After discussion with Mrs Cloverdale and her regular GP, you recommend that she stop taking the Serc, Naprosyn, glibenclamide, panadeine and after some discussion, she agrees to decrease the temazepam to 10mg daily and then stop. She will start regular paracetamol and change the ACE inhibitor to Ramipril 10mg daily.
Within 4 weeks her heart failure had improved and the frusemide was discontinued. Mrs Cloverdale was commenced on calcium (calcium carbonate 600mg) and Vitamin D (Ostelin 1000 IU), with a loading dose of 3 tablets, 3x daily for 2 weeks, after which she will remain on the maintenance dose.
A follow-up blood pressure is 135/85 with only a 10mmhg postural drop, measured immediately upon standing and then again after two minutes. Her blood sugars are improved with no further hypoglycaemia. Her children comment that she seems clearer in her mind and steadier on her feet. She is no longer experiencing the dizzy spells.