Describe Pharmacotherapy for Cardiovascular Disorders

Describe Pharmacotherapy for Cardiovascular Disorders

Pharmacokinetics 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.

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.

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). 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.

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’s 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’s blood is very high. These lipids are deposited along blood vessels, restricting the flow of blood in the body.

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. 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.

References

Alfarisi, O., Mave, V., Gaikwad, S., Sahasrabudhe, T., Ramachandran, G., Kumar, H., … & Raskar, S. (2018). Effect of diabetes mellitus on the pharmacokinetics and pharmacodynamics of tuberculosis treatment. Antimicrobial Agents and Chemotherapy, 62(11), 1-14.

Flynn, J. T., Bradford, M. C., & Harvey, E. M. (2016). Intravenous hydralazine in hospitalized children and adolescents with hypertension. The Journal of Pediatrics, 168, 88-92.

Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., … & 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). Blood Pressure, 23(1), 3-16.

Mangoni, A. A., & Jarmuzewska, E. A. (2019). The influence of heart failure on the pharmacokinetics of cardiovascular and non‐cardiovascular drugs: A critical appraisal of the evidence. British Journal of Clinical Pharmacology, 85(1), 20-36.

Navar-Boggan, A. M., Peterson, E. D., D’Agostino Sr, R. B., Neely, B., Sniderman, A. D., & Pencina, M. J. (2015). Hyperlipidemia in early adulthood increases long-term risk of coronary heart disease. Circulation, 131(5), 451-458.

Oparil, S., & Schmieder, R. E. (2015). New approaches in the treatment of hypertension. Circulation Research, 116(6), 1074-1095.

Assignment: Pharmacotherapy for Cardiovascular Disorders
…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
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
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 School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School 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.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
NURS_6521_Week2_Assignment_Rubric
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Excellent Good Fair Poor
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Points Range: 23 (23%) – 25 (25%)
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 20 (20%) – 22 (22%)
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 0 (0%) – 17 (17%)
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Points Range: 27 (27%) – 30 (30%)
The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.
Accurate, complete, and aligned examples are provided to support the response.

Points Range: 24 (24%) – 26 (26%)
The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.
Accurate examples may be provided to support the response.

Points Range: 21 (21%) – 23 (23%)
The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.
Inaccurate or vague examples are provided to support the response.

Points Range: 0 (0%) – 20 (20%)
The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.
Inaccurate and vague examples may be provided to support the response, or is missing.

Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
Points Range: 27 (27%) – 30 (30%)
The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.
The response includes an accurate and detailed explanation to support the recommended improvements.

Points Range: 24 (24%) – 26 (26%)
The response accurately explains how to improve the patient’s drug therapy plan.
The response may include an accurate explanation to support the recommended improvements.

Points Range: 21 (21%) – 23 (23%)
The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.
The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.

Points Range: 0 (0%) – 20 (20%)
The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.
The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100

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