Pharmacotherapy For Cardiovascular Conditions assignment
Pharmacotherapy For Cardiovascular Conditions assignment
Introduction
Cardiovascular diseases affect the heart and blood vessels causing abnormal heart rhythms, heart valve disease, or narrowing of the blood vessels in the heart. Therefore, causing arrhythmias, valve disease, coronary artery disease, peripheral artery disease, pericardial disease, and deep vein thrombosis. Causes of heart diseases are high blood pressure, diabetes, sedentary lifestyle, hyperlipidemia, and family history of heart disease (Lopez, et al, 2018). Treatment options for cardiovascular heart disease are medication, surgery, and rehabilitation. Pharmacotherapy For Cardiovascular Conditions assignment
The medication improves blood flow, regulates rhythm, and reduces low-density lipoproteins. Cardiac rehabilitation includes lifestyle modification and exercise. Surgeries of the heart are coronary artery bypass, grafting, valve repair, or replacement surgery. In this case, the patient has cardiovascular disease due to his clinical presentation (slow heartbeat). He has a previous history of S/P angioplasty, MI three years ago, PVD s/p left femoral to posterior bypass, and A-Fib four years ago. In addition, he presents with the risk factors for cardiovascular heart disease like hypertension and diabetes. The patient’s age, body weight, drug interactions, and pathophysiology determine drug effectiveness. Pharmacotherapy For Cardiovascular Conditions assignment
BUY NOW A PLAGIARISM-FREE PAPER HERE
Explain How The Factor You Selected Might Influence The Pharmacokinetic And Pharmacodynamic Processes In The Patient From The Case Study You Were Assigned
Pharmacokinetics is how the drugs reach their site of action and their excretion from the body. This process includes absorption, distribution, metabolism, and excretion. Pharmacodynamics describes the intensity of a drug concerning its concentration in body fluid, usually at the site of drug action. Factors affecting the pharmacodynamics processes are drug interactions, pathophysiological factors, and patient factors. The factors affecting the patient’s pharmacokinetics and pharmacodynamics are drug interactions pathophysiology, lifestyle, habits, age, and multiple diagnoses (Chen, et al, 2017). Diuretics, spironolactone, ACEIs low dose, beta-blockers, Digoxin, nitrates, and anticoagulants are recommended for a patient with cardiovascular disease. However, these drugs may not achieve their therapeutic effects due to drug-drug interactions.
Drug interaction is the reaction of a drug to food, another drug, or the disease itself. drug-to-drug interactions decrease the effectiveness of another drug. These interactions may cause therapeutic failure or adverse effects (Tornio, et al, 2019). Digoxin, diltiazem, metoprolol, imdur, and ASA EC are the prescribed drugs for heart failure. For example, drug interaction with metoprolol increases toxicity and increases the risk of bradycardia (Grassi, G. 2018). Co-administration of digoxin and aspirin increases the risk of hyperkalemia. These are severe side effects of a patient with heart failure because they worsen the function of the heart. Ibuprofen causes excessive accumulation of calcium and water retention. Co-administration of ibuprofen and diltiazem increases water retention thus worsening the symptoms. Lisinopril and aspirin reduce the renal function of the patient and diminish the antihypertensive activity in ACE inhibitors.
Medical history of hypertension, diabetes mellitus, and heart failure promotes poly-pharmacy in the patient. Being an elderly patient poly-pharmacy causes tiredness, diarrhea, weakness, confusion, and dizziness. These effects may cause skipping medication, obesity, and drug overdose thus affecting the pharmacokinetics and pharmacodynamics of a drug. This patient has multiple diagnoses like hypertension and diabetes mellitus. Co-administration of these drugs may affect renal function and therefore affect pharmacokinetics and pharmacodynamics. Patient pathophysiological problems such as hyperkalemia, chronic kidney disease, and hyperglycemia affect the choice of drugs for the patient (Tornio, et al, 2019). For example, aspirin increases hyperkalemia and warfarin affects the kidneys thus should be used cautiously in patients with CKD. Pharmacotherapy For Cardiovascular Conditions assignment
Describe How Changes In The Processes Might Impact The Patient’s Recommended Drug Therapy. Be Specific And Provide Examples.
