Margaret Ellison

High · 61

Maggie · 78F · DOB 12 Mar 1948 · MRN RN-48291

78-year-old woman with HFpEF, CKD 3b, type 2 diabetes and anticoagulation for AF. Polypharmacy and a nocturnal hypnotic are the dominant reversible risks.

Outpatients · Heart Failure

Allergies: Penicillin (rash) · Latex

For full active treatment · ReSPECT completed 2026-04

Zopiclone — Beers / falls

Hypnotic without a stop date after a documented overnight fall.

eGFR 38 on ACEI + diuretic + metformin

Triple renal stress. Recheck electrolytes if any dose change.

Potassium 5.1 mmol/L

Upper reference on ramipril. Limits uptitration and spironolactone.

Clinical parameters

eGFR

38mL/min/1.73m²

Ref >60

Potassium

5.1mmol/L

Ref 3.5–5.0

NT-proBNP

1280ng/L

Ref <400

Organ risk

Conditions

Heart failure with preserved EF

NYHA II · EF 56%

2022-11

CKD stage 3b

Baseline eGFR 36–40

2020-06

Type 2 diabetes

2014-02

Atrial fibrillation

CHA2DS2-VASc 6

2019-08

Hypertension

2008

Osteoarthritis, knees

2016

Care team

Dr Amara Okonkwo

Named consultant

Priya Shah

Heart failure CNS

James Cole

Clinical pharmacist

Next encounter

HF / pharmacology joint clinic

Sun 20 Sep · 10:30

Riverside · Room 3 · Dr Okonkwo & J. Cole

Review hypnotic, ACEI, SGLT2 candidacy.