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NURS 6521 Pharmacotherapy for Cardiovascular Disorders Assignment Example
NURS 6521 Pharmacotherapy for Cardiovascular Disorders Assignment
NURS 6521 Pharmacotherapy for Cardiovascular Disorders Assignment Brief
Course: NURS 6521 – Advanced Pharmacology
Assignment Title: NURS 6521 Pharmacotherapy for Cardiovascular Disorders Assignment
Assignment Instructions Overview
This assignment focuses on the pharmacotherapy for cardiovascular disorders, emphasizing the critical role of advanced practice nurses in recommending and managing treatment options. It highlights the importance of understanding and considering various patient-specific factors that influence pharmacokinetic and pharmacodynamic processes. Students are required to review relevant resources, analyze a case study, and reflect on how specific factors affect drug therapy plans.
Understanding Assignment Objectives
The primary objective of this assignment is to ensure that students can effectively recommend appropriate pharmacotherapy for cardiovascular disorders while considering individual patient factors such as genetics, gender, ethnicity, age, or behavioral factors. Students should demonstrate their ability to assess how these factors influence pharmacokinetics (absorption, distribution, metabolism, and excretion of drugs) and pharmacodynamics (drug effects and mechanisms of action), and make informed adjustments to optimize patient outcomes.
The Student’s Role
As an advanced practice nurse, the student’s role involves critically analyzing a patient case study to understand the impact of selected factors on drug therapy. The student must:
- Review relevant academic and clinical resources.
- Select and reflect on one specific factor (genetics, gender, ethnicity, age, or behavior).
- Analyze how the chosen factor influences pharmacokinetic and pharmacodynamic processes.
- Discuss how these changes might affect the recommended drug therapy.
- Propose improvements or alternatives to the current drug therapy plan, supported by clinical evidence.
Competencies Measured
This assignment measures several key competencies, including:
- Clinical Assessment Skills: The ability to assess patient-specific factors and their impact on drug therapy.
- Pharmacology Knowledge: Understanding the principles of pharmacokinetics and pharmacodynamics and their application to cardiovascular disorders.
- Critical Thinking: Analyzing complex clinical scenarios and making evidence-based decisions to optimize drug therapy.
- Communication: Clearly articulating the rationale for modifying or recommending drug therapy in written form.
- Ethical and Patient-Centered Care: Ensuring that drug therapy recommendations are safe, effective, and tailored to individual patient needs.
You Can Also Check Other Related Assessments for the NURS 6521 – Advanced Pharmacology Course:
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NURS 6521 Ethical and Legal Implications of Prescribing Drugs Assignment Example
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NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Assignment Example
NURS 6521 Diabetes and Drug Treatments Discussion Paper Assignment Example
NURS 6521 Decision Tree for Neurological and Musculoskeletal Disorders Assignment Example
NURS 6521 Decision Making When Treating Psychological Disorders Discussion Assignment Example
NURS 6521 Off-Label Drug Use in Pediatrics Assignment Example
NURS 6521 Pharmacotherapy for Cardiovascular Disorders Assignment Example
Introduction
Cardiovascular disorders remain a significant health challenge, especially in the aging population. Advanced practice nurses (APNs) must recommend effective and safe treatment options, considering patient-specific factors that influence pharmacokinetics and pharmacodynamics. This paper examines the impact of age on these processes and discusses potential improvements in drug therapy plans for elderly patients with cardiovascular disorders.
Influence of Age on Pharmacokinetics and Pharmacodynamics
Aging significantly affects pharmacokinetic and pharmacodynamic processes, altering drug absorption, distribution, metabolism, and excretion. Age-related changes include decreased renal function, reduced hepatic blood flow, increased body fat, and decreased muscle mass and total body water, all of which impact drug efficacy and safety (Van den Anker, Reed, Allegaert & Kearns, 2018).
Absorption
In elderly patients, the absorption of drugs can be slower due to decreased gastrointestinal motility and reduced secretion of digestive enzymes (Cossart et al., 2019). These changes can impair the bioavailability of medications, requiring adjustments in drug dosing and administration schedules.
Distribution
The increase in body fat and decrease in lean body mass and total body water in elderly patients affect drug distribution. Lipophilic drugs may have an increased volume of distribution, leading to prolonged drug action, while hydrophilic drugs may have a reduced volume of distribution, resulting in higher plasma concentrations and potential toxicity (Cossart et al., 2019).
