NURS 6512 Pharmacotherapy for Cardiovascular Disorders

NURS 6512 Pharmacotherapy for Cardiovascular Disorders

Sample Answer for NURS 6512 Pharmacotherapy for Cardiovascular Disorders Included After Question

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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders.

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. 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 NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School 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 link. 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 button. 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 Submit button to complete your submission. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

NURS_6521_Week2_Assignment_Rubric

Excellent Good Fair Poor
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Points Range: 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.
Points Range: 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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 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.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Points Range: 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.

Points Range: 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.

Points Range: 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.

Points Range: 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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
Points Range: 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.

Points Range: 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.

Points Range: 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.

Points Range: 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.

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.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
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.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100

NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

A Sample Answer For the Assignment: NURS 6512 Pharmacotherapy for Cardiovascular Disorders

Title: NURS 6512 Pharmacotherapy for Cardiovascular Disorders

 

Cardiovascular System

The patient is dealing with a major cardiovascular issue based on the case study. All the current medication prescribed to the patient needs to be reviewed for appropriate changes. Cardiovascular disease counts as a major cause of disability and leads to a cause of death globally. The statistic indicates that approximately a person dies within approximately 36 seconds in the United States due to cardiovascular disease (Benjamin et al., 2019). Therefore, cardiovascular disease is the major cause of health disparities and increases the cost of health care. It is vital to consider the patient’s lifestyle, history, and review to manage HH’s illness effectively. This paper addresses the factors that influence a patient’s pharmacokinetics and pharmacodynamics process and gives changes that impact the recommended drug therapy.

Factor Influencing Pharmacokinetic and Pharmacodynamics Process in the Patient

Based on the case study, the factor that I have selected is age, which can lead to drug toxicity and influence the pharmacokinetics of different medications. Age causes an increase in the altered metabolism and blood concentration of drugs (Giri et al., 2018). A decrease in renal function causes an alteration of drug pharmacokinetics such as glomerular filtration rate and reduces blood flow. Age-related changes that occur in a patient include physiological factors and temperature (Giri et al., 2018). The physiological factors cognition, ventricular aerial stiffness, endothelial function, and electric conduction (Rosenthal & Burchum, 2021). Most people are sensitive to antihypertensive medication due to sympathetic neuronal and baroreceptor response (Giri et al., 2018).

Glipizide is used to cure an adult with type 2 diabetes mellitus. The drug effectively promotes insulin release from the beta cells since it reduces glucose output from the liver (Addul-Ghani et al., 2021). For patients with inadequate metabolic control, the combination of metformin and Glipizide helps reach the goal of HbA1c within three months (Addul-Ghani et al., 2021). Glipizide is effective since it has a short life and effect duration, thus lowering the risk of long-lasting hypoglycemia (Addul-Ghani et al., 2021). Patients taking Glipizide with thyroid hormone, estrogen-containing contraceptives, thiazide diuretics, nicotinic acid, and calcium channel blockers have a high potential for hyperglycemia (Rosenthal & Burchum, 2021).

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Metformin effectively improves glycemic control, which takes place without inducing hypoglycemia or causing

NURS 6512 Pharmacotherapy for Cardiovascular Disorders
NURS 6512 Pharmacotherapy for Cardiovascular Disorders

obesity, thus considered a first-line pharmacologic treatment (Shurrab & Arafa, 2020). The drug inhibits gluconeogenesis by causing a block on the mitochondrial redox shuttle, thus acting in the liver (Shurrab & Arafa, 2020). Metformin is identified to cause gastrointestinal adverse effects such as nausea, diarrhea, and vomiting (Shurrab & Arafa, 2020). FDA labels warn against prescribing Metformin drug therapy for patients with acute heart failure when supplemented with hypoxemia and hypoperfusion.

Hydrochlorothiazide (HCTZ) is used to treat hypertension since it is a thiazide-type diuretic (Rosenthal & Burchum, 2021). The drug inhibits the sodium chloride co-transparent system leading to the distal of the convoluted tubules (Rosenthal & Burchum, 2021). A lower level of blood pressure is achieved due to the diuretic action. However, studies have declined hydrochloride as an ACE inhibitor for reducing the risk of cardiovascular disease (Handelsman et al., 2020). The adverse effect caused by the use of hydrochlorothiazide is the development of hyperglycemia (Rosenthal & Burchum, 2021). The drug therapy effectively manages latent diabetes and causes an increase in triglycerides and cholesterol (Rosenthal & Burchum, 2021). The combination of HCTZ with calcium channel blockers and ACE inhibitors effectively reduces hypertension.

Atenolol acts as a beta blocker that causes an effect on blood circulation and the heart. The drug helps treat hypertension and angina, effectively bind the beta-1 adrenergic receptors in the vascular smooth muscle (Habib et al., 2021). This affects the chronotropic actions of the endogenous catecholamine. The process leads to a decrease in myocardial contractility heart rate and lowers blood pressure. The drug therapy is limited for a patient with moderate severely impaired renal (Habib et al., 2021). The side effects of Atenolol use include causing weight gain and heart failure for some patients.

Hydralazine drug causes direct relaxation of the arteriolar smooth muscle. This is considered an antihypertensive agent and phthalazine derivative (Sangshetti et al., 2019). A reverse antihypertensive effect is likely to be experienced due to vasodilation (Sangshetti et al., 2019). This is caused by hydralazine followed by a reflex sympathetic response. The drug therapy is effective when combined with isosorbide dinitrate in reducing hypertension. The side effects of using hydralazine cause a lupus-like syndrome in rare cases. However, the drug leads to discontinuation of the drug (Sangshetti et al., 2019).

