Pharmacotherapy for cardiovascular diseases.

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. Photo Credit: Getty Images/Science Photo Library RF As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. Pharmacotherapy for cardiovascular

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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. • Pharmacotherapy for cardiovascular diseases.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: •Pharmacotherapy for cardiovascular diseases. 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). Pharmacotherapy for cardiovascular diseases.All papers submitted must use this formatting. Scenario 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. Pharmacotherapy for cardiovascular diseases.

Pharmacotherapy in Cardiovascular Diseases

The presented scenario of patient AO is referred as hyperlipidemia and hypertension. The client takes simvastatin, atenolol, doxazosin, sertraline, and hydralazine. The patient current condition reveals having obese and has recently added almost 9 pounds. More so, with such description, the client is vulnerable of developing a cardiovascular disease.

Risk Factor

The patient’s condition is catalyzed by oneself behavior that put her in obese condition as well as rapid gaining of weight within a short time. Besides, the body condition is linked with consumption of processed food rich in calories. Still, it shows that the patient does not engage in physical excesses. Obese condition is defined as the accumulation of grease within intra- abdominal muscles and intravascular space. Mostly, obese condition is linked with hypertensive condition since it involves the accumulation of fats causing activation of the renin angiotensin hence leading to sodium retention as well as increasing renal absorption (Yusuf, et al, 2020)..Pharmacotherapy for cardiovascular diseases.

While having an obese condition it becomes complicated to treat since it has been associated with hyperlipidemia and hypercholesterolemia. More so, this results to impair circulation of oxygen and transportation of nutrients thus affecting pharmacodynamics and pharmacokinetics. Lack of exercise and leads to fat accumulation in the body leading to deposition of plagues that causes vasoconstriction that causes hypertension occurrence as seen in hypercholesterolemia (Yusuf, et al, 2020). Pharmacotherapy for cardiovascular diseases.

In addition, the achievement of a significant therapeutic outcome in the management of the cardiovascular disease involves understanding of possible risk factors and how they are involves in the management of the illness. In this case, the patient will engage with a new dieting program and switch in to a healthy diet as well as high fiber. Still, the client with employ physical activities to facilitate attainment of healthy remedies. More so, with such a clinical understanding context it will influence decision making on dieting and therapeutic changes to acquire treatment goal. Pharmacotherapy for cardiovascular diseases.

Pharmacodynamics & Pharmacokinetics

According to the AO case it is not clear whether the patient sticks to prescribed medication since she takes other pills on daily basis. According to AHA (American Heart Association), guideline hypertensive patients should be given a combined treatment therapy primarily to minimize noncompliance and side effects. More so, the patient is at risk of hydralazine associated SLE. In addition, combination of atenolol and doxazosin synergistic effects such as the blocking of alpha 1 receptor that leads to dilation of blood vessels thus reducing peripheral resistance. Pharmacotherapy for cardiovascular diseases.

Improving the Drug Therapy Plan

The patient medication plan has different area that requires improving. For instance, AO’s prescription includes atenolol that is characterized as a Beta-blocker. A beta blocker act by blocking the effects of adrenaline which influences vasodilation, lowers blood pressure, and improve blood flow. More so, Beta blockers plays a major role in hyperlipidemia as this is revealed by research. Moreover, the FDA recommendation does not approve this medication as a 1^st line drug in management of hypertension. Pharmacotherapy for cardiovascular diseases.

Based on these reasons, atenolol must be discontinued in this patient’s drug therapy. Discontinuation of atenolol should also prompt the discontinuation of hydralazine since the latter is administered alongside a diuretic and a beta-blocker. The FDA recommends diuretics for hypertension 1^st line managements. For this patient, a daily dose of is the most appropriate. Pharmacotherapy for cardiovascular diseases.

Based on this argument, use of atenolol must be halted in the patient prescription. Also, discontinuation of this drug should be accompanied by discontinuation of hydrazine since this is taken alongside a beta blocker and a diuretic. More so, the FDA approves the use of diuretics as a hypertension 1^st drug. In this case, the patient will take a daily dose of12.5mg hydrochlorothiazide (HCTZ) since it the most effective. On the other hand, thiazide diuretic, HCTZ works within the renal system by reducing the reabsorption rate of sodium within the distal convoluted. Also, thiazide is effective since they can be used by a patient with diabetes since they reduce mortalities rate associated with heart diseases. This dose should be administered with the lowest dosage level possible. Still, the patient should be checked diabetes in order to distinguish her condition.

According to Lin, et al, (2020) simvastatin statin is best for the management of hyperlipidemia. simvastatin act in the body by reduction of cholesterol production by blocking the HMG enzyme. The FDA approves and recommend this drug to be used as 1^st line solution in management of hyperlipidemia based on the client’s cholesterol standards. Therefore, to know whether to use simvastatin is applicable, I would test cholesterol first.