heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke\u2014some of the leading risk factors for heart disease\u2026<\/p>\n
\u2014Murphy et al., 2018<\/p>\n
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.<\/p>\n
Photo Credit: Getty Images\/Science Photo Library RF<\/p>\n
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.<\/p>\n
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<\/a><\/p>\n Write<\/strong> a 2- to 3-page paper that addresses the following:<\/p>\n Reminder:<\/strong> 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<\/a>). All papers submitted must use this formatting.<\/p>\n To submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n Pharmacokinetics<\/a> refers to the processes that the body subjects a drug to once it is introduced to the body. These processes include absorption, distribution, metabolism, and excretion. Pharmacodynamics, on the other hand, refers to the effects that drugs cause to the body, like the side effects of the drug. Both pharmacokinetics and pharmacodynamics are affected by factors such as the medical history of a patient, other medication that the patient is using, and patient characteristics, such as age and sex. From the given case study, pharmacokinetics and pharmacodynamics in Patient CB are affected by the medical history of the patient and the current drugs being taken NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders.<\/p>\n Treatment for patients with cardiovascular disease is always a challenge due to many comorbidities involved. These require different drugs, which have different reactions and side effects. Moreover, these reactions are not usually uniform among all patients. Consequently, it is necessary to continually monitor the patient to avoid adverse drug reactions (Mangoni & Jarmuzewska, 2019). Patient CB has a history of stroke and is currently suffering from type 2 diabetes mellitus, hypertension, and hyperlipidemia. All these conditions play a significant role in pharmacokinetics and pharmacodynamics. Diabetes, for example, increases mycobacterial burden among some patients, which affects treatment (Alfarisi et al., 2018). Additionally, patients with diabetes mellitus have difficulties in excreting toxins from the kidney, which puts them at a heightened risk of developing diabetic nephropathy that can potentially complicate their treatment further.<\/p>\n The patient, however, is under a Glipizide 10 mg dosage, which helps to prevent kidney damage. Since patient CB is taking multiple medications and is suffering from diabetes, it is easy for toxins to accumulate in the body. Hypertension is another significant condition that affects pharmacokinetics and pharmacodynamics. Since patient CB is suffering from the condition, it is necessary to consider its effects and the significance of pharmacotherapy interventions (Oparil & Schmieder, 2015). For example, the patient is under Verapamil 180 mg CD daily dosage, which helps to lower blood pressure and prevent stroke (Mancia et al., 2014) NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders. The drug, however, has adverse effects on the body of the patient. It slows down the heartbeat rate and may cause severe liver damage and other mild effects, including headaches, nausea, and vomiting. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders<\/p>\n In treating the patient, it is necessary to consider the aforementioned side effects of the drugs. The patient is also under a Hydralazine 25 mg dosage, which is used in the treatment of high blood pressure. This drug\u2019s pharmacodynamics is counter to that of Verapamil 180 mg. This is because it increases the heartbeat of the patient, while Verapamil 180 mg lowers the pulse (Flynn, Bradford, & Harvey, 2016). Such counter-reactions may be fatal to the patient and, therefore, using such drugs concurrently is ill-advised. Hyperlipidemia is another condition that is affecting patient CB, and which plays a critical role in pharmacokinetics and pharmacodynamics. Hyperlipidemia means that the level of lipids (such as triglycerides and cholesterol) in the patient\u2019s blood is very high. These lipids are deposited along blood vessels, restricting the flow of blood in the body.