Pharmacotherapy for Cardiovascular Disorders

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Assignment: Pharmacotherapy for Cardiovascular Disorders

 

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 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.

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.

 

****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, 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 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache

Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD

Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID

HCTZ 12.5 mg QD Humalog 8u with meals

PE:

BP 110/50 Pulse 38 bpm Resp 14/min

Rest of physical exam unremarkable

Labs:

K+ 6.9 WBC 5,800/mm3

Na+ 135 Hct 35%

Cr 1.9 Dig 2.78

BUN 35 INR 2.3

Gluc 102

 

 

Resources

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 33, “Review of Hemodynamics” (pp. 285–289)
  • Chapter 37, “Diuretics” (pp. 290–296)
  • Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
  • Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
  • Chapter 40, “Vasodilators” (pp. 313–317)
  • Chapter 41, “Drugs for Hypertension” (pp. 316–324)
  • Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
  • Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
  • Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
  • Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
  • Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)

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