Pharmacotherapy for Cardiovascular Disorders Assignment

Pharmacotherapy for Cardiovascular Disorders Assignment

Behavior impact on pharmacokinetics and pharmacodynamics

High blood pressure, also known as hypertension (HTN), affects nearly 29 percent of adults in the United States. When someone has high blood pressure, it raises their chances of getting heart disease, heart failure, a heart attack, or a stroke. High blood pressure often doesn’t show any early signs, which is why it’s sometimes called “the silent killer.” Behavior plays a big role in whether someone develops high blood pressure or not. Things like being overweight, drinking alcohol, and eating too much salt can increase the risk. Changing behaviors, like eating healthier and exercising, can help lower the risk of high blood pressure, especially for someone who’s overweight and has recently gained weight.

People with high cholesterol levels, a condition known as hyperlipidemia (HLD), are more likely to have heart disease. High cholesterol can be caused by things like being overweight, eating fatty foods, having diabetes, or taking certain medications. People who eat a lot of fast food and don’t exercise much are at higher risk because these habits lead to a diet high in salt and cholesterol. Making changes to diet, exercise, and stress levels can help prevent both high blood pressure and high cholesterol. The way the body processes and reacts to medications can also be influenced by diet and nutrition. It’s important to know that taking medicine with or without food can affect how well the body absorbs it, which can change how effective the medication is. For example, certain fruits like apples, oranges, and grapes can affect how well the body absorbs a medication called atenolol.

Effects of Changing the Process on the Recommended Medication Therapy for the Patient

The main goal of diagnosing and treating high blood pressure is to reduce the risk of heart problems and kidney issues. Hydrochlorothiazide is usually the first medication prescribed for mild high blood pressure. Other medications like ACE inhibitors, beta-blockers, calcium channel blockers, or angiotensin II receptor blockers might be added if needed. Atenolol, which is a type of beta-blocker, is given to a patient named AO. For more severe high blood pressure, hydralazine, a vasodilator, might be used, especially for people with essential hypertension. Another medication called doxazosin can help lower cholesterol levels and relax the muscles around blood vessels to reduce blood pressure.

Unlike certain antidepressants that can raise blood pressure, sertraline, which is a selective serotonin reuptake inhibitor (SSRI), doesn’t have this effect. Simvastatin is often the first choice for treating high cholesterol because it lowers levels of LDL (bad cholesterol) and triglycerides while increasing HDL (good cholesterol). However, people who drink alcohol or have liver problems should avoid taking simvastatin because it can raise certain enzyme levels in the liver. This is why statins are commonly used to treat heart disease.

Improving the Medication Plan

When starting simvastatin, it’s usually best to begin with a low dose, like 20–40mg, in patients who don’t have any known risk factors for heart problems. After six weeks, the level of LDL in the blood should be checked, and then treatment should continue for six to twelve months with the goal of lowering LDL to less than 100mg/dL. Taking simvastatin at night is recommended because that’s when the body produces the most cholesterol. The patient gained weight because of fluid retention, so instead of atenolol, which can worsen high cholesterol levels, indapamide should be prescribed. This medication is better suited for treating mild to moderate high blood pressure and doesn’t affect cholesterol levels as much. For the patient currently taking hydralazine twice daily, switching to a three-times-a-day dosing schedule might be better. It’s important to monitor the patient closely for any possible interactions between the new medications and ones they’re already taking.

NSG-533-IKC – Advanced Pharmacology Module V: Pain Management Discussion

Pharmacotherapy for Cardiovascular Disorders Assignment

Behavior impact on pharmacokinetics and pharmacodynamics

Hypertension (HTN) affects around 29 percent of the adult population in the United States. Having high blood pressure raises one’s risk of cardiovascular disease, including heart failure, myocardial infarction, and stroke. Due to the lack of early signs, high blood pressure (HBP) is frequently referred to as “the silent killer” (Kovell et al., 2015). HTN may be categorized as either essential or non-essential. In addition to age and ethnicity, behavioral variables such as obesity, alcohol use, and dietary salt intake are essential Pharmacotherapy for Cardiovascular Disorders Assignment Essay Example. We may reduce HTN risk by changing one’s behavior toward a patient with a background of obesity and just gained 9 pounds. Cholesterol levels are elevated in people with hyperlipidemia (HLD).

