Hypertension or COPD Medication Essay Assignment

Hypertension or COPD Medication Essay Assignment

Assignment: Hypertension or COPD Medication

Choose either hypertension or COPD. Discuss at least three symptoms caused by physiologic changes and consequences of the disease and how pharmaceutical treatments are designed to alleviate those symptoms. What are the risks and benefits of these treatments? What patient education is needed? Locate at least one scholarly website or video that discusses a hypertension or COPD medication.

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Hypertension Management

CASE SUMMARY: Mr. James Franks is a 64-year-old African-American male. Presents today with complaints of occasional headache. Mr. Franks has a 14-year history of hypertension with co-morbid diagnoses of diabetes mellitus type 2 for 16 years, COPD GOLD 3/group c, Benign Prostatic Hypertrophy (BPH), Chronic Kidney Disease (CKD), and Gout. He has been taking Naproxen Sodium to relieve gout pain. Plan of care today will focus on Mr. Franks hypertension, with reeducation to lower salt intake, education to not consume alcohol with current medications, weigh daily while on diuretic and report losses and gains of three pounds daily and five pounds in one week, and refer to home health for nurse to educate patient on medications and manage medications administration times, monitor vital signs, monitor for adverse side effects, and educate on disease process.

5334 CASE SUMMARY TABLE

1. Symptoms: List two pertinent signs and symptoms

Headache

Dizziness

14-year history of hypertension with current blood pressure readings in office 162/90 sitting and 164/92 standing

2. Recommended Drugs: **Drug of choice – list at least 3 recommended drugs

List recommended drugs as indicated for this diagnosis

· Demadex (Torsemide) 2.5–5 mg once daily, may increase to 10 mg once daily after 4–6 wk (Vallerand, Deglin, & Sanoski, 2017).

· Prinivil, Zestril (Lisinopril) 10mg daily with Creatinine Clearance (CCr) of >60mL/minute, 5mg daily CCr of 30 – 60mL/minute, 2.5mg daily CCr of 10 – 30mL/minute (Vallerand, Deglin, & Sanoski, 2017).

· Norvasc (Amlodipine) 5 – 10mg daily (Vallerand, Deglin, & Sanoski, 2017).

· Tylenol (Acetaminophen) 500mg one to two tabs every six hours as needed for pain (Vallerand, Deglin, & Sanoski, 2017).

3. Drug Categories and Subcategories: Identify the category of each recommended drug.

· Demadex (Torsemide) is therapeutically an antihypertensive, pharmacologically a loop-diuretic, and a pregnancy B category medication (Vallerand, Deglin, & Sanoski, 2017).

· Prinivil, Zestril (Lisinopril) is therapeutically an antihypertensive and pharmacologically classified as an angiotensin-converting enzyme and a pregnancy category D medication (Vallerand, Deglin, & Sanoski, 2017).

· Norvasc (Amlodipine) is therapeutically an antihypertensive and pharmacologically a Calcium Channel Blocker and is a pregnancy category C medication (Vallerand, Deglin, & Sanoski, 2017).

· Tylenol (Acetaminophen) therapeutically a non-opioid pain reliever and an antipyretic and a pregnancy B category medication (Vallerand, Deglin, & Sanoski, 2017).

4. Drug(s) of Choice: FOR THE MAIN DIAGNOSIS ONLY, provide the chosen drug(s) of choice for treatment.

5. Rationale: Provide rationale, clinical guidelines, or evidence for the selected drug of choice

· Demadex (Torsemide) blocks the active reabsorption of sodium and does not have a profound effect on the glomerular filtration rate (Vadivelan, 2013).

· Prinivil, Zestril (Lisinopril) Angiotensin-Converting Enzymes are recommended in those hypertensive individuals with concomitant diagnoses of DM and CKD (NKF, n.d.).

· Tylenol (Acetaminophen) Non-Steroid Anti-Inflammatory Drugs carry a greater risk to increase blood pressure at levels for pain relief (NSAIDs, n.d.).

