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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
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 for this Assignment.
o Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:
Atenolol 12.5 mg daily
Doxazosin 8 mg daily
Hydralazine 10 mg qid
Sertraline 25 mg daily
Simvastatin 80 mg daily
• Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
o WE ARE SELECTING “OBESITY” as the factor that affects the patient’s pharmacokinetic and pharmacodynamic processes.
• 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.
• There are several prominent classes of medications that are commonly used to treat each of these disorders, focus on the pharmacokinetic and pharmacodynamic factors that separate each class from others. Focus on patient-specific factors that will impact the response and potential change in therapy.
The treatment guidelines for some of the cardiovascular issues that we are discussing this week. These treatment guidelines are critical. As APNs, you will be expected to know this information! The disorders that we are talking about this week are ubiquitous, and many of you will be dealing with patients with these issues regularly. For example, beta blockers were once widely used to treat hypertension, but as new APNs, you must recognize that the data on beta blockers in treating hypertension is reserved for select patients, and that typically they are not recommended as a first-line treatment unless the patient has a history of MI, HF, etc.
The following guidelines will be helpful for this week:
o JNC 8 Guidelines for the treatment of hypertension in adults
o ACC/AHA national cholesterol treatment guidelines
o ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for Diagnosis and Management of Patients with Stable Ischemic Heart Disease, and
o the ACCF/AHA Guideline for the Management of Heart Failure
o These disorders are ubiquitous and the pharmacological principles that direct their treatment can be extremely valuable in any capacity as an APN.
Write a 3-page paper that addresses the following:
• Introduction
• Body
• Explain how the factor (WE ARE SELECTING “OBESITY” as the factor that affects the patient’s pharmacokinetic and pharmacodynamic processes.) 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.
• Summary
Reminder: 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 – All papers submitted must use this formatting.
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