Simvastatin is used as an adjunct to diet thus used as an oral HMG-CoA reductase inhibitor. A patient using Simvastatin gain a reduction in dyslipidemia and a decline in cholesterol production (Di Bello et al., 2020). The cholesterol synthesis is catalyzed by converting HMC-CoA to mevalonate, completely inhibited by hepatic hydroxymethyl-glutaryl coenzyme A (HMG-CoA) reductase (Di Bello et al., 2020). The agent effectively reduces the lipoprotein level and lowers the plasma cholesterol. The side effect of using Simvastatin 80mg is that it has a higher risk of possible rhabdomyolysis and myopathy after 12 months of use (Di Bello et al., 2020).

Verapamil is used to treat hypertension, atrial tachyarrhythmia, and angina pectoris and is classified in the class of calcium channel blockers. It helps block the cardiac muscle cells and influx of calcium ions into the vascular smooth muscle in the membrane depolarization (Savage et al., 2020). The action helps in decreasing the oxygen consumption and the cardiac work. The drug is also effective in causing a reduction in atrial–ventricular conduction. This helps in controlling the supraventricular tachyarrhythmia (Savage et al., 2020). The side effect of using verapamil include causing transient serum enzyme elevation to be mild to moderate and the liver injury from mild (Savage et al., 2020).

Improving Drug Therapy Plan

The patient can experience congestive heart failure (CHF) when there is a combination of verapamil, atenolol, and Hydrochlorothiazide (HCTZ) (Rosenthal & Burchum, 2021). For effective control of stroke, it is important to control blood pressure. It is important to avoid duplicitous therapy, which causes harm. Interaction between verapamil and Simvastatin leads to an increase in the blood level of Simvastatin (Di Bello et al., 2020). The act leads to kidney damage and rhabdomyolysis and causing liver damage. Atenolol can cause an increase in the duration of hypoglycemic symptoms along with Glipizide (Habib et al., 2021).

Conclusion

It is important to ensure that a patient is educated on the need to consider frequent blood glucose monitoring. This is a result of atenolol due to the symptom of hypoglycemia. The symptom of hypoglycemia include heart palpitations, rapid heartbeat, and tremor (Rosenthal & Burchum, 2021).

 

 

References

Abdul-Ghani, M., Puckett, C., Adams, J., Khattab, A., Baskoy, G., Cersosimo, E., … & DeFronzo, R. A. (2021). Durability of triple combination therapy versus stepwise addition therapy in patients with new-onset T2DM: 3-year follow-up of EDICT. Diabetes care44(2), 433-439. https://diabetesjournals.org/care/article-abstract/44/2/433/35501

Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., … & American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2019). Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation139(10), e56-e528. https://www.ahajournals.org/doi/abs/10.1161/cir.0000000000000659

Di Bello, E., Zwergel, C., Mai, A., & Valente, S. (2020). The innovative potential of statins in cancer: new targets for new therapies. Frontiers in Chemistry8, 516. https://www.frontiersin.org/articles/10.3389/fchem.2020.00516/full

Giri, B., Dey, S., Das, T., Sarkar, M., Banerjee, J., & Dash, S. K. (2018). Chronic hyperglycemia mediated physiological alteration and metabolic distortion leads to organ dysfunction, infection, cancer progression and other pathophysiological consequences: an update on glucose toxicity. Biomedicine & Pharmacotherapy107, 306-328. https://www.sciencedirect.com/science/article/pii/S0753332218322406

Habib, S., Alam, M., Mustafa, M., & Verma, A. K(2021). Role of Beta-Blockers as an Effective Cardio protective Agents, an insight in to Tackling with Cardiovascular Diseases (CVDs) and Hypertension. https://www.researchgate.net/profile/Abhishek-Kumar-Verma-2/publication/354694288

Handelsman, Y., Jellinger, P. S., Guerin, C. K., Bloomgarden, Z. T., Brinton, E. A., Budoff, M. J., … & Wyne, K. L. (2020). Consensus statement by the American association of clinical Endocrinologists and American College of Endocrinology on the management of dyslipidemia and prevention of cardiovascular disease algorithm–2020 executive summary. Endocrine Practice26(10), 1196-1224. https://www.sciencedirect.com/science/article/pii/S1530891X20482047

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants. Elsevier.

Sangshetti, J., Pathan, S. K., Patil, R., Ansari, S. A., Chhajed, S., Arote, R., & Shinde, D. B. (2019). Synthesis and biological activity of structurally diverse phthalazine derivatives: A systematic review. Bioorganic & Medicinal Chemistry27(18), 3979-3997. https://www.sciencedirect.com/science/article/pii/S0968089619310193

Savage, R. D., Visentin, J. D., Bronskill, S. E., Wang, X., Gruneir, A., Giannakeas, V., … & McCarthy, L. M. (2020). Evaluation of a common prescribing cascade of calcium channel blockers and diuretics in older adults with hypertension. JAMA Internal Medicine180(5), 643-651. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2761272

Shurrab, N. T., & Arafa, E. S. A. (2020). Metformin: A review of its therapeutic efficacy and adverse effects. Obesity Medicine17, 100186. https://www.sciencedirect.com/science/article/pii/S2451847620300063