NURS 6521 Week 2 Pharmacotherapy for Cardiovascular Disorders
High blood pressure, known as hypertension (HTN), is a concern for about 29 percent of adults in the United States. It’s a risk factor for cardiovascular problems like heart failure, heart attacks, and strokes. High blood pressure often doesn’t show early signs, earning it the nickname “the silent killer” (Kovell et al., 2015). There are two types of HTN: essential and non-essential. Along with age and ethnicity, behaviors like being overweight, drinking alcohol, and eating too much salt are significant factors. Changing one’s behavior, especially for someone who’s gained nine pounds and has a history of obesity, can reduce the risk of HTN.
Interaction of Nurse Informaticists with Other Professionals
People with high cholesterol levels may have hyperlipidemia (HLD). This condition is linked to coronary heart disease and can be influenced by factors like obesity, high-fat diets, diseases such as diabetes, and certain medications like beta-blockers (Arcangelo et al., 2017). Making healthier choices in diet and exercise can have a big impact on both HTN and HLD.
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What you eat and how you take medication can affect how drugs work in your body. Whether you take medicine with or without food can change how it’s absorbed, making it more or less effective. For example, certain fluids like apple, orange, and grape juices can influence how your body absorbs a drug like atenolol.
Changing the Treatment Plan for the Patient
The main goal in dealing with HTN is to reduce heart problems and kidney issues. Hydrochlorothiazide is the initial treatment for stage I hypertension. If necessary, it can be combined with ACE inhibitors, beta-blockers, calcium channel blockers, or angiotensin II receptor blockers. Atenolol, a beta-blocker, is prescribed for patient AO.
In stage II hypertension, especially for those with essential hypertension, hydralazine can be used as a vasodilator. Doxazosin is also a helpful medication, as it lowers cholesterol levels and relaxes smooth muscles to reduce blood pressure.
When it comes to medications, Sertraline is a better choice than tricyclic antidepressants because it doesn’t raise blood pressure (Arcangelo et al., 2017). Simvastatin is the top choice for treating high cholesterol since it lowers LDL and triglyceride levels while increasing HDL, the “good” cholesterol. However, individuals with liver issues or those who drink alcohol should avoid taking simvastatin to prevent increased transaminase levels.
Enhancing the Drug Therapy Plan
Start simvastatin at a low dose of 20–40mg for patients with no known cardiovascular risk factors. After six weeks, measure LDL levels, and then continue treatment for six to twelve months, with the goal of reducing LDL to less than 100mg/dL. To make the most of it, take simvastatin at night when the body produces most cholesterol (Struijker-Boudier, 2017).
For the patient who gained nine pounds due to fluid retention, it’s better to switch to indapamide 2.5mg daily instead of atenolol for stage I and II hypertension. This change is recommended because hydrochlorothiazide can increase HLD levels. Since the patient will be taking new medications, closely monitor for potential drug interactions (Arcangelo et al., 2017).
References:
– Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
– Kovell, L. C., Ahmed, H. M., Misra, S., Whelton, S. P., Prokopowicz, G. P., Blumenthal, R. S., & Mcevoy, J. W. (2015). US Hypertension management guidelines: A review of the recent past and recommendations for the future. Journal of the American Heart Association, 4(12).
– Struijker-Boudier, H. (2017). Should a statin be given to all hypertensive patients? Artery Research, 18.
– Oikonomou, E., Psaltopoulou, T., Georgiopoulos, G., Siasos, G., Kokko, E., Antonopoulos, A., & … Tousoulis, D. (2018). Western dietary pattern is associated with severe coronary artery disease. Angiology, 69(4).
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.
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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