Lethargy in a 65-yr-old Man

Past Medical History

  • Medical history: Hypertension since age 47 yr that is moderately controlled with three antihypertensive drugs. Hypercholesterolemia that was diagnosed in his early 50s and for which he takes an unknown drug. Depression for which he takes an unknown drug. Chronic back pain for which he takes oxycodone. No history of stroke or transient ischemic attacks, coronary artery disease, renal disease, cancer, diabetes, or autoimmune disorders.

  • Surgical history: Negative

  • Medications: Oxycodone and unknown antihypertensive drugs, lipid-lowering drug, and antidepressant.

  • Allergies: No known drug or environmental allergies.

  • Family history: One brother with hypertension. Father died at age 76 from complications of myocardial infarction.

  • Social history: Patient is divorced with 2 children. He used to work as a bus driver but is on disability because of chronic back pain. He used to smoke cigarettes but quit 10 yr ago. He drinks 2 to 3 beers daily. He smokes marijuana once or twice/yr.