Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6521

Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6521

Pharmacotherapy for Cardiovascular Disorders

Patient AO has gained nine pounds of weight and is diagnosed with hyperlipidemia and hypertension. These patients require an effective plan of treatment to help them manage their health. Both hyperlipidemia and hypertension are connected, and one is a risk factor of the other. Using this case, it is evident that the treatment plan is

Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

not working out for patient AO. This is because the patient is still having weight gain and is diagnosed with two dangerous cardiovascular conditions. Approximately seventy million in the United States are diagnosed with hypertension. This translates to about one in every three people, and the statistics are not good (Arcangelo et al., 2017). This paper aims to analyze how old age affects the patient’s pharmacokinetics and pharmacodynamics processes. It also suggests how to improve patient AO treatment plan for cardiovascular condition.

Impact of Age on Pharmacodynamics and Pharmacokinetics

In this scenario, the patient has 3 major medical issues namely high cholesterol level, high blood pressure, and obesity. As people age and need treatment, there is a need to understand the pharmacodynamics and pharmacokinetics in old age. As one ages, the process of drug absorption, metabolisms, distribution, and excretion are drastically decreased (Thürmann, 2020). Due to the decrease in hepatic flow in older people, the rate of drug metabolism by the hepatic cells is lowered. Therefore, drugs having high extraction ratios will have an increase in bioavailability. Therefore, to avoid drug toxicity, initial dosages of medicines need to be given to older patients. It is critical to note that aging also affects renal functions by reducing its excretory function. Hence, these factors show how healthcare providers need to know the dosage prescription for older patients (Reeve et al., 2017).

Besides, older people are also marked with decreased gastric emptying, slow peristalsis, and colonic transit. These physiological changes in old age affect the rate of absorption (Arcangelo et al., 2017). It is essential to note that factors such as height, weight, behavioral characteristics, and weight are considered before selecting drugs and other treatment plans.

When the drug reaches its targeted site, the pharmacodynamics processes are triggered. When the drug comes to its targeted site, old age could alter the pharmacodynamics because of the changes in the binding site, differences in the post-receptor effects, and chemical interactions. The magnitude of drug response is dependent on other parameters. They include the receptors’ density, the affinity of the receptors to the drug, and the signal transduction pathways.

How to Improve the Patient’s Drug Therapy Plan

In determining the best treatment plan for the patient, detailed history taking should be conducted, more laboratory tests such as blood chemistry, EKG, liver, and renal function tests need to be undertaken (Kapoor, 2021). It is also noted that patient AO is on several blood pressure drugs. It is challenging to know the types of drugs that are effective. There is a need to determine the cause to select the right medicine to use in control hypertension. Secondly, drug interaction needs to be investigated since patient AO is put on many medications. It is essential to start the patient on low dosages then increase the amount steadily to avoid toxicity. Additionally, Patient AO’s loss of weight should be part of the plan of treatment.

In older adults, to help ensure the dosages are prescribed as per the age, it will be necessary to conduct renal function tests. This will help determine the drug dosage, optimize the patient’s hydration status, and be aware of the nephrotoxic drugs to be avoided (Peterson et al., 2018). Also, in the elderly, the use of SSRIs has been reported to have an increased risk of GI bleeding due to their antiplatelet properties. Because of this, the Sertraline for patient AO needs to be investigated for any potential risks before continuation (, & , 2019).

In conclusion, I will recommend the entire medication regimen be stopped. However, I would also suggest more investigations be conducted to find the source of hypertension, obesity, and hyperlipidemia to properly select the drugs in managing the conditions and promote quick healing.

Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6521

…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

Photo Credit: Getty Images/Science Photo Library RF

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare for Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2 of Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

Write a 2- to 3-page paper that addresses the following:

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

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Pharmacotherapy for Cardiovascular Disorders

Patient AO has gained nine pounds of weight and is diagnosed with hyperlipidemia and hypertension. These patients require an effective plan of treatment to help them manage their health. Both hyperlipidemia and hypertension are connected, and one is a risk factor of the other. Using this case, it is evident that the treatment plan is not working out for patient AO. This is because the patient is still having weight gain and is diagnosed with two dangerous cardiovascular conditions. Approximately seventy million in the United States are diagnosed with hypertension. This translates to about one in every three people, and the statistics are not good (Arcangelo et al., 2017).

