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.
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
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.
4 references not more than 5 years
Patient CB is an 88 year-old female with a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following:
- Glipizide 10 mg po daily
- HCTZ 25 mg daily
- Atenolol 25 mg po daily
- Simvastatin 80 mg daily
- Verapamil 180 mg CD daily
Cardiovascular pharmacotherapy plays a truly major role in the management of cardiovascular disease across its whole spectrum. Drug therapy has been shown to be a life-saving or life-prolonging intervention in many cardiovascular conditions and a quality of life enhancer in others, as a result of its role in the improvement of otherwise debilitating symptoms. Over the past few years, physicians have continued to witness—and benefit from—the arrival of large numbers of pharmacological agents which have objectively been shown to have beneficial effects. Among the areas that had benefited the most from this influx of newer pharmacological agents are dyslipidaemia, diabetes, coronary artery disease, heart failure, thrombosis and coagulation disorders, stroke prevention, and cardiac arrhythmias such as atrial fibrillation.
Albeit truly welcome by the medical community, the relentless arrival of newer pharmacological agents represents a major challenge to the busy practising physician, for a variety of reasons. Health practitioners not only have to be conversant with the indications, absolute contraindications, and appropriate dosages of the new drugs but also—and very critically—with their adverse effects, their interactions with other cardiovascular and non-cardiovascular agents, and their effects on other organs and systems. Physicians are also expected to be aware of the basic pharmacological characteristics of the drugs they prescribe and to ensure that their therapeutic decisions are based on solid evidence.
Individual patient responsiveness, the impact of polypharmacy, subtle differences between agents grouped within drug classes, and the role of age and gender regarding drug efficacy and undesirable effects are also critically important.
An interesting phenomenon has emerged in recent years, namely that pharmacological knowledge and drug management of speciﬁc diseases is commonly devolved to ‘disease-speciﬁc’ experts, a fact that reduces the involvement of the general practitioner in everyday life patient management. The therapeutic challenge is compounded by the increasing complexity of the management guidelines emanating from different international cardiac societies in their attempt to make their recommendations more exhaustive and applicable to every clinical situation.
In view of all of the above, the European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacotherapy has produced this Handbook on Cardiovascular Therapy, which aims at assisting physicians in their difﬁcult task of prescribing wisely. The book is expected to facilitate access to practical information regarding cardiovascular diseases and their treatment, focusing on different aspects of pharmacotherapy as well as current recommendations for disease management. Previously published as ‘Drugs in Cardiology’, this fully revised handbook is aligned with the ESC Clinical Practice Guidelines