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.
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
Case Study 3
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, and 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 50 mg BID
Warfarin 5 mg QD
Ibuprofen 200 mg 2 tabs prn headache
Lisinopril 20 mg QD
Imdur 30 mg QD
HCTZ 12.5 mg QD
Humalog 8u with meals
Lantus 26u QHS
Ca++/Vit D 500mg/200 IU BID
Famotidine 20 mg QHS
Multivitamin QD
PE:
BP 110/50
Pulse 38 bpm
Resp 14/min
The rest of the physical exam was unremarkable
Labs:
K+ 6.9
Na+ 135
Cr 1.9
BUN 35
Gluc 102
Dig 2.78
INR 2.3
WBC 5,800/mm3
Hct 35%
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 of 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.
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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…heart disease remain first appeared on My Blog.
