[ANSWERED 2023] Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been

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.

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.–Levels of Achievement:

Excellent 23 (23%) – 25 (25%)

The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.

Good 20 (20%) – 22 (22%)

The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.

Fair 18 (18%) – 19 (19%)

The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.

Poor 0 (0%) – 17 (17%)

The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.

Feedback:

Describe how changes in the processes might impact the patient‘s recommended drug therapy. Be specific and provide examples.–Levels of Achievement:

Excellent 27 (27%) – 30 (30%)

The response accurately and completely describes in detail how changes in the processes might impact the patient‘s recommended drug therapy. Accurate, complete, and aligned examples are provided to support the response.

Good 24 (24%) – 26 (26%)

The response accurately describes how changes in the processes might impact the patient‘s recommended drug therapy. Accurate examples may be provided to support the response.

Fair 21 (21%) – 23 (23%)

The response inaccurately or vaguely describes how changes in the processes might impact the patient‘s recommended drug therapy. Inaccurate or vague examples are provided to support the response.

Poor 0 (0%) – 20 (20%)

The response inaccurately and vaguely describes how changes in the processes might impact the patient‘s recommended drug therapy, or is missing. Inaccurate and vague examples may be provided to support the response, or is missing.

Feedback:

Explain how you might improve the patient‘s drug therapy plan, and explain why you would make these recommended improvements.–

Levels of Achievement:

Excellent 27 (27%) – 30 (30%)

The response accurately and clearly explains in detail how to improve the patient‘s drug therapy plan. The response includes an accurate and detailed explanation to support the recommended improvements.

Good 24 (24%) – 26 (26%)

The response accurately explains how to improve the patient‘s drug therapy plan. The response may include an accurate explanation to support the recommended improvements.

Fair 21 (21%) – 23 (23%)

The response inaccurately or vaguely explains how to improve the patient‘s drug therapy plan. The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.

Poor 0 (0%) – 20 (20%)

The response inaccurately and vaguely explains how to improve the patient‘s drug therapy plan, or is missing. The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.

Feedback:

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.–Levels of Achievement:

Excellent 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

Good 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Fair 3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Poor 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

Feedback:

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation–Levels of Achievement:

Excellent 5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors

Good 4 (4%) – 4 (4%)

Contains a few (1–2) grammar, spelling, and punctuation errors

Fair 3.5 (3.5%) – 3.5 (3.5%)

Contains several (3–4) grammar, spelling, and punctuation errors

Poor 0 (0%) – 3 (3%)

Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

Feedback:

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–Levels of Achievement:

Excellent 5 (5%) – 5 (5%)

Uses correct APA format with no errors

Good 4 (4%) – 4 (4%)

Contains a few (1–2) APA format errors

Fair 3.5 (3.5%) – 3.5 (3.5%)

Contains several (3–4) APA format errors

Poor 0 (0%) – 3 (3%)

EXPERT ANSWER AND EXPLANATION

Pharmacotherapy for Cardiovascular Disorders

Cardiovascular disorders are among the chronic conditions that profoundly threaten human life. One of the most common cardiovascular conditions is hypertension. According to Arcangelo et al. (2017), about 70 million US citizens have hypertension. Other cardiovascular diseases affect more than 20% of the American population. The report shows that heart-related diseases are a threat to human life. The pharmacotherapy knowledge of cardiovascular conditions profoundly affects treatment therapies.

Thus, nurses should have proper knowledge about factors affecting the pharmacokinetic and pharmacodynamic processes in their respective patients before prescribing the medication (Fongemie & Felix-Getzik, 2015). Therefore, this paper discusses the pharmacotherapy of cardiovascular diseases by looking at factors that influence pharmacodynamics and pharmacokinetic process, describe how the transformation might affect the drug therapy, and give an explanation on how the treatment can be improved.

How Gender Might Influence Pharmacokinetic and Pharmacodynamic Processes

Gender can determine how patients respond to various cardiovascular drugs. According to Rosenthal and Burchum (2018), medicine can be more reactive in women compared to men and vice versa. The following are examples of how gender determines drug response between men and women. Digoxin does not affect men in any way in terms of mortality. However, when women take the same dosage of the medication, their mortality rate may increase (Luepke et al., 2017).

Another example is derived from the assigned case. When men take Atenolol 12.5 mg daily, they are likely to experience erectile dysfunction signs (Rosenthal & Burchum, 2018). In other words, they may have problems having sexual intercourse. However, women’s sexual function is not affected by the drug.

