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Pharmacotherapy for Cardiovascular Disorders

Pharmacotherapy for Cardiovascular Disorders

Pharmacotherapy for Cardiovascular Disorders

Pharmacokinetics and pharmacodynamics are two essential concepts in pharmacology. Pharmacokinetics refers to the absorption, distribution, metabolism, and excretion of a drug, while pharmacodynamics relates to the effects of a drug on the body. Both concepts are essential in understanding how drugs work in the body and how they can be used to treat various medical conditions(Hilmer & Kirkpatrick, 2021). Many factors can affect the pharmacokinetics and pharmacodynamics of a medication. The route of administration, the patient’s age, weight, renal function, and the drug’s formulation and interactions with other medications can all play a role. In addition, the pharmacokinetics and pharmacodynamics of a medicine can be affected by disease states such as liver disease or diabetes. In the case of BN, the factors that will impact the pharmacokinetics and pharmacodynamics are age, the interactions between the drug the patient is using, and the patient’s comorbidities. The highlight will be investigating how comorbidities affect pharmacodynamics and pharmacokinetics.

The patient, BN, suffers from hypertension, CAD, MI, type 2 DM, and atrial fibrillation. Hypertension, coronary artery disease (CAD), myocardial infarction (MI), type 2 diabetes mellitus (DM), and atrial fibrillation (AF) are all conditions that can affect the pharmacodynamics and pharmacokinetics of a patient. According to (Mauvais-Jarvis et al., 2021), hypertension can increase the risk of adverse effects from many medications and reduce the efficacy of some drugs. CAD can also reduce the effectiveness of some drugs and increase the risk of adverse effects from others. MI can also increase the risk of adverse effects from some medicines and reduce the efficacy of others. Type 2 DM can also affect the pharmacodynamics and pharmacokinetics of a patient. Drugs metabolized by the liver may have reduced effectiveness in patients with type 2 DM, and some medications may have an increased risk of adverse effects. Atrial fibrillation can also reduce the efficacy of some drugs and increase the risk of adverse effects from others. The pharmacokinetics and pharmacodynamics of a medicine can be impacted by various factors, including the patient’s age, weight, and renal function.

Changes in these processes can impact the patient’s response to the drug and may require a change in the dose or frequency of administration. In patients with cardiovascular disorders, changes in the pharmacokinetics and pharmacodynamics of a drug can significantly impact the patient’s condition. Changes in the pharmacokinetics of cardiovascular medicines can substantially affect the efficacy and safety of these medications (Whittaker et al., 2018). For example, a change in the absorption rate of a drug might lead to it being less effective, or a change in the elimination rate might lead to the drug accumulating in the body and causing side effects. Changes in the pharmacodynamics of cardiovascular drugs can also have a significant impact. For example, a change in how the drug interacts with the target protein could lead to the drug being less effective, or a change in the way the drug is metabolized could lead to it causing unexpected side effects. Therefore, it is crucial to be aware of the potential for changes in the pharmacokinetics and pharmacodynamics of cardiovascular drugs when prescribing these medications.

Pharmacotherapy for Cardiovascular Disorders

There are a few ways to improve the drug therapy plan for a patient with cardiovascular problems, other comorbidities, and multiple drugs like BN. As in (Beldhuis et al., 2022), one is increasing the frequency of monitoring the patient’s blood pressure and heart rate. It would help ensure that the medications are working as intended and that the patient’s condition is not deteriorating. The regimen that the patient is on has some interacting drugs. Therefore, frequent monitoring of the vitals ensures that the regimen is working optimally for the patient’s benefit. Another way to improve the drug therapy plan would be to add or adjust medications to keep the patient’s blood pressure and heart rate within a safe range. Depending on the patient’s response to the drug, there will be a need to tap down or up the dosages to ensure that the influence of PK and PD are checked. Finally, it is essential to educate the patient on lifestyle changes that can help to improve their cardiovascular health, such as eating a healthy diet and exercising regularly.

References

Beldhuis, I. E., Lam, C. S., Testani, J. M., Voors, A. A., Van Spall, H. G., Ter Maaten, J. M., & Damman, K. (2022). Evidence-Based Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease. Circulation, 145(9), 693– 712.

Hilmer, S. N., & Kirkpatrick, C. M. J. (2021). New Horizons in the impact of frailty on pharmacokinetics: Latest developments. Age and Ageing, 50(4), 1054–1063. https://doi.org/10.1093/ageing/afab003

Mauvais-Jarvis, F., Berthold, H. K., Campesi, I., Carrero, J.-J., Dakal, S., Franconi, F., Gouni- Berthold, I., Heiman, M. L., Kautzky-Willer, A., & Klein, S. L. (2021). Sex-based pharmacological response to drugs. Pharmacological Reviews, 73(2), 730–762.

Whittaker, C. F., Miklich, M. A., Patel, R. S., & Fink, J. C. (2018). Medication safety principles and practice in CKD. Clinical Journal of the American Society of Nephrology, 13(11), 1738–1746.

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Question 


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…

Pharmacotherapy for Cardiovascular Disorders

Pharmacotherapy for Cardiovascular Disorders

—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

 

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