. q. day, discontinuing her Diltiazem and starting on Hydrochlorothiazide 25 mg p.o. q. daily and starting Beta blocker Lopressor 25 mg p.o. q.i.d. and increasing as tolerated according to her blood pressure. The right breast abscess was drained without incident and she was started on IV antibiotics which included Ancef 1 gram IV q. 8h. Other notable events in the hospital included a Psychiatry consult who suggested that the patient had a history of major depression and recommended ruling organic brain disease and a polysonography was done for monitoring of sleep apnea and an MMTI for further diagnostic evaluation. The patient had an uneventful postoperative course with her blood pressure remaining moderately elevated and resolution of her symptoms of right breast tenderness. On discharge, she was given Enteric coated aspirin 325 mg p.o. q. day, Colace 100 mg p.o. b.i.d., Hydrochlorothiazide 25 mg p.o. q. daily, Lisinopril 40 mg p.o. q. daily, Tylox 1-2 capsules p.o. q. 4-6h. p.r.n. pain, Atenolol 100 mg p.o. q. daily, and Cephradine 100 mg p.o. q.i.d. times five days, with follow-up in the TLET HOSPITAL Clinic with Dr. Mcgowan and in a Hmotmed Dell An Community Hospital Medical Service.
Has the patient had multiple diltiazem prescriptions
discontinuing her Diltiazem and starting on Hydrochlorothiazide 25 mg p.o. q. daily