…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.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from
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.
Solution:
Pharmacotherapy for Cardiovascular Disorders
In the case study provided, AO is diagnosed with hypertension and hyperlipidemia and has a medical history of obesity, having recently gained 9 pounds. The medication taken by the patient includes Atenolol, Doxazosin, Hydralazine, Sertraline, and Simvastatin 80 mg daily.
Patient Factor
The patient factor selected is age. According to Katzung (2018), age significantly affects cardiovascular medications’ pharmacokinetics and pharmacodynamics, especially in patients with obesity, hyperlipidemia, and hypertension. As one’s age increase, the first pass cytochrome P450 isoenzymes metabolism in the liver decreases in effectiveness mainly because the liver deteriorates with age. This means that oral drugs metabolized in the liver to become inactive metabolites begin accumulating in the body following their administration following delayed metabolism (Hammer & McPhee, 2018). Hydralazine, a drug for treating hypertension currently used by AO, is affected by liver metabolism. Age can also affect CVD drug’s pharmacokinetics and pharmacodynamics through the decline in renal function due to age. This compromises drug excretion via the renal route in older patients, leading to a dangerous accumulation of drugs and their metabolites in the body. Hydralazine and atenolol are among the drugs whose excretion is affected by impaired renal function (Rosenthal & Burchum, 2018). In aged persons, gastrointestinal absorption of substances, including oral medications, is much less efficacious. AO takes all drugs orally and thus, they may not be absorbed to optimal levels, leading to reduced plasma concentrations that do not attain the needed therapeutic levels (Rosenthal & Burchum, 2018). Another way age affects a drug’s pharmacokinetics and pharmacodynamics is via changes in body mass. Older patients have a less lean body mass which affects the …Please click the icon below to purchase full answer at only $10