A patient with cardiovascular disease should be on the follow-up to monitor the progress of the patient as well de-prescribe medication. this patient with diabetes mellitus, hypertension, and cardiovascular disease needs medicine that controls all the three parameters without increasing the risk of toxicity and excessive interactions. Drugs I would recommend the patient are Sitagliptin 50mg PO once daily for type two diabetes mellitus, Losartan 50mg PO once daily for hypertension, digoxin 0.25 mg for atrial fibrillation and heart rate control, and aspirin 81mg PO once daily for arthritic pain and antiplatelet prophylaxis. Changing the patient’s prescription reduced a load of drugs making it easier to comply with the medication. In addition, the patient achieves the maximum desired therapeutic effects with fewer side effects (Tornio, et al, 2019). For example, HCTZ is a diuretic that increases blood sugar levels thus antagonizing the Humalog and Lantus. Lisinopril also increases the risk of kidney failure and heart failure.
Explain How You Might Improve The Patient’s Drug Therapy Plan And Explain Why You Would Make These Recommended Improvements.
The purpose of improving a patient’s drug therapy is to achieve therapeutic effects with no side effects and minimal drug interactions. Therefore, the care provider should understand the patient’s medication-taking behavior, talk about the side effects, assess health literacy, and reduce complexity (Qaseem, et al, 2017). The care provider should list the desired objectives before prescribing medicine to the patient. Other factors to consider when changing the therapy plan are the physiological changes that come with age and the adverse effects of drugs. The reason I would make these improvements on this patient is to control blood pressure, blood glucose and improve bradycardia. The cause of bradycardia in the patient is due to metoprolol. Lisinopril also decreases the function of the kidneys. Pharmacotherapy For Cardiovascular Conditions assignment
Conclusion
Elderly patients’ prescriptions should be written by authorized healthcare providers to avoid medication errors. However, in patients with cardiovascular diseases, the choice of drugs should suit the therapeutic needs. The care provider should also check the drug-drug interactions as well as long-term effects of a drug
This week we start the cardiovascular system. Please use the following scenario for your assignment: BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital. Upon presentation to the hospital: PMH: HTN x 7 years Type II DM CAD s/p angioplasty 2 years ago MI 3 years ago EF = 60% PVD s/p left femoral to posterior bypass Hx of A Fib x 4 years Medications: Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID HCTZ 12.5 mg QD Humalog 8u with meals PE: BP 110/50 Pulse 38 bpm Resp 14/min Rest of physical exam unremarkable Labs: K+ 6.9 WBC 5,800/mm3 Na+ 135 Hct 35% Cr 1.9 Dig 2.78 BUN 35 INR 2.3 Gluc 102 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. 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. 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. Pharmacotherapy For Cardiovascular Conditions assignment
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. Resources: Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Chapter 33, “Review of Hemodynamics” (pp. 285–289) Chapter 37, “Diuretics” (pp. 290–296) Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307) Chapter 39, “Calcium Channel Blockers” (pp. 308–312) Chapter 40, “Vasodilators” (pp. 313–317) Chapter 41, “Drugs for Hypertension” (pp. 316–324) Chapter 42, “Drugs for Heart Failure” (pp. 325–336) Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348) Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363) Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371) Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388) Rubrics: Rubric Detail Name: NURS_6521_Week2_Assignment_Rubric Grid View List View 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. 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. 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. 18 (18%) – 19 (19%) The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. 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. 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. 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. 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. 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. 27 (27%) – 30 (30%) The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.
BUY NOW A PLAGIARISM-FREE PAPER HERE
The response includes an accurate and detailed explanation to support the recommended improvements. 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. 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. 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. Pharmacotherapy For Cardiovascular Conditions assignment
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. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 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 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors 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. 5 (5%) – 5 (5%) Uses correct APA format with no errors 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors Total Points: 100 Name: NURS_6521_Week2_Assignment_Rubric Pharmacotherapy For Cardiovascular Conditions assignment
