CMTM Certified in Medication Therapy Management

CMTM Certified in Medication T…

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1. A 67-year-old male with a history of hypertension, type 2 diabetes, and osteoarthritis presents for a Comprehensive Medication Review (CMR). During the session, the pharmacist discovers the patient is taking both lisinopril 20 mg daily and over-the-counter ibuprofen 400 mg three times daily for knee pain. The patient's most recent serum creatinine has increased from 1.1 mg/dL to 1.6 mg/dL over the last three months, and his blood pressure is 152/94 mmHg. What is the most appropriate clinical intervention to address this medication-related problem?

Increase the dose of lisinopril to 40 mg daily to better control the elevated blood pressure.Discontinue ibuprofen and recommend topical diclofenac or scheduled acetaminophen.Add hydrochlorothiazide 12.5 mg daily to the regimen to counteract the fluid retention.Advise the patient to take the ibuprofen and lisinopril at least 12 hours apart.

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