Metabolism
Aging is associated with decreased liver volume and hepatic blood flow, impairing drug metabolism. This can lead to higher plasma concentrations of drugs metabolized by the liver, increasing the risk of adverse effects (Van den Anker et al., 2018). For example, elderly patients may experience prolonged effects and toxicity from drugs like statins, which are metabolized in the liver.
Excretion
Reduced renal function in elderly patients decreases drug clearance, resulting in higher plasma drug levels and increased risk of toxicity (Rosenthal & Burchum, 2018). This is particularly concerning for drugs with a narrow therapeutic index, such as atenolol and other cardiovascular medications.
Impact on Recommended Drug Therapy
The patient is currently prescribed atenolol, doxazosin, hydralazine, sertraline, and simvastatin. Each of these drugs requires careful consideration in elderly patients due to altered pharmacokinetic and pharmacodynamic processes.
Atenolol
Atenolol, a beta-blocker, is used to treat hypertension but can lead to increased sensitivity and side effects in elderly patients. The increased absorption and plasma concentration of atenolol in older adults necessitate a lower dosage to prevent adverse effects like bradycardia and hypotension (Wang et al., 2019).
Doxazosin
Doxazosin, an alpha-blocker, can cause severe side effects such as dizziness and fainting due to increased sensitivity and plasma concentration in elderly patients. Co-administration with beta-blockers like atenolol can exacerbate these effects, leading to dangerously low blood pressure (Abdi & Campbell, 2018).
Sertraline
Sertraline, used for hyperlipidemia, can cause gastrointestinal complications, which are more severe in elderly patients due to decreased mucous lining and impaired drug absorption. This can lead to reduced drug efficacy and increased side effects (Chen et al., 2016).
Simvastatin
Simvastatin, a statin for high cholesterol, can impair liver function and cause muscle problems, particularly in the elderly. The increased risk of liver failure and muscle issues necessitates careful monitoring and potential dosage adjustments (Rosenthal & Burchum, 2018).
Improving the Patient’s Drug Therapy Plan
To optimize the patient’s drug therapy plan, several adjustments are recommended:
- Discontinue Atenolol and Doxazosin: Given the risk of severe hypotension and cardiovascular complications, these drugs should be replaced with a safer alternative. Thiazide diuretics, such as hydrochlorothiazide at a low dose (12.5 mg), are recommended as a first-line treatment for hypertension in elderly patients due to their efficacy and lower risk of severe side effects (Rosenthal & Burchum, 2018).
- Adjust Simvastatin Dosage: To reduce the risk of diabetes and other side effects, the dose of simvastatin should be lowered to 40 mg. This adjustment helps mitigate the potential adverse effects while maintaining its efficacy in managing hyperlipidemia.
- Non-Pharmacologic Treatments: Incorporate lifestyle modifications, including regular exercise, weight control, and dietary changes (low sodium, sugar, and fat intake), to support pharmacologic treatments and reduce the need for multiple medications (AHA, 2019).
Conclusion
Age significantly influences pharmacokinetic and pharmacodynamic processes, requiring careful consideration in drug therapy plans for elderly patients. By adjusting dosages, discontinuing certain medications, and incorporating non-pharmacologic treatments, advanced practice nurses can improve the safety and efficacy of cardiovascular pharmacotherapy in older adults.
References
Abdi, E., & Campbell, A. (2018). Urological symptoms and side effects of treatment. In The MASCC Textbook of Cancer Supportive Care and Survivorship (pp. 469-503). Springer, Cham.
Chen, S. T., Narvaez, T. A., Harwood, D. G., Leskin, L. P., Brommelhoff, J. A., Bussel, N., & Sultzer, D. L. (2016). Sertraline for the treatment of depression in vascular cognitive impairment. The American Journal of Geriatric Psychiatry, 24(3), S171-S172.
Cossart, A. R., Cottrell, W. N., Campbell, S. B., Isbel, N. M., & Staatz, C. E. (2019). Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients. Translational andrology and urology, 8(Suppl 2), S198.
Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.
Van den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental changes in pharmacokinetics and pharmacodynamics. The Journal of Clinical Pharmacology, 58, S10-S25.
Wang, Q., Xiang, B., Chen, S., & Ji, Y. (2019). Efficacy and safety of oral atenolol for the treatment of infantile haemangioma: A systematic review. Australasian Journal of Dermatology, 60(3), 181-185.
Detailed Assessment Instructions for the NURS 6521 Pharmacotherapy for Cardiovascular Disorders Assignment
Assignment: 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 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.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
- Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 2 Assignment You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submitbutton to complete your submission.
Submit Your Assignment by Day 7 of Week 2
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