NURS 6521 Week 2 Assignment Case Study - Pharmacotherapy for Cardiovascular Diseases

Assignment: Pharmacotherapy for Cardiovascular Diseases The chosen factor The factor that might influence the pharmacokinetic and pharmacodynamic processes of the patient is age. His advancing age comes with impairment in the function of regulatory processes, which are important towards functionally integrating his organs and cells. Consequently, his body may fail to carry out homeostasis when faced with physiological stress. This means there are both pharmacokinetic and pharmacodynamic changes to expect. On the one hand, pharmacokinetic changes refer to what the patient’s body does to the drug. They usually revolve around the absorption of drugs, how they are distributed across different body compartments, how they are excreted, as well as their metabolism (Ruscin & Linnebur, 2021). Some of the pharmacokinetic changes to expect with advanced age include reduced hepatic and renal clearance. He may also experience increased volume of lipid soluble drugs in distribution. On the other hand, pharmacodynamic changes refers to what the drug does to the patient’s body. This is determined by factors such as receptor binding, chemical interactions, and postreceptor effects (Ruscin & Linnebur, 2021). Some of the pharmacodynamic changes to expect include increased sensitivity to certain drugs, especially psychotropic, anticoagulants, and cardiovascular drugs. How changes in the processes might impact the patient’s recommended drug therapy. So far, the drugs that are given to the patient and need to be looked at include Digozin, Diltiazem, Metoprolol, Lisinopril, Imdur, HCTZ. Warfarin. Digozin, to begin with, is in the class of medicines referred to as digitalis glycosides. They are meant to improve the efficiency and strength of the heart, thus control the rhythm and rate of the patient’s heart beat, which then 3 reduces the swelling of the hands and improves blood circulation (Fialova et al., 2018). Digozin will lead to higher serum levels among the elderly. Second, Diltiazem belongs to the class of drugs referred to as calcium-channel blockers. Its pharmacodynamic effect includes a reduction in acute PR interval prolongation, as well as an increase in chronic and acute antihypertensive effect. As for metoprolol, they belong to the class of drugs referred to as beta blockers. They slow the person’s heart rate and relax their blood muscles to reduce blood pressure and improve blood flow (Fialova et al., 2018). Lisinopril belongs to the class of medications referred to as ACE inhibitors. They are meant to reduce blood pressure and help deal with heart failure. They reduce blood volume and cause the blood vessels to relax. Imdur are nitrates meant to prevent angina attacks. Warfarin has an increasing anticoagulant effect. Thus, warfarin are anticoagulants meant to prevent blood clots. HCTZ are diuretics commonly known as water pills. They will make the person make more urine to help treat edema, common with people having kidney disorders or congestive heart failure. All of these drugs are meant to help the patient who has age-related problems. When it comes to famotidine and ibuprofen, there is no evidence to show age-related problems that would reduce its usefulness among the elderly patient (Maanen, Wilting & Jansen, 2019). However, it is important to note that some elderly patients have kidney problems. In case this is so, then the dose of these drugs can be adjusted accordingly. Improving the patient’s drug therapy plan Digozin is a water-soluble polar drug. It has a small distribution volume, which translates to higher serum levels among the elderly (Fialova et al., 2018). Therefore, it will help to reduce the dosage of Digozin to accommodate the change. The dose of HCTZ being given to the patient is within the required low range that can effectively reduce his blood pressure given that he has hypertension. Therefore, there may be no need to adjust the dosage. 4 References Fialova, D., Kummer, I., Drzaic, M., & Leppee, M. (2018). Ageism in medication use in older patients. Contemporary Perspectives on Ageism, 19, 213-240. Maanen, A. C. D., Wilting, I., & Jansen, P. A. (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), . Ruscin, J. M., & Linnebur, S. A. (2021, July). Pharmacodynamics in older adults. MSD Manual. Retrieved from adults/pharmacodynamics-in-older-adults Ruscin, J. M., & Linnebur, S. A. (2021, July). Pharmacokinetics in older adults. MSD Manual. Retrieved from adults/pharmacokinetics-in-older-adults