6. Contraindications and or Risks, as appropriate: Identify contraindications and risks as appropriate

· Demadex (Torsemide) hypersensitivity; cross-sensitivity may occur with thiazides and sulfonamides; use with caution in sever liver disease as a potassium sparing diuretic may be needed in conjunction, decreased electrolytes, diabetes, increased azotemia, the elderly as they may have an increased risk of side effects like hypotension and electrolyte imbalances, pregnancy, lactation, and pediatric populations (Vallerand, Deglin, & Sanoski, 2017).

· Prinivil, Zestril (Lisinopril) hypersensitivity, a history of angioedema previously, concurrent use of aliskiren in individuals with diabetes or CKD with CCr less than 60mL/minute, do not use in pregnancy as fetal death can occur, do not breastfeed; use cautiously in renal impairment, hepatic impairment, concurrent diuretic therapy, as a monotherapy in African American patients, hyponatremia, hypovolemia, women of childbearing age, surgery, anesthesia, excessive hypotension may occur when used with other antihypertensive medications or diuretics (Vallerand, Deglin, & Sanoski, 2017).

· Tylenol (Acetaminophen) previous hypersensitivity; consumption of alcohol, aspartame, saccharine, yellow dye number five, sugar, tartrazine, active liver disease, hepatic impairment (Vallerand, Deglin, & Sanoski, 2017).

7. What Patients Must Understand: Identify at least 3 appropriate teaching points for the patient and/or family (HINT: 3 teaching points is rarely adequate for good patient care)

Demadex (Torsemide)

· Side effects/Adverse reactions include:

Dermadex (Torsemide) headache, dizziness, hypotension, nervousness, ringing of the ears, hearing loss, constipation, diarrhea, dry mouth, vomiting, indigestion, increased blood urea nitrogen, increased urination, hyperglycemia, rash, Steven’s Johnson Disease, light sensitivity, hyperuricemia, hypocalcemia, hyponatremia, metabolic acidosis, dehydration, hypovolemia, Toxic Epidermal Necrolysis, hypokalemia, hypomagnesemia, arthralgia, hypochloremia, myalgia, and muscle cramps (Vallerand, Deglin, & Sanoski, 2017).

Prinivil, Zestril (Lisinopril) dizziness, headache, fatigue, drowsiness, vertigo, weakness, cough, dyspnea, vomiting, anorexia, tachycardia, chest pain, edema, abdominal pain, taste disturbances, problems getting, or maintaining erections, constipation, diarrhea, hyperuricemia, renal dysfunction, renal failure, rashes, proteinuria, flushing, pruritis, hyperkalemia, angioedema, agranulocytosis, muscle pain, back pain, myalgia (Vallerand, Deglin, Sanoski, 2017).

Demadex (Toresemide) increases low blood pressure when used with other blood pressure medications, nitrates or consumption of alcohol take blood pressure prior to taking and avoid drinking alcohol; use of NSAIDs such as aspirin, naproxen sodium, and ibuprofen may decrease the effects of this medication and increase your risk of salicylate poisoning (Vallerand, Deglin, & Sanoski, 2017).

Tylenol (Acetaminophen) agitation, headache, anxiety, fatigue, atelectasis, insomnia, difficulty breathing, hepatoxicity, hypotension, hypertension, constipation, nausea, increased liver enzymes, vomiting, hypokalemia, renal failure in chronic use of high doses, neutropenia, pancytopenia, trismus, Steven’s Johnson’s Disease, muscle spasms, rash, Acute Generalized Exthematous Pustulosis, Toxic Epidermal Necrolysis, urticaria (Vallerand, Deglin, & Sanoski, 2017).

· Avoid using salt substitutes and foods with high potassium unless directed by your primary care provider (Vallerand, Deglin, Sanoski, 2017).

· Take Demadex (Torsemide) as directed, take missed doses as soon as you have missed them unless it is close to the next dose, do not double doses (Vallerand, Deglin, & Sanoski, 2017).

