24 Jun CONSIDER HOW CHANGES IN THE PHARMACEUTICAL AND PHARMACOLOGIC PROCESSES MIGHT IMPACT THE PATIENT’S RECOMMENDED DRUG THERAPY.
As the leading cause of death in the United States for both men and women, cardiovascular disorders account for 7 million hospitalizations per year (NCSL, 2012). This is the result of the extensive treatment and care that is often required for patients with these disorders. While the incidences of hospitalizations and death are still high, the mortality rate of cardiovascular disorders has been declining since the 1960s (CDC, 2011). Improved treatment options have contributed to this decline, as well as more knowledge on patient risk factors. 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 in×uence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. Consider the following case studies: Case Study 1: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5 mg daily Doxazosin 8 mg daily Hydralazine 10 mg qid Sertraline 25 mg daily Simvastatin 80 mg daily Case Study 2: Patient HM has a history of atrial Öbrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following: Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun Aspirin 81 mg daily Metformin 1000 mg po bid Glyburide 10 mg bid Atenolol 100 mg po daily Motrin 200 mg 1–3 tablets every 6 hours as needed for pain Case Study 3: Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following: Glipizide 10 mg po daily HCTZ 25 mg daily Atenolol 25 mg po daily Hydralazine 25 mg qid Simvastatin 80 mg daily Verapamil 180 mg CD daily To prepare: •Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text. ****************************************************** •Select one of the three case studies, as well as one the following factors: genetics, gender, ethnicity, age, or behavior factors. ****************************************************** •Re×ect on how the factor you selected might in×uence the patient’s pharmacokinetic and pharmacodynamic processes. •Consider how changes in the pharmaceutical and pharmacologic 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. Re×ect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. Post on or before Day 3 an explanation of how the factor you selected might in×uence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you selected. Then, describe how changes in the processes might impact the patient’s recommended drug therapy. Finally, explain how you might improve the patient’s drug therapy plan. RESOURCES: CANNOT USE RESOURCES OLDER THAN 5 YEARS. MUST ALL BE SCHOLARY RESOURCES Week 3 Learning Resources Increase text size Decrease text size Print Page This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below. Required Resources Readings •Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins. ?Chapter 19, “Hypertension” (pp. 230–246) This chapter examines the relationships between the cardiovascular, nervous, and renal systems. It then describes diagnostic criteria for hypertension patients, drugs used to treat hypertension and possible adverse reactions, monitoring patient response, and patient education. ?Chapter 20, “Hyperlipidemia” (pp. 247–262) This chapter explores causes of hyperlipidemia, treatments for hyperlipidemia patients, and methods for monitoring patient response. It also reviews strategies for risk assessment and patient education. ? Chapter 21, “Chronic Stable Angina” (pp. 263–277) This chapter begins by exploring factors that contribute to chronic stable angina, types of drugs used in treatment, and diagnostic criteria for initiating drug therapy. It also examines methods for monitoring patient response to treatment and educating patients on self-care. ?Chapter 22, “Heart Failure” (pp. 278–297) This chapter examines the process of prescribing drugs to treat heart failure and explores effects of prescribed drugs, proper dosages, and possible adverse reactions. ? Chapter 49, “Anticoagulation Disturbances” (pp. 764–803) This chapter covers drug therapy options for three disorders requiring anticoagulants: venous thromboembolism, atrial Öbrillation, and ischemic stroke. It also explains the process of initiating and managing drug therapy for patients with these disorders. •Drugs.com. (2012). Retrieved from https://www.drugs.com/ This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker. Media •Laureate Education, Inc. (Executive Producer). (2012). Hypertension and hyperlipidemia. Baltimore, MD: Author. This media presentation outlines hypertension and hyperlipidemia including contributing factors, evaluation, treatment, and implications. Note: The approximate length of this media piece is 10 minutes. Optional Resources Refer to the Optional Resources listed in Week 1. Please proceed to the Discussion.
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