NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders Example 2 Pharmacotherapy for Cardiovascular Disorders
NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders Example 2
Pharmacotherapy for Cardiovascular Disorders
Cardiovascular diseases continue to pose a significant global health challenge, leading to a substantial number of deaths, particularly in the United States (Murphy et al., 2019). Advanced practice nurses play a critical role in recommending personalized treatment options due to the high prevalence of risk factors such as hypertension, hyperlipidemia, and tobacco use (Xu et al., 2022).
Patient characteristics like age, gender, ethnicity, and behavior significantly influence medication therapy’s safety and effectiveness for cardiovascular diseases (Piña et al., 2020). The purpose of this paper is to explore the case of an 86-year-old patient with multiple cardiovascular conditions, including atrial fibrillation, hypertension, and chronic kidney disease. The focus will be on examining how the patient’s age impacts pharmacokinetics and pharmacodynamics processes.
Impact of Age on Pharmacokinetic and Pharmacodynamic Processes
The aging process is commonly associated with various simultaneous health conditions, leading to the need for multiple medications to manage these issues. As individuals age, significant physiological changes occur that significantly impact how drugs are processed in the body (pharmacokinetics) and their effects on the body (pharmacodynamics) (Polaka et al., 2022). Changes in renal function related to aging are significant in the case of AB, an 86-year-old patient with several cardiovascular issues. The decrease in kidney function becomes an essential factor, impacting the elimination of medications and potentially resulting in drug buildup, thereby increasing the likelihood of adverse effects.
Various age-related alterations might significantly impact pharmacokinetic processes, intensifying the intricacies linked to medication treatment. A study by Vinarov et al. (2021) links old age to reduced stomach acid secretion and motility, which can lead to slower medication absorption. This delay could impact the initiation of pharmacological activity and require careful deliberation of dosing timing to maximize therapeutic efficacy.
The aging process leads to a decrease in the overall amount of water in the body and an increase in body fat, which can affect how medications are distributed throughout the body. Specifically, medicines soluble in fat may have larger quantities because they are stored more in adipose tissue (Vinarov et al., 2021). This modification in the distribution dynamics can affect both the initiation and length of the pharmacological effect.
In their study, Maanen et al. (2019) established that diminished hepatic enzyme activity associated with aging contributes to a reduced rate of drug metabolism, which may lead to heightened drug exposure. Due to the reduced metabolic capacity, it is necessary to change the amount of medication given to avoid adverse effects and ensure that the treatment remains effective. Diminished renal function is a characteristic feature of the aging process and directly affects the clearance of drugs.
Renal impairment can result in reduced drug excretion, which can increase the likelihood of drug buildup and raise the risk of toxicity (Maanen et al., 2019). Monitoring renal function and appropriately changing drug dosages are essential to a secure and efficient drug therapy regimen. Incorporating these age-related factors into the broader context of pharmacokinetics and pharmacodynamics processes guarantees a thorough comprehension of the difficulties and possibilities in handling cardiovascular illnesses in the senior demographic.
Impact on AB’s Drug Therapy
The recommended pharmacological therapy must be carefully considered in light of age-related changes and the complex nature of cardiovascular problems. Digoxin buildup is more likely due to age-related reductions in hepatic enzyme activity and decreased renal function, which could result in toxicity (Maher et al., 2020). Digoxin levels must be carefully monitored to reduce this risk, and thorough supervision is necessary for therapeutic efficacy without sacrificing safety.
According to Hui (2020), age-related alterations, such as reduced sensitivity and density of beta-receptors, may affect how well metoprolol regulates heart rate, requiring lower doses for the intended effect. Treatment strategy should be modified according to these age-related changes to preserve ideal heart rate regulation and general cardiovascular stability.
The age-related decline in hepatic enzyme activity and protein binding can exacerbate warfarin’s anticoagulant action, increasing the risk of bleeding (Maanen et al., 2019). Regularly monitoring international normalized ratio levels is essential to manage this potential problem. This meticulous approach ensures that warfarin dosages are adjusted promptly, striking a delicate balance between minimizing the risk of bleeding and preventing thrombosis. The decreased hepatic enzyme activity and age-related changes in renal function also elevate susceptibility to APAP-induced liver injury.
Adjusting APAP dosages or exploring alternative pain management techniques may be necessary to address this issue effectively. By adopting this proactive strategy, the risk of side effects is minimized while enhancing AB’s medication therapy safety profile. This tailored method considers the intricate interplay between age-related physiological changes and each drug’s unique pharmacological properties, fostering a comprehensive, patient-centered approach to cardiovascular therapy.
Improving AB’s Drug Therapy Plan
To improve AB’s drug therapy plan, a comprehensive approach is needed, considering age-related changes. Starting with a lower dose for all medications is a prudent strategy to minimize adverse effects and ensure therapeutic efficacy. As Maher et al. (2020) contend, vigilant monitoring of drug levels, particularly for medications like warfarin and digoxin, allows for precise titration to maintain therapeutic levels without compromising safety. Shorter-acting medications can be incorporated into the plan to minimize drug accumulation and respond to changing clinical conditions.
A systematic review of AB’s medication list is necessary to identify and discontinue unnecessary medications. Patient education about drugs, their significance, potential side effects, and adherence is crucial. It is essential to address additional risk factors like high blood pressure and long-term kidney disease to enhance overall health and optimize the response to medications. Other treatment options, such as changing one’s lifestyle, should also be considered. This approach establishes a patient-centered framework, aligning with the unique considerations posed by AB’s age-related changes, ensuring the safety and efficacy of drug therapy.
Conclusion
Understanding the complex ways aging affects PK and PD processes is essential to treating cardiovascular problems in older people. APNs can improve treatment outcomes and reduce risks for older patients, such as AB, by introducing tailored dosing, increasing patient education, and customizing medication therapy strategies to account for age-related changes. This research highlights the significance of individualized care in enhancing medication therapy for cardiovascular illnesses in the geriatric population through its multidimensional approach.
References
Hui, R. (2020). Hypertension drug therapy. Advances in Experimental Medicine and Biology, 149–268. https://doi.org/10.1007/978-981-15-2517-9_6
Maanen, A. C. D., Wilting, I., & Jansen, P. A. F. (2019). Prescribing medicines to older people—How to consider the impact of ageing on human organ and body functions. British Journal of Clinical Pharmacology, 86(10), 1921–1930. https://doi.org/10.1111/bcp.14094