· Take Lisinopril as directed at the same time every day even if you are feeling well, take any missed doses as soon as you notice unless it is time for your next dose, do not double up on dose, and do not stop taking unless directed to do so (Vallerand, Deglin, & Sanoski, 2017).

· Avoid driving and other activities that require you to be mentally alert until you know how you react on Lisinopril (Vallerand, Deglin, & Sanoski, 2017).

· Change positions slowly and allow yourself time to get acclimated to the new position prior to walking to decrease your chances of sudden low blood pressure (Vallerand, Deglin, & Sanoski, 2017).

· Avoid drinking alcohol, exercising in hot weather, or standing for long periods of time as this will increase your chance of low blood pressure (Vallerand, Deglin, & Sanoski, 2017).

· When you first start taking Lisinopril you may notice a change in how things taste, this usually subsides after eight to 12 weeks with continued therapy (Vallerand, Deglin, & Sanoski, 2017).

· If you are scheduled for surgery it is important for you to advise the surgeon of use of Lisinopril (Vallerand, Deglin, & Sanoski, 2017).

· Weigh daily and contact the office if you gain two to three pounds in one day (Vallerand, Deglin, & Sanoski, 2017).

· Do not take any over-the-counter medications, including herbal and vitamin supplements without consulting primary care provider first (Vallerand, Deglin, & Sanoski, 2017).

· Contact office if you notice a rash, muscle cramps, weakness, nausea, numbness, dizziness, tingling of extremities (Vallerand, Deglin, & Sanoski, 2017).

· Monitor your blood sugar closely as this medication may increase your blood sugar (Vallerand, Deglin, & Sanoski, 2017).

· Take Demadex (Torsemide) even if you start feeling better, it is not a cure for your hypertension (Vallerand, Deglin, Sanoski, 2017).

· It is important that you keep a close watch on your salt intake and decrease this intake, exercise by walking daily, reduce your stress, and avoid drinking alcohol to assist in decreasing your blood pressure (Vallerand, Deglin, & Sanoski, 2017).

· Do not take naproxen sodium for your gout pain, take acetaminophen as they can increase your blood pressure (NSAIDs, n.d.).

· Do not drink alcohol while taking, or limit your alcohol consumption to less than three glasses if taking one or two doses of Tylenol (Acetaminophen) as this increases hepatoxic effects (Vallerand, Deglin, & Sanoski, 2017).

· Do not take Tylenol (Acetaminophen) NSAIDs with this medication as this may further damage your renal system (Vallerand, Deglin, & Sanoski, 2017).

· Do not exceed 2grams of Tylenol (Acetaminophen) daily to limit your chances of hepatoxicity (Vallerand, Deglin, & Sanoski, 2017).

· Do not take Tylenol (Acetaminophen) longer than 10 days unless directed to do so by your primary care provider (Vallerand, Deglin, & Sanoski, 2017).

· Stop taking Tylenol (Acetaminophen) if you develop a rash and call the office (Vallerand, Deglin, & Sanoskin, 2017).

· Read all over-the-counter medication labels to determine if they contain acetaminophen to avoid taking more than your recommended daily amount (Vallernad, Deglin, & Sanoski, 207).

The Prescription(s)

Shannon Delite Leake, RN, Student FNP

727 I Live Here Lane

Mt. Pleasant, TX 75455

Cell #: (903) 867-5301

Fax #: (903) 867-5302

DEA # DL55599999

NPI # 012345678

License # 99991006

Name: xxxx DOB: 08/17/19xx

Address: 123 Pharmacology Drive, Mt. Pleasant, TX 75455 Date: October 26, 2017

Male / F : Circle one

Allergies: No known drug allergies . Weight: 95 killograms 209 pounds)

Pt Phone:903-903-9033

Drug: Demadex (Torsemide)

Sig: 5mg daily for 4 weeks

Dispense: #28 (Twenty-eight)

Refills: No Refills .

Void after: October 26, 2018.