<\/p>\n The high levels of lipid in the blood predispose the patient to stroke or myocardial infarction, commonly known as a heart attack (Navar-Boggan et al., 2015). The patient is under a Simvastatin 80 mg dosage to control the condition. However, this drug has negative effects on patients with diabetes. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders. Therefore, administering Simvastatin 80 mg puts patient CB at risk because he is also suffering from type 2 diabetes mellitus. When prescribing drugs to patients with cardiovascular disease, the physician must pay close attention to all the variables involved to avoid adverse drug reactions. For Patient CB, his conditions complicate pharmacokinetic and pharmacodynamics due to comorbidities NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders<\/p>\n Alfarisi, O., Mave, V., Gaikwad, S., Sahasrabudhe, T., Ramachandran, G., Kumar, H., \u2026 & Raskar, S. (2018). Effect of diabetes mellitus on the pharmacokinetics and pharmacodynamics of tuberculosis treatment.\u00a0Antimicrobial Agents and Chemotherapy<\/em>,\u00a062<\/em>(11), 1-14.<\/p>\n Flynn, J. T., Bradford, M. C., & Harvey, E. M. (2016). Intravenous hydralazine in hospitalized children and adolescents with hypertension.\u00a0The Journal of Pediatrics<\/em>,\u00a0168<\/em>, 88-92. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders<\/p>\n Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., B\u00f6hm, M., \u2026 & Galderisi, M. (2014). 2013 ESH\/ESC Practice guidelines for the management of arterial hypertension: ESH-ESC: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).\u00a0Blood Pressure<\/em>,\u00a023<\/em>(1), 3-16.<\/p>\n Mangoni, A. A., & Jarmuzewska, E. A. (2019). The influence of heart failure on the pharmacokinetics of cardiovascular and non\u2010cardiovascular drugs: A critical appraisal of the evidence.\u00a0British Journal of Clinical Pharmacology<\/em>,\u00a085<\/em>(1), 20-36.<\/p>\n Navar-Boggan, A. M., Peterson, E. D., D\u2019Agostino Sr, R. B., Neely, B., Sniderman, A. D., & Pencina, M. J. (2015). Hyperlipidemia in early adulthood increases long-term risk of coronary heart disease.\u00a0Circulation<\/em>,\u00a0131<\/em>(5), 451-458.<\/p>\n Oparil, S., & Schmieder, R. E. (2015). New approaches in the treatment of hypertension.\u00a0Circulation Research<\/em>,\u00a0116<\/em>(6), 1074-1095.<\/p>\n The prevalence and impact of cardiovascular disorders in the U.S. are undeniable, especially in contributing to the nation’s morbidity and mortality rates. Effective pharmacotherapeutic strategies are paramount, and these must be tailored according to individual patient characteristics. The case of LM, an 89-year-old female with a vast array of health complications, serves as a vivid representation of the complexities involved. Central to this discussion is the role of age, a factor with significant implications on both pharmacokinetics (the journey of a drug through the body) and pharmacodynamics (the body’s response to the drug).<\/p>\n Age plays a pivotal role in determining how drugs interact with the body. Elderly individuals often undergo physiological changes that can drastically alter the absorption, distribution, metabolism, and excretion of drugs. For instance, delayed gastric emptying and reduced gastrointestinal blood flow can result in a slower absorption rate for many medications in older adults. Similarly, reduced muscle mass and decreased serum albumin can impact how drugs are distributed throughout the body. When it comes to metabolism, the decrease in hepatic blood flow and liver mass commonly seen in elderly patients can reduce the body’s ability to process drugs effectively. Finally, diminished renal function, evident in LM’s eGFR of 45 ml\/min, can affect drug excretion, posing potential risks for toxicity (Nightingale et al., 2019).<\/p>\n Moreover, the body’s response to drugs, or pharmacodynamics, undergoes changes with age. Older adults might experience heightened sensitivity to certain medications, leading to unpredictable or altered responses, thus increasing the potential for adverse reactions (McKearney & Coleman, 2020).