Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6051

Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6051

A Sample Answer For the Assignment: Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6051

Introduction

The processes that a medicine goes through in the body after administration are referred to as pharmacokinetics. Absorption, distribution, metabolism, and excretion are all included in this. Pharmacodynamics, on the other hand, deals with the effects that drugs have on the body, such as adverse effects.

Variables like a patient’s genetics, gender, ethnicity, age, behavioral factors, medical history, and concurrent drugs all have an impact on pharmacokinetics and pharmacodynamics. According to the case study, these variables especially age do indeed change the drugs pharmacokinetics and pharmacodynamics (Rosenthal. & Burchum, 2018).

Age influencing pharmacodynamics and pharmacokinetics

The patient is of advanced age whereby it has been stated that they are 74 years old this is indeed can affect the pharmacodynamics and pharmacokinetics related to the drug. In advanced age you find the boy’s physiology has changed thus affecting the pharmacokinetics and elements such as absorption, distribution, metabolism and excretion. One of the most significant impacts in old age is whereby you’ll have a decreased glomeruli filtration rate which determines the level of drug elimination. Since it is decreased it could lead to the drug being retained in the system and leading to toxicity (Sieder et al., 2016).

In old age there is also decreased gastrointestinal motility thus leading to delayed absorption rate. This leads to delayed onset of pharmacological effects of drugs thus making them less effective. The peak drug concentrations are also affected hence the drug doesn’t reach its maximum capacity for effect (Mangoni & Jarmuzewska, 2019).

Age also increases the body fat which could lead to increase the volume of distribution increases. Therefore if the drug has to be distributed to a wider area than affection it will affect its expected performance thus not delivering the desired therapeutic effect. Due to the increased body fat there is also decreased body water levels thus leading to the drug’s elimination half-lives also getting increased (Sieder et al., 2016).

Having an advanced age also affects metabolism which mostly occurs in the liver. This occurs in due to the decreased required enzymes that may no longer be available due to the physiological changes that occur because of age. This also leads to decreased clearance hence the already metabolised drug aren’t cleared from the system (Mangoni & Jarmuzewska, 2019).

Age impacting pharmacodynamics occurs through decrease in effect for beta-adrenergic agents. This is due to decrease in response in the vascular, cardiac, and pulmonary tissues due to a decline in some required proteins. There is also reduced sensitivity to drugs due to the body’s receptors undergoing physiological changes. Therefore if the response and sensitivity is inhibited the desired therapeutic effect isn’t achieved.

Homeostatic mechanisms are also seen to influence the pharmacodynamics in that in advanced age it is reduced. The mechanisms are seen to reduce in old age. Therefore in the case the drugs lead to adverse effects the body takes a longer period of time to return to the initial state (Sieder et al., 2016).

Changes in the Process that Impact the Patient’s Recommended Drug Therapy

Due to the old age the pharmacodynamics and pharmacokinetics has been impacted. The absorption has been delayed due to decreased gastric motility, on the distribution end the volume of distribution has increased due to the increased body fat and the metabolism due to decreased enzymes has also decreased.

The physiological changes in the glomeruli has decreased the glomeruli filtration rate hence decreasing excretion and could lead to toxicity. The pharmacodynamics due to decrease in sensitivity, decrease in response and reduced homeostatic mechanisms negatively affect it (Mancia et al., 2014).

Therefore encompassing all this there is a definite change in the recommended drug therapy in order to benefit the patient. The changes are in medication such as atenolol will be used in place of the beta-blocker metoprolol, starting at 25 to 200 mg per day. However, fast response is attainable with longer release modules and can be delivered thrice daily, thus it’s advised to begin new medication, notably such as beta-blockers, with prolonged release formulae.

Instead of ibuprofen that is contraindicated with warfarin patients should be prescribed acetaminophen orally 500mg thrice daily to manage the pain. I would also advise using lipid-lowering drugs other than statins to lower the low-density lipoprotein cholesterol levels (Mangoni & Jarmuzewska, 2019).

How to Improve the Drug Therapy Plan

Patients with a high risk of cardiovascular disease, a heart attack, or is known diabetic, such as this patient, are advised to begin taking a moderate-intensity statin with the aim of reducing LDL-C levels by 30% or more. For this patient, it is advised to utilize Ezetimibe, administered orally at a dose of 10 mg each day. Cardiovascular diseases, diabetes mellitus, left ventricular dysfunction and diabetic neuropathy can receive treatment by use of angiotensin converting enzyme inhibitors.

They can also be used to prevent strokes. Starting doses of ramipril range from 1.25 mg to 2.5 mg orally every day. This medication is also recognized to lessen myocardial infarctions, strokes, and fatalities. Moreover aside from changes in medications can make other alterations such as diet change, smoking cessation, weight loss, provision of health education from medical professionals and physical activity is required (Mayor, 2017).

Conclusion

The majority of deaths globally are currently caused by cardiovascular disorders, and diabetes is frequently found in these people. It is thought that people with type diabetes are more likely than non-diabetics to die from cardiovascular illnesses. In order to get the best results in the management of cardiovascular diseases which aims to maximize the benefits of available treatments while minimizing patient harm clinicians must possess basic knowledge of pharmacokinetics and pharmacodynamics (Rosenthal. & Burchum, 2018).