Also, Hydralazine can cause erectile dysfunction in men. However, the medicine does not cause any sexual problems in women. Lastly, women react more to opioids compared to men, and thus they can be relieved from pain by fewer painkillers compared to men. Metabolism of drugs is also different in women and men Fongemie and Felix-Getzik (2015) report that enzyme expression is lower in men and higher in men.

Impact of Changes in Process on The Patient’s Recommended Drug Therapy

Gender can play a huge role in a patient’s recommended medication. For instance, when prescribing drugs that are metabolized by CYP2B6 enzyme, the nurse should increase the dosage in women and decrease dosage in men (Fongemie & Felix-Getzik, 2015). In this case, if the patient AO is a man, the nurse should reduce the dosage of Sertraline therapy, and if the patient is a woman, the nurse should maintain the dosage.

Also, the nurse should monitor the patient closely to see how the individual reacts to Atenolol and Hydralazine in case the patient is a man. If the patient exhibits erectile dysfunction at higher levels, then the nurse will have to change the medication. However, if can the patient is a woman, the nurse will not worry about erectile dysfunction issues.

How to Improve the Patient’s Drug Therapy Plan

The drug therapy plan will be improved in the following ways. First, I would enhance the dose of Sertraline if the patient is a woman and reduce the treatment in case the patient is a man. Also, in case the patient is a woman, I would educate her to include exercise in her routine to improve the metabolic rate of the medication (Murphy et al., 2018). Also, I will closely monitor the patient to see how he or she reacts to drugs.

In conclusion, understanding the pharmacokinetic and pharmacodynamic processes of drug therapies is so essential. The knowledge can help a nurse know how drugs respond in various factors and develop a proper treatment to improve the patient’s condition.

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.

Fongemie, J., & Felix-Getzik, E. (2015). A Review of Nebivolol Pharmacology and Clinical Evidence. Drugs, 75(12), 1349–1371. https://doi.org/10.1007/s40265-015-0435-5

Luepke, K. H., Suda, K. J., Boucher, H., Russo, R. L., Bonney, M. W., Hunt, T. D., & Mohr III, J. F. (2017). Past, present, and future of antibacterial economics: increasing bacterial resistance, limited antibiotic pipeline, and societal implications. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 37(1), 71-84. https://doi.org/10.1002/phar.1868

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

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

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FAQs

Which Drug can Increase Metabolic Rate?

There are several drugs that can increase metabolic rate, but it is important to note that these drugs should only be used under the guidance of a healthcare professional and should not be taken without a prescription.

One example of a drug that can increase metabolic rate is thyroxine, also known as T4. Thyroxine is a hormone produced by the thyroid gland that plays a key role in regulating metabolism. In people with hypothyroidism, the thyroid gland does not produce enough thyroxine, which can result in a slow metabolism. Taking thyroxine supplements can help to increase metabolic rate and improve energy levels.

Another example of a drug that can increase metabolic rate is Clenbuterol, which is a bronchodilator that is sometimes used to treat respiratory conditions such as asthma. However, it is also used by some athletes as a performance-enhancing drug because it has been shown to increase metabolic rate and promote weight loss.

It is important to note that both of these drugs can have serious side effects and should only be taken under the guidance of a healthcare professional. There are also non-drug methods to increase metabolic rate, such as exercise and a healthy diet, which can be effective and safer in the long term.

How Does Body Weight Affect Drug Action?

Body weight can affect drug action in several ways, as the dosage and pharmacokinetics (how the body processes the drug) of a drug can vary depending on a person’s body weight. Here are some ways in which body weight can impact drug action:

1. Dosage: The recommended dosage of a drug is usually based on the weight of the patient. A drug dose that is appropriate for a person with a higher body weight may be too high for a person with a lower body weight, and vice versa. For example, a higher dose of a medication may be required to achieve the desired therapeutic effect in a person who weighs more.
2. Distribution: The distribution of a drug throughout the body can be influenced by a person’s body weight. Some drugs are distributed primarily in body fat, and therefore may have a longer duration of action in individuals with a higher body weight due to the increased amount of fat tissue in their bodies.
3. Metabolism: The rate at which a drug is metabolized by the body can be influenced by body weight. For example, some drugs are metabolized more slowly in individuals with a higher body weight due to the increased amount of body fat, which can prolong the duration of action of the drug.
4. Clearance: The clearance of a drug from the body can also be influenced by body weight. Some drugs are cleared more rapidly in individuals with a higher body weight due to their increased metabolic rate, which can lead to a shorter duration of action of the drug.