<\/p>\n Given LM’s age and observed health metrics, there is a pressing need for keen scrutiny of her medication regimen. Amlodipine, prescribed for her hypertension, may be contributing to her experience (Rafeq & Salzman, 2022). The diuretic, Furosemide, when combined with her diabetes medications, Metformin and Glyburide, poses a potential risk for significant shifts in her electrolyte levels, which could be exacerbating her risk for falls (Ali et al., 2019). Celecoxib, prescribed for osteoarthritis, has known potential to aggravate hypertension and further decline kidney function, especially in the elderly (White et al., 2000).<\/p>\n In light of the pharmacokinetic and pharmacodynamic considerations induced by age and LM’s evident health complexities, it is essential to revisit and possibly modify her medication regimen.<\/p>\n A thorough reevaluation of her antihypertensive medications is a priority. Given her recorded supine blood pressure, an adjustment in the dosage or a switch from amlodipine to another antihypertensive class with fewer side effects related to edema might be beneficial.<\/p>\n Regular monitoring of LM’s glucose, potassium, and overall renal function can ensure the safety of her diabetes medications combined with the diuretic (Davies et al., 2022). Additionally, her pain management strategy needs to be readdressed. It might be more advantageous to explore non-drug interventions or consider switching from celecoxib to acetaminophen, a medication with a better safety profile for the elderly (Alorfi, 2023).<\/p>\n The case of LM underscores the importance of meticulous pharmacotherapeutic planning, especially in elderly patients with multiple health challenges. Age-induced changes in pharmacokinetics and pharmacodynamics necessitate a tailored approach, ensuring not just effective treatment but also the well-being and safety of the patient. Collaborative and informed medical decisions remain the linchpin in achieving optimal therapeutic outcomes.<\/p>\n Ali, S., Peterson, G. M., Bereznicki, L. R., & Salahudeen, M. S. (2020). Association between anticholinergic drug burden and mortality in older people: a systematic review.\u00a0European Journal of Clinical Pharmacology<\/em>,\u00a076<\/em>(3), 319\u2013335. https:\/\/doi.org\/10.1007\/s00228-019-02795-x<\/a><\/p>\n Alorfi NM. (2023). Pharmacological Methods of Pain Management: Narrative Review of Medication Used.\u00a0International Journal of General Medicine<\/em>,\u00a0ume 16<\/em>, 3247\u20133256.<\/p>\n Davies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Del Prato, S., Mathieu, C., Mingrone, G., Rossing, P., Tankova, T., Tsapas, A., & Buse, J. B. (2022, November 1). Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association and the European Association for the Study of Diabetes.\u00a0Diabetes Care<\/em>,\u00a045<\/em>(11), 2753.<\/p>\n McKearney, K., & Coleman, J. J. (2020). Prescribing medicines for elderly patients.\u00a0Medicine<\/em>,\u00a048<\/em>(7), 463\u2013467. https:\/\/doi.org\/10.1016\/j.mpmed.2020.04.004<\/a><\/p>\n Nightingale, G., Schwartz, R., Kachur, E., Dixon, B. N., Cote, C., Barlow, A., Barlow, B., & Medina, P. (2019). Clinical pharmacology of oncology agents in older adults: A comprehensive review of how chronologic and functional age can influence treatment-related effects.\u00a0Journal of Geriatric Oncology<\/em>,\u00a010<\/em>(1), 4\u201330. https:\/\/doi.org\/10.1016\/j.jgo.2018.06.008<\/a><\/p>\nTo Prepare<\/strong><\/h2>\n
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By Day 7 of Week 2<\/strong><\/h2>\n
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Submission and Grading Information<\/strong><\/h2>\n
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A Sample Answer For the Assignment: NURS 6512 Assignment Pharmacotherapy for Cardiovascular Disorders<\/strong><\/h2>\n
Title: <\/strong> NURS 6512 Assignment Pharmacotherapy for Cardiovascular Disorders<\/strong><\/h2>\n
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References<\/h2>\n
A Sample Answer 2 For the Assignment: NURS 6512 Assignment Pharmacotherapy for Cardiovascular Disorders<\/strong><\/h2>\n
Title: <\/strong> NURS 6512 Assignment Pharmacotherapy for Cardiovascular Disorders<\/strong><\/h2>\n
Introduction<\/strong><\/h2>\n
Age’s Impact on Pharmacokinetics and Pharmacodynamics<\/strong><\/h2>\n
Implications for LM’s Drug Therapy<\/strong><\/h2>\n
Recommendations for Drug Therapy Modification<\/strong><\/h2>\n
Conclusion<\/strong><\/h2>\n
References<\/strong><\/h2>\n