Substitution Permitted: yes

Dispense as written: no

Signature: Shannon Delite Leake

Shannon Delite Leake, RN, Student FNP

727 I Live Here Lane Hypertension or COPD Medication Essay Assignment

Mt. Pleasant, TX 75455

Cell #: (903) 867-xxxx

Fax #: (903) 867-xxxx

DEA # DL5559

NPI # 012345

License # 99991

Name: xx DOB: 08/17/19xx

Address: 123 Pharmacology Drive, xx Date: October 26, 20xx

Male / F : Circle one

Allergies: No known drug allergies . Weight: 95 killograms 209 pounds)

Pt Phone:903-903-xxxx

Drug: Zesril (Lisinopril)

Sig: 5mg daily for 4 weeks

Dispense: #28 (Twenty-eight)

Refills: No Refills .

Void after: October 26, 2018.

Substitution Permitted: yes

Dispense as written: no

Signature: Shannon Delite Leake

9. Supplementary Documentation:

Hypertension

*Population: Known as the “Silent Killer”, hypertension is the most diagnosed condition in the United States, affecting roughly one in three adults over 29-years-old and increased to nearly two-thirds of the population who are over 60, affects men and women equally, with African Americans ranking with higher rates of high blood pressure (McNance, et al, 2014).

*Pathophysiology: Increased cardiac output, total peripheral resistance, or both cause hypertension. Cardiac output is increased by any condition that increases either blood viscosity or vasoconstriction (McNance, et al, 2014).

*Symptoms: In the early stages the only symptom is increased blood pressure, which leads to its alias of the “Silent Killer” (McNance, et al, 2014).

*Goals of Treatment: Slow progression of disease process by controlling high blood pressure at or below specified range for age of individual and co-morbid diagnoses Traynor, 2014). Hypertension or COPD Medication Essay Assignment

Demadex (Lisinopril)

*Class: Antihypertensive, Loop-Diuretic (Vallerand, Deglin, & Sanoski, 2017).

*Indications: Edema due to heart failure, renal disease, hepatic disease, or hypertension (Vallerand, Deglin, & Sanoski, 2017).

*Mechanism of Action: Inhibits the reabsorption of chloride and sodium in the Loop of Henle and the distal renal tubule; increases excretion of water, sodium, chloride, hydrogen, magnesium, and calcium with its effect persisting in the presence of renal function impairment; decreased blood pressure (Vallerand, Deglin, & Sanoski, 2017).

*Pharmacodynamics: 80% absorbed orally, widely distributed, with around 99% protein binding (Vallerand, Deglin, & Sanoski, 2017).

*Pharmacokinetics: 20% excreted in urine and 80% metabolized in the liver (Vallerand, Deglin, & Sanoski, 2017).

Generic Name: Demadex (Vallerand, Deglin, & Sanoski, 2017). Hypertension or COPD Medication Essay Assignment

Brand Name: Torsemide (Vallerand, Deglin, & Sanoski, 2017).

*Indications: Edema due to heart failure, renal disease, hepatic disease, or hypertension (Vallerand, Deglin, & Sanoski, 2017).

Outcomes: Slow progression of disease process by controlling high blood pressure at or below specified range for age of individual and co-morbid diagnoses Traynor, 2014).

Instructions: Take 5mg by mouth daily for four weeks and return to office.

Zestril (Lisinopril)

Class: Antihypertensive, Angiotensin-Converting Enzyme (ACEi) inhibitor (Vallerand, Deglin, Sanoski, 2017).

Indications: Monotherapy, or polytherapy to manage hypertension, manage heart failure, reduce risk of death following myocardial infarction, reduce risk of heart failure following myocardial infarction (Vallerand, Deglin, & Sanoski, 2017)

Mechanism of Action: ACEi’s block conversion of angiotensin I to angiotensin II (a vasoconstrictor), prevent the degradation of bradykinin and other vasodialatory prostaglandins (Vallerand, Deglin, & Sanoski, 2017).

Pharmacodynamics: 25% is absorbed in oral administration, cross the placenta, minimal penetration of Central Nervous System (CNS), enters breast milk (Vallerand, Deglin, &B Sanoski, 2017).