How Does Body Fat Affect Drug Distribution?

Body fat can affect drug distribution in several ways. Some drugs have a high affinity for fat tissue, which means that they may be more readily absorbed and stored in adipose tissue (body fat) than in other tissues in the body. As a result, the distribution of the drug in the body may be affected by the amount of body fat present.

Here are some ways in which body fat can impact drug distribution:

1. Increased volume of distribution: The volume of distribution (Vd) is a pharmacokinetic parameter that describes the extent to which a drug is distributed throughout the body. In general, drugs that have a high affinity for fat tissue tend to have a larger Vd, which means that they are distributed more extensively throughout the body and can potentially accumulate in adipose tissue.
2. Delayed onset of action: Because drugs that are highly bound to fat tissue may accumulate in adipose tissue, their distribution to other tissues in the body may be delayed. This can result in a delayed onset of action, as the drug may take longer to reach its target site in the body.
3. Prolonged duration of action: Similarly, drugs that are highly bound to fat tissue may be released more slowly from adipose tissue into the bloodstream, which can result in a prolonged duration of action of the drug.
4. Altered pharmacokinetics: The pharmacokinetics of a drug, such as its metabolism and clearance from the body, can also be affected by body fat. For example, some drugs may be metabolized more slowly in individuals with a higher body fat percentage, which can lead to a longer duration of action and potential toxicity.

Does Diabetes Cause Hypertension?

Hypertension and Dyslipidemia

Hypertension, or high blood pressure, is a common health condition characterized by high levels of force exerted by blood against the arterial walls. Dyslipidemia, on the other hand, refers to an abnormal lipid profile in the blood. Both conditions are closely intertwined and often coexist, particularly in individuals with diabetes.

What Causes Hyperlipidemia?

Hyperlipidemia is primarily caused by various factors, including unhealthy dietary habits, sedentary lifestyle, and genetic predisposition. Uncontrolled diabetes can also contribute to the development of hyperlipidemia due to high blood sugar levels. Over time, this can damage blood vessels, increase the risk of atherosclerosis, and subsequently lead to hypertension.

Hypertension, Hyperlipidemia, and Diabetes

The relationship between hypertension, hyperlipidemia, and diabetes is complex but well-established. Individuals with diabetes are more likely to have both hypertension and dyslipidemia compared to those without diabetes. The interplay between these conditions can create a vicious cycle, where each condition amplifies the risk and severity of the other.

Does Hyperlipidemia Cause Diabetes?

While hyperlipidemia can contribute to the development of hypertension in individuals with diabetes, it is essential to understand that hyperlipidemia itself does not cause diabetes. However, it is considered a risk factor for the development of type 2 diabetes. Elevated levels of LDL cholesterol and triglycerides and reduced levels of HDL cholesterol associated with hyperlipidemia can affect insulin sensitivity and impair glucose metabolism, increasing the risk of diabetes.

Hypertension and Hyperlipidemia Treatment

Effective management of hypertension and hyperlipidemia is crucial for individuals with diabetes to reduce the risk of cardiovascular complications. Lifestyle modifications play a vital role in treatment and include adopting a healthy diet, regular exercise, weight management, and smoking cessation. Medications are also commonly prescribed to control blood pressure and lipid levels, such as antihypertensives, statins, and fibrates.

The Relationship Between Hypertension and Hyperlipidemia

Hypertension and hyperlipidemia often coexist due to shared risk factors and underlying pathophysiology. Dyslipidemia can lead to the development of atherosclerosis, causing arterial narrowing and increased blood pressure. Conversely, the elevated blood pressure associated with hypertension can damage blood vessels, contributing to the development of dyslipidemia. Hence, addressing both conditions comprehensively is essential for optimal management.

Hypertension, Hyperlipidemia, and ICD-10

In the medical field, the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes are used for diagnostic purposes, including hypertension and hyperlipidemia, as well as diabetes. These codes enable accurate documentation and tracking of these conditions for billing and healthcare record-keeping.

In summary, diabetes can contribute to the development of hypertension, in part due to the presence of dyslipidemia. Hyperlipidemia is not the direct cause of diabetes but is considered a risk factor. Proper control and management of hypertension and hyperlipidemia are crucial for individuals with diabetes to minimize the risk of cardiovascular complications. By addressing these conditions together, healthcare providers can work towards helping patients lead healthier lives.