References

Hoover, L. E. (2019). Cholesterol management: ACC/AHA Updates guideline. Https://eds-a-       ebscohost-com-ezp.waldenulibrary.org/eds/pdfviwer/

Mayor, S. (2017). Pharmacokinetics: Optimizing safe and effective prescribing.             Https://onlinelibrary.wiley.com/doi/pdf/10.1002/psb.1551

Rosenthal, L.D. & Burchum. J.R. (2018). Lehne’s pharmacotherapeutics for advanced practice    providers. St. Louis, MO: Elsevier.

Sieder, S. T., Kalus, J. & Lanfear, D. E. (2016). Cardiovascular pharmacokinetics,            Pharmacodynamics and Pharmacogenomics for the clinical practitioner. Https://eds-a-  ebscohost-com.ezp.waldenulibrary.org/eds/delivery/

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.

Pharmacotherapy

Nurses have the critical role of ensuring that safety and quality is promoted in the provision of healthcare services. They ensure that the rights of the patients are protected in caring for them. They also advocate for the provision of safe environments that promote the health and wellbeing of the patients. Nurses also promote safety by ensuring that patients receive the right drug, at the right time, through the right route, and dosage.

In doing this, they utilize their knowledge in pharmacokinetics and pharmacotherapeutics. They also explore the factors that influence drug pharmacokinetics and pharmacotherapeutics. Therefore, this research paper explores the influence of gender on the pharmacokinetics and pharmacokinetics of a drug.

The selected factor that influences the pharmacokinetics and pharmacotherapy of drugs prescribed to the patient in the assigned case study is gender. Gender refers to the expression of one’s function using masculinity and femininity. There exist significant differences in the response of men and women to drugs. For instance, women are highly at a risk of being overdosed when compared to men.

This is attributed to factors such as their high level of sensitivity to drugs alongside the behavior of women in relation to drug use (Tamargo et al., 2017). Women also have a small volume distribution, high free drug fraction, and low drug clearance when compared to the men.

The rate of drug absorption is also different in males and females. For instance, women receive a wide range of drug dosages through the transdermal route due to their large subcutaneous lipid content than men are. The absorption of drugs such as rifampicin is also higher in men than in women. The rate of drug metabolism is also generally higher in women than in men. This is attributed to factors that include the high levels of CYP3A isoenzymes that increase first pass metabolism of drugs that are administered orally.

However, the rate of drug absorption is high in men than in women. The difference is attributed to the fact that the mean transit time of drugs in men is shorter in men than in women. There is also a significant difference in the pharmacodynamics of drugs between men and women. The difference arises from the high sensitivity to cortisol suppression in women than in men. Women are also vulnerable to the effects of helper T lymphocytes and basophils (Graziani & Nisticò, 2015). Therefore, these factors contribute to the differences in pharmacodynamics and pharmacokinetics in men and women.

The changes in the processes of a patient have an impact on the recommended drug therapy. A change in the processes will imply that the pharmacodynamics and pharmacotherapeutics of are altered. For instance, a change in renal elimination will affect renal clearance of drugs. This will result in a change in the drug regime since drugs that are eliminated by other routes such as liver and feces have to be prescribed to the patient. A change in the processes will also increase the risk of toxicity and drug-related interactions (Rodieux et al., 2015). Consequently, it increases the need for a revision of the recommended drug therapy.

Several interventions can be embraced to improve the patient’s drug therapy. One of them is obtaining comprehensive history from the patient. This will eliminate incidences of adverse reactions to drugs due to history of drug sensitivities. The other intervention is through educating the patient about the importance of the drug, its interactions, side effects, and adverse effects to report should they occur.

Educating them increases their level of understanding, hence, adherence to medications. The last intervention is prioritizing the rights and principles of safe prescribing and drug use in healthcare. The administration of drugs should ensure that the drug is given to the right patient, through the right route, dosage, and time (Costa et al., 2015). Therefore, I will make these recommendations to ensure safety in drug use, hence, health and wellbeing of the patients.

In summary, gender influences the pharmacokinetics and pharmacotherapy of drugs prescribed to the patient in the case study. Women are likely to be affected by drug-related toxicities than men due to their high level of sensitivity to drugs. A change in processes such as renal elimination alters the prescribed regime of a given drug. Therefore, nurses should aim at adopting interventions that increase the effectiveness of drug therapy.

References

Costa, E., Giardini, A., Savin, M., Menditto, E., Lehane, E., Laosa, O., … & Marengoni, A. (2015). Interventional tools to improve medication adherence: review of literature. Patient preference and adherence, 9, 1303.

Graziani, M., & Nisticò, R. (2015). Gender differences in pharmacokinetics and pharmacodynamics of methadone substitution therapy. Frontiers in pharmacology, 6, 122.

Rodieux, F., Wilbaux, M., van den Anker, J. N., & Pfister, M. (2015). Effect of kidney function on drug kinetics and dosing in neonates, infants, and children. Clinical pharmacokinetics, 54(12), 1183-1204.

Tamargo, J., Rosano, G., Walther, T., Duarte, J., Niessner, A., Kaski, J. C., … & Torp-Pedersen, C. (2017). Gender differences in the effects of cardiovascular drugs. European Heart Journal–Cardiovascular Pharmacotherapy, 3(3), 163-182.

..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

Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6051

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. Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6051

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. Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6051

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 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.

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. Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6051

Grading Criteria

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Week 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

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Submit your Week 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

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Week 2 Assignment

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

To go to the next week:

Week 3

Week 2: Cardiovascular System