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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.

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…

To Prepare

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.
Case Study

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

Atenolol 12.5 mg daily

Doxazosin 8 mg daily

Hydralazine 10 mg qid

Sertraline 25 mg daily

Simvastatin 80 mg daily

Sample Solution

here are numerous ways to measure physical activity behaviour. The most frequently used measurement tool is a questionnaire (Booth et al., 1996). Questionnaires are low in cost, low in participant burden and are easily administered (Rennie & Wareham, 1998). A questionnaire developed in the Netherlands designed to measure physical activity behaviour is the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). The SQUASH is based on the compendium of physical activities by Ainsworth, which classifies different activities according to their energy expenditure (Ainsworth et al., 2000). It measures physical activity during commuting, leisure activities, household and at work or school. A strong advantage of the SQUASH is that it only takes five minutes to administer. This questionnaire has proven to be a fairly reliable instrument in measuring physical activity behaviour in healthy adults among the Dutch population (Wendel-Vos et al., 2003). The SQUASH was originally designed for healthy adults but it has also been proven a valid instrument among patients who had a total hip arthoplasty (Wagenmakers et al., 2008) and has been used in studies with osteoarthritis patients (Bossen et al., 2013). The adjusted SQUASH Commissioned by the research group Revalidatie, Sport en Bewegen (ReSpAct, www.respact.nl) there was a need to change the original SQUASH into a measurement tool more suitable for persons with a physical disability or chronic disease. This target population has a different perceived intensity of activities compared to the healthy population (Dawes et al., 2005) and is partly wheelchair dependent or uses mobility aid (Hoekstra et al., 2016). An adjusted version of the SQUASH was developed. Since adjustments have been made to the original SQUASH, it is uncertain if this renewed version still has the same validity as shown in the previous study by Wendel-Vos et al. (2003). The aim of this study therefore was to determine the concurrent validity of the adjusted SQUASH in physically disabled and chronically ill patients.
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