NURS 6521 Week 2 Assignment - Pharmacotherapy for Cardiovascular Disorders

Introduction Several risk variables, such as older age, increase the likelihood of drug-induced disorders. This paper will synthesize pharmacotherapy for cardiovascular diseases and describe pharmacokinetic and pharmacodynamic processes in the supplied scenario (D. A. Sychev et al., 2021). Age-related changes in body systems, regular monitoring of the medicine's safety, altering the dose regimen, and revising the treatment plan can optimize pharmacotherapy, thus, decreasing the risk of adverse reactions and drug-induced illnesses in older patients. The Influence of Age on the Pharmacokinetic and Pharmacodynamic Processes The patient's age substantially impacts the pharmacokinetic and pharmacodynamic processes by raising the likelihood of adverse medication responses. Both at rest and during activity, the cardiac output of elderly adults is reduced, as are their weight, renal filtration capacity, liver volume, and hepatic blood flow. This longer medication half-life may result from lower absorption and the associated risk of diminished hepatic enzyme activity; hence, continuous monitoring and reevaluation of prescriptions are required (Thürmann, P. A., 2020). The safety profiles of medications are influenced by these shifts in how they are absorbed, metabolized, distributed, and excreted (D. A. Sychev et al., 2021). How Changes in the Processes Impact the Patient's Drug Therapy Because of his previous cardiac history, the patient is at risk for reduced cardiac output, impaired renal function, and impaired clearance. Digoxin toxicity can occur in patients with insufficient creatinine clearance.BN creatinine level is slightly elevated at 1.9, while the digoxin level of 2.78 is also elevated. Digoxin poisoning is a potentially lethal condition among the elderly. Practitioners who prescribe Digoxin must maintain a high degree of suspicion for digoxin toxicity, including the capacity to identify whether digoxin concentrations are within the therapeutic range, considering factors such as comorbidities (Zeynep ÖZTÜRK, & Serap ÇUHADAR. (2018). Although ibuprofen is provided as needed for headaches, it can be substituted with another medicine, such as Tylenol, because ibuprofen increase bleeding risk when taken with warfarin. NSAIDs also increase the risk of falls, mental problems in the elderly, and the chance of stroke. Therefore, these risks and advantages should be carefully weighed to optimize overall patient outcomes, particularly in the elderly. Improvements to Current Drug Regimen Considering the patient's cardiac, kidney, and renal functions are fragile due to age and medical history, as a practitioner, I would adjust the current pharmacological therapy to ensure that the patient receives a safe medication dosage. The patient is taking an excessive number of drugs. This might result in drug interactions and harmful consequences. The objective would be to reduce the patient's drug regimen to the least suitable dosage while achieving the desired effects. It is essential to use caution while giving an older patient a thiazide diuretic (Hctz) because of the risk of dehydration. In place of Digoxin, another inotrope, such as clonidine, might be used. Summary Changes in pharmacokinetic and pharmacodynamic processes may affect the prescribed pharmacological treatment for the patient. Drugs can cause adverse effects even when given at the approved adult dose. As individuals age and develop new illnesses, even a treatment plan that has always been well tolerated may now pose a threat. In addition to receptor alterations and homeostatic mechanism deficiencies with age, cardiovascular medications have a significant hypotensive impact on the elderly. As a result, regular monitoring is critical for patients like BN who receive cardiovascular drugs. References D. A. Sychev, O. D. Ostroumova, A. P. Pereverzev, A. I. Kochetkov, T. M. Ostroumova, M. V. Klepikova, & E. Yu. Ebzeeva. (2021). Advanced Age as a Risk Factor of Drug-Induced Diseases. Безопасность и Риск Фармакотерапии, 9(1), 15–24. Peeters, L. E. J., Kester, M. P., Feyz, L., Van Den Bemt, P. M. L. A., Koch, B. C. P., Van Gelder, T., & Versmissen, J. (2019). Pharmacokinetic and pharmacodynamic considerations in the treatment of the elderly patient with hypertension. Expert opinion on drug metabolism & toxicology, 15(4), 287-297. Thürmann, P. A. (2020). Pharmacodynamics and pharmacokinetics in older adults. Current Opinion in Anesthesiology, 33(1), 109-113. Zeynep ÖZTÜRK, & Serap ÇUHADAR. (2018). Effects of Age, Gender, and Comorbid Diseases on Serum Digoxin Levels During Digoxin Treatment. Bezmiâlem Science, 6(1), 31–36.