Coronary heart disease is indeed a factor in the development of HLD. HLD is caused by environmental variables such as obesity, foods rich in lipids, illness conditions such as Diabetes mellitus, and drugs like beta-blockers (Arcangelo et al., 2017). It has a significant effect on HLD and HTN when people engage in this practice. The everyday use of fast food and lack of exercise exposes them to a diet heavy in sodium and cholesterol. HTN and HLD are prevented due to changes in nutrition, exercise, and stress reduction (Oikonomou et al., 2018). The metabolism and reaction of medications in the body influence a person’s diet and nutrition. It is important to note that the intake of medicine is affected by the presence or absence of meals, which may lower or raise the solubility of the prescription. The uptake of atenolol by the body might be affected by fluids such as apple, orange, and grape.

Impact of change in the process on the patient’s recommended drug therapy.

Decreasing cardiovascular deaths and renal difficulties is the primary focus of HTN diagnosis and treatment efforts. Hydrochlorothiazide is the first-line treatment for stage I hypertension, which may be supplemented with ACE inhibitors, beta-blockers, calcium channel blocks, or angiotensin II receptor blockers, if necessary. Atenolol, a beta-blocker, is being administered to patient AO. Hydralazine may be used as a vasodilator to treat stage II hypertension, particularly in individuals with essential hypertension. HTN sufferers may benefit from Doxazosin, which lowers cholesterol levels and relaxes smooth muscles to lower blood pressure.

In contrast to tricyclic antidepressants, Sertraline is a selective serotonin reuptake inhibitor (SSRI) that does not raise blood pressure (Arcangelo et al., 2017). Simvastatin is the first-line treatment for high cholesterol since it reduces LDL and triglyceride levels while boosting HDL, the good cholesterol. Those who use alcohol or have liver illness should avoid taking simvastatin because of the risk of increased transaminase levels. As a result, statins are often utilized as the first-line treatment for cardiovascular disease (Struijker-Boudier, 2017).

Improving Drug Therapy Plan

Simvastatin should be started at a low dosage of 20–40mg in patients with no known cardiovascular risk factors, followed by a six-week LDL measurement, and then a six–to–12-month period of treatment in which the aim is to drop LDL to less than 100mg/dL. For this reason, it is recommended to take simvastatin at night, when most cholesterol production occurs (Struijker- Boudier, 2017). Fluid retention is to blame for the patient’s 9-pound weight increase. Indapamide 2.5mg daily, rather than atenolol, is the first-line treatment for stage I and II hypertension since hydrochlorothiazide may induce elevated levels of HLD. My recommendation is to switch to three-times-a-day administration of hydralazine for the patient, who is now taking it twice daily. I will watch the patient for any possible drug interactions since the patient will also be taking new drugs (Arcangelo et al., 2017).

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Oikonomou, E., Psaltopoulou, T., Georgiopoulos, G., Siasos, G., Kokko, E., Antonopoulos, A., & … Tousoulis, D. (2018). Western dietary pattern is associated with severe coronary artery disease. Angiology, 69(4), 339-346. doi:10.1177/0003319717721603

Struijker-Boudier, H. (2017). Should a statin be given to all hypertensive patients? Artery Research, 18, 66-68. doi: 10.1016/j.artres.2017.04.001

Kovell, L. C., Ahmed, H. M., Misra, S., Whelton, S. P., Prokopowicz, G. P., Blumenthal, R. S., & Mcevoy, J. W. (2015). US Hypertension management guidelines: A review of the recent past and recommendations for the future. Journal of the American Heart Association, 4(12). doi:10.1161/jaha.115.002315

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 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.

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