Pharmacokinetics: 100% excreted via the kidney (Vallerand, Deglin, & Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Generic Name: Lisinopril

Brand Name: Zestril, Prinivil

Dose: 5mg daily by mouth

Instructions: Take 5mg by mouth daily for four weeks then return to office.

Side/Adverse Effects: dizziness, headache, fatigue, drowsiness, vertigo, weakness, cough, dyspnea, vomiting, anorexia, tachycardia, chest pain, edema, abdominal pain, taste disturbances, problems getting, or maintaining erections, constipation, diarrhea, hyperuricemia, renal dysfunction, renal failure, rashes, proteinuria, flushing, pruritis, hyperkalemia, angioedema, agranulocytosis, muscle pain, back pain, myalgia (Vallerand, Deglin, Sanoski, 2017).

Demadex (Toresemide) increases low blood pressure when used with other blood pressure medications, nitrates or consumption of alcohol take blood pressure prior to taking and avoid drinking alcohol; use of NSAIDs such as aspirin, naproxen sodium, and ibuprofen may decrease the effects of this medication and increase your risk of salicylate poisoning (Vallerand, Deglin, & Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Outcomes: Reduction of blood pressure

Tylenol (Acetaminophen)

Class: Non-Opioid pain reliever, antipyretic (Vallerand, Deglin, & Sanoski, 2017).

Indications:

Mechanism of Action:

Pharmacodynamics:

Pharmacokinetics:

GENERIC NAME

Generic Name: Acetaminophen (Vallerand, Deglin, & Sanoski, 2017).

Brand Name: Tylenol (Vallerand, Deglin, & Sanoski, 2017).

Dose: 500mg

Indications: Relief of mild to moderate pain (Vallerand, Deglin, & Sanoski, 2017).

Instructions: Take one tablet for mild pain by mouth every six hours as needed for pain and take two tablets every six hours for moderate pain (Vallerand, Deglin, & Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Side/Adverse Effects: Tylenol (Acetaminophen) agitation, headache, anxiety, fatigue, atelectasis, insomnia, difficulty breathing, hepatoxicity, hypotension, hypertension, constipation, nausea, increased liver enzymes, vomiting, hypokalemia, renal failure in chronic use of high doses, neutropenia, pancytopenia, trismus, Steven’s Johnson’s Disease, muscle spasms, rash, Acute Generalized Exthematous Pustulosis, Toxic Epidermal Necrolysis, urticaria (Vallerand, Deglin, & Sanoski, 2017).

Outcomes: Relief of mild to moderate pain (Vallerand, Deglin, & Sanoski, 2017).

Side/Adverse Effects include: headache, dizziness, hypotension, nervousness, ringing of the ears, hearing loss, constipation, diarrhea, dry mouth, vomiting, indigestion, increased blood urea nitrogen, increased urination, hyperglycemia, rash, Steven’s Johnson Disease, light sensitivity, hyperuricemia, hypocalcemia, hyponatremia, metabolic acidosis, dehydration, hypovolemia, Toxic Epidermal Necrolysis, hypokalemia, hypomagnesemia, arthralgia, hypochloremia, myalgia, and muscle cramps (Vallerand, Deglin, & Sanoski, 2017).*Outcomes: Increased ability to tolerate physical activity and walk further due to reduction of IC (Vallerand, Deglin, & Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Counseling: Side effects/Adverse reactions include:

Avoid using salt substitutes and foods with high potassium unless directed by your primary care provider (Vallerand, Deglin, Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Take Demadex (Torsemide) as directed, take missed doses as soon as you have missed them unless it is close to the next dose, do not double doses (Vallerand, Deglin, & Sanoski, 2017).

Take Lisinopril as directed at the same time every day even if you are feeling well, take any missed doses as soon as you notice unless it is time for your next dose, do not double up on dose, and do not stop taking unless directed to do so (Vallerand, Deglin, & Sanoski, 2017).

Avoid driving and other activities that require you to be mentally alert until you know how you react on Lisinopril (Vallerand, Deglin, & Sanoski, 2017).