Impact of Age on Pharmacodynamics and Pharmacokinetics

In this scenario, the patient is suffering from three problems; high cholesterol level, high blood pressure, and obesity. As people age and need treatment, there is a need to understand the pharmacodynamics and pharmacokinetics in old age (Sera & Uritsky). As one ages, the process of drug absorption, metabolisms, distribution, and excretion are drastically decreased. Due to the decrease in hepatic flow in older people, the rate of drug metabolism by the hepatic cells is lowered. Therefore, drugs having high extraction ratios will have an increase in bioavailability. Therefore, to avoid drug toxicity, initial dosages of medicines need to be given to older patients. It is critical to note that aging also affects renal functions by reducing its excretory function. Hence, these factors show how healthcare providers need to know the dosage prescription for older patients.

Besides, older people are also marked with decreased gastric emptying, slow peristalsis, and colonic transit. These physiological changes in old age affect the rate of absorption (Arcangelo et al., 2017). It is essential to note that factors such as height, weight, behavioral characteristics, and weight are considered before selecting drugs and other treatment plans.

When the drug reaches its targeted site, the pharmacodynamics processes are triggered (Jaobson, 2013). When the drug comes to its targeted site, old age could alter the pharmacodynamics because of the changes in the binding site, differences in the post-receptor effects, and chemical interactions (Durakovic & Vitezic, n.d). The magnitude of drug response is dependent on other parameters. They include the receptors’ density, the affinity of the receptors to the drug, and the signal transduction pathways.

How to Improve the Patient’s Drug Therapy Plan

In determining the best treatment plan for the patient, detailed history taking should be conducted, more laboratory tests such as blood chemistry, EKG, liver, and renal function tests need to be undertaken. It is also noted that patient AO is on several blood pressure drugs (Topinková et al., 2012). It is challenging to know the types of drugs that are effective. There is a need to determine the cause to select the right medicine to use in control hypertension. Secondly, drug interaction needs to be investigated since patient AO is put on many medications. It is essential to start the patient on low dosages then increase the amount steadily to avoid toxicity. Additionally, Patient AO’s loss of weight should be part of the plan of treatment.

In older adults, to help ensure the dosages are prescribed as per the age, it will be necessary to conduct renal function tests. This will help determine the drug dosage, optimize the patient’s hydration status, and be aware of the nephrotoxic drugs to be avoided (Jacobson, 2013). Also, in the elderly, the use of SSRIs has been reported to have an increased risk of GI bleeding due to their antiplatelet properties (Carlo & Alpert, 2015). Because of this, the Sertraline for patient AO needs to be investigated for any potential risks before continuation.

In conclusion, I will recommend the entire medication regimen be stopped. However, I would also suggest more investigations be conducted to find the source of hypertension, obesity, and hyperlipidemia to properly select the drugs in managing the conditions and promote quick healing.

References

Arcangelo, V.P., Peterson, A.M., Wilbur, V., & Reinhold, J.A. (2017). Pharmacotherapeutics for Advanced Practice. A Practical Approach. (4th Ed.). Philadelphia, PA: Wolters Kluwer

Carlo, A. D., & Alpert, J. E. (2015). Geriatric Psychopharmacology: Pharmacokinetic and Pharmacodynamic Considerations. Psychiatric Annals, 45(7), 336. Doi: 10.3928/00485713-20150626-04

Durakovic, Z., & Vitezic, D. (n.d). Pharmacodynamics and pharmacokinetics in the elderly. Periodicum Biologorum, 115(4), 517-520.

Jacobson, S. (2013). Effects of pharmacokinetic and pharmacodynamic changes in the elderly. Psychiatric Times, (1),

Sera, L., & Uritsky, T. (2016). Pharmacokinetic and pharmacodynamic changes in older adults and implications for palliative care. Progress in Palliative Care, 24(5), 255-261. doi:10.1080/09699260.2016.1192319

Topinková, E., Baeyens, J.P., Michel, J.P. et al. (2012). Evidence-Based Strategies for the Optimization of Pharmacotherapy in Older People. Drugs Aging 29, 477–494. https://doi.org/10.2165/11632400-000000000-00000

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What’s Coming Up in Week 3?

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Next week, you will examine strategies for the treatment and management of respiratory disorders, including asthma. You will analyze asthma and stepwise management and consider the impact of this approach for patient health.

Next Week

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Week 3

Week 3: Respiratory System

Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

Learning Objectives

Students will:

Evaluate drug therapy plans for asthma
Assess the impact of asthma treatments on patients
Analyze the stepwise approach to asthma treatment and management

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Chapter 62, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 557–579)
Chapter 63, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 580–588)

Document: APA Presentation Template

Optional Resources (click to expand/reduce)

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This web resource presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.