type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example
MODULE 2: Cardiovascular / Respiratory Systems, Week 2 Assignment
CASE STUDY 2: Patient HM has a history of atrial fibrillation 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 po daily MWF and 2.5 mg daily T, TH, Sat, Sun
• Aspirin 81 mg po daily
• Metformin 1000 mg po bid
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• Glyburide 10 mg po bid
• Atenolol 100 mg po daily
• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain
type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example
o 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. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
- 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. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
Pharmacotherapy for Cardiovascular Disorders
Cardiovascular diseases (CVDs) refer to numerous conditions that interfere with the functioning of the heart/or blood vessels. Some of the common CVDs include hypertension, heart failure, stroke, and coronary artery disease (CAD). In a case scenario where Patient AO is diagnosed with hypertension and hyperlipidemia, and has a history of obesity, understanding the genetics can help in the diagnosis and treatment of CVDs. High blood pressure or (hypertension) is manifested through a force exerted by the blood against the walls of the blood vessels while hyperlipidemia is the presence of too many lipids in the blood, which leads to the blockage of arteries after an increase in fatty deposits. Advanced practice nurses should understand the pharmacokinetic and pharmacodynamic processes of CVD in order to enhance drug therapy plan for their patients. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
CVD present complex traits, and understanding the genetics of CVD requires consideration of interactions among genetic sex, race, as well as hormonal status. Genetics affect pharmacokinetics and pharmacodynamics process of CVD through controlling all features of cardiovascular system. Heritable risk factors contribute to higher blood pressure (BP) levels while genetic variants tend to create a cumulative effect of about 10 mmHg higher systolic BP levels before an individual attains the age of 50 years (Pazoki et al., 2018). A genetic variation may interfere with how the protein works in the body, leading to the accumulation of cholesterol in the arteries. Genetic risks are known since birth; hence, impossible to modify them (Pazoki et al., 2018). If a family member is found to be having CVD, other family members should go for screening, as they may be having the same disease without showing symptoms. Individuals with genetic risk can be identified early in life and are encouraged to undergo lifestyle modification. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
However, evaluations into the genetics of CVD among men and women are hindered by the failure to incorporate the sex chromosomes within genome-wide association studies (Winham, De Andrade & Miller, 2015). Sex differences in cardiovascular disorders emanate from interactions among genetic, hormonal, as well as environmental factors, which create individual risks of the diseases. Although hypertension is one of the major risk factors for developing CVD, there is no sufficient information on the ideal dosage of antihypertensive drugs, especially for the elderly. Accepting to change some lifestyle habits, in addition to having healthy dietary patterns can assist in counteracting genetic variations linked to obesity and CVD (Heianza & Qi, 2018).
Prescribing the right dose is critical in the treatment of cardiovascular diseases, as it relieves patients from a hospital stay, hospital readmission, and saving the costs of seeking medical attention. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example. Due to changes in pharmacokinetics and pharmacodynamics processes, experts recommend on starting dosages, and later a stepwise increase of dosages, which would lead to enhanced BP control, as well as less adverse drug reactions among the elderly patients (Peeters et al., 2019). The changes happen because the disease is capable of transforming receptor binding, adjusting the binding proteins, as well as reducing receptor sensitivity.
The patient in this scenario was prescribed with Atenolol, Doxazosin, Hydralazine, Sertraline, and Simvastatin to manage cardiovascular disorders. Atenolol is mainly utilized as first-line treatment for hypertension, and can be used alone or with other medications (Wiysonge et al., 2017). Both Doxazosin and Hydralazine are vital in calming the arterial pressure. The use of Simvastatin is meant to lower the cholesterol by blocking the production of cholesterol while Sertraline is an antidepressant. Simvastatin will assist in reducing fats, which have made the patient gain nine pounds. The medications are likely to alter the pharmacokinetic and pharmacodynamic processes within the body, leading to the recovery from cardiovascular disorders. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
Patient AO is under medications but may require an improved drug therapy plan in order to detect and prevent medication-related problems. As an advanced practice nurse, I should improve the drug therapy plan by educating the patient concerning his/her therapy, any adverse effect, as well as actions to take in case a problem emerges. I should evaluate the patient’s drug therapy by checking whether he/she has taken the medications as prescribed by the pharmacist. Most medications should be utilized with caution due to age-related changes pharmacokinetics (Rochon, Schmader & Givens, 2019). Drug therapy problems require an assessment for severity, acuteness, as well as how fast the resolution of a particular problem should occur. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
If there were a need to adjust the drug therapy, I would do so and explain to the patient the need to adjust the therapy. Polypharmacy, which involves taking multiple medications simultaneously, should be treated with caution, as it is linked to increased incidences of an adverse drug event, as well as increased hospital readmission (Rochon, Schmader & Givens, 2019). Genetically-determined hypertension and its complications are managed through adopting healthy lifestyle. Thus, I would recommend a change in behavior and adopting a lifestyle that encourages physical activity and healthy eating. Developing a pharmaceutical opinion program can help in reaching patients who seem to be at a higher risk of medication-related problems. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example.
References
Heianza, Y., & Qi, L. (2018). Impact of genes and environment on obesity and cardiovascular disease. Endocrinology, 160(1), 81-100.
Pazoki, R., Dehghan, A., Evangelou, E., Warren, H., Gao, H., Caulfield, M., … & Tzoulaki, I. (2018). Genetic predisposition to high blood pressure and lifestyle factors: associations with midlife blood pressure levels and cardiovascular events. Circulation, 137(7), 653-661.
Peeters, L. E. J., Kester, M. P., Feyz, L., Van Den Bemt, P. M. L. A., Koch, B. C. P., Van Gelder, T., & Versmissen, J. (2019). Pharmacokinetic and pharmacodynamic considerations in the treatment of the elderly patient with hypertension. Expert opinion on drug metabolism & toxicology, 15(4), 287-297. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example
Rochon, P. A., Schmader, K., & Givens, J. (2019). Drug prescribing for older adults. UpToDate. Retrieved from https://www.uptodate.com/contents/drug-prescribing-for-older-adults#H32
Winham, S. J., De Andrade, M., & Miller, V. M. (2015). Genetics of cardiovascular disease: the importance of sex and ethnicity. Atherosclerosis, 241(1), 219-228.
Wiysonge, C. S., Bradley, H. A., Volmink, J., Mayosi, B. M., & Opie, L. H. (2017). Beta‐blockers for hypertension. Cochrane database of systematic reviews, (1).
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. type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease essay example