Change positions slowly and allow yourself time to get acclimated to the new position prior to walking to decrease your chances of sudden low blood pressure (Vallerand, Deglin, & Sanoski, 2017).

Avoid drinking alcohol, exercising in hot weather, or standing for long periods of time as this will increase your chance of low blood pressure (Vallerand, Deglin, & Sanoski, 2017).

When you first start taking Lisinopril you may notice a change in how things taste, this usually subsides after eight to 12 weeks with continued therapy (Vallerand, Deglin, & Sanoski, 2017).

Do not drink alcohol while taking, or limit your alcohol consumption to less than three glasses if taking one or two doses of Tylenol (Acetaminophen) as this increases hepatoxic effects (Vallerand, Deglin, & Sanoski, 2017).

Do not take Tylenol (Acetaminophen) NSAIDs with this medication as this may further damage your renal system (Vallerand, Deglin, & Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Do not exceed 2grams of Tylenol (Acetaminophen) daily to limit your chances of hepatoxicity (Vallerand, Deglin, & Sanoski, 2017).

Do not take Tylenol (Acetaminophen) longer than 10 days unless directed to do so by your primary care provider (Vallerand, Deglin, & Sanoski, 2017).

Stop taking Tylenol (Acetaminophen) if you develop a rash and call the office (Vallerand, Deglin, & Sanoskin, 2017).

Read all over-the-counter medication labels to determine if they contain acetaminophen to avoid taking more than your recommended daily amount (Vallernad, Deglin, & Sanoski, 207).

If you are scheduled for surgery it is important for you to advise the surgeon of use of Lisinopril (Vallerand, Deglin, & Sanoski, 2017).

Weigh daily and contact the office if you gain two to three pounds in one day (Vallerand, Deglin, & Sanoski, 2017).

Do not take any over-the-counter medications, including herbal and vitamin supplements without consulting primary care provider first (Vallerand, Deglin, & Sanoski, 2017).

Contact office if you notice a rash, muscle cramps, weakness, nausea, numbness, dizziness, tingling of extremities (Vallerand, Deglin, & Sanoski, 2017) Hypertension or COPD Medication Essay Assignment.

Monitor your blood sugar closely as this medication may increase your blood sugar (Vallerand, Deglin, & Sanoski, 2017).

Take Demadex (Torsemide) even if you start feeling better, it is not a cure for your hypertension (Vallerand, Deglin, Sanoski, 2017).

It is important that you keep a close watch on your salt intake and decrease this intake, exercise by walking daily, reduce your stress, and avoid drinking alcohol to assist in decreasing your blood pressure (Vallerand, Deglin, & Sanoski, 2017).

Do not take naproxen sodium for your gout pain, take acetaminophen as they can increase your blood pressure (NSAIDs, n.d.).

References

McCance, K. L., & Huether, S. E., Brashers, V. L., Rote, N.S… (2014). Pathophysiology: the biologic basis for disease in adults and children. St. Louis, MO: Elsevier

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NKF KDOQI GUIDELINES. (n.d.). Retrieved October 28, 2017, from http://www2.kidney.org/professionals/kdoqi/guideline_diabetes/guide3.htm

NSAIDs and Hypertension, (n.d.). Retrieved October 28, 2017, from https://www.uptodate.com/contents/nsaids-and-acetaminophen-effects-on-blood-pressure-and-hypertension

Traynor, K. (2014). New hypertension guidelines may simplify treatment. American Journal of Health-System Pharmacy, 71(4), 263-264. doi:10.2146/news140014

Vadivelan, M. (2013). Torsemide: A New Loop Diuretic. Indian Journal of Clinical Practice, 24(4), 385-388. Retrieved from medind.nic.in/iaa/t13/i9/iaat13i9p385.pd Hypertension or COPD Medication Essay Assignment.

Vallerand, A. H., Deglin, J. H., & Sanoski, C. A. (2017). Davis’s drug guide for nurses. Philadelphia: F.A. Davis Company. Hypertension or COPD Medication Essay Assignment