Pharmacotherapy for Cardiovascular Disorders (Case Study Sample)

Pharmacotherapy for Cardiovascular Disorders
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Pharmacotherapy for Cardiovascular Disorders
The patient has a history of atrial fibrillation and a Transient Ischemic Attack (TIA). Further, HM has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease. The patient is currently taking Warfarin 5 mg daily MWF and 2.5mg daily on Tuesdays, Thursdays, Saturdays, and Sundays. In addition, the patient takes Aspirin 81mg daily, Metformin 1000 mg PO Bid, Glyburide 10mg Bid, Atenolol 100 mg PO daily, and Motrin 200 mg 1-3 tablets every 6 hours as required for the pain. Based on the provided information and the illnesses affecting the patient, one can argue that HM is an elderly patient, above the age of 65 years. Zathar et al. (2019) indicate that atrial fibrillation is more common among older people than it is among the young. The disease’s negative risks such as the development of stroke increase with age making atrial fibrillation a serious public health concern.
How Age Affects Pharmacokinetic and Pharmacodynamics Processes
The age of a person has a significant effect on the drug actions and absorption in the body. As one grows old, several body composition changes occur leading to a decrease in body mass and water content. At the same time, lipid levels rise due to slower metabolic oxidation and high lipid solubility. According to Brenes-Salazar et al. (2015), other pharmacokinetic changes including slowed absorption, distribution, metabolism, and excretion of materials, reduced renal and hepatic clearance, and retention of fluid in the intestinal mucosa.
The slowed absorption process has both positive and negative effects on the patient. First, the retention of water in the intestinal mucosa inhibits absorption meaning that one has to be given a higher dose to attain favorable results. At the same time, since metabolism II is preserved with age, a patient can benefit from taking a lower dose to counteract the effects of the diseases. Similarly, low absorption rates mean that the half-life of the medication is increased which means one can take a reduced dose to attain stability. The pharmacodynamic change that is likely to occur to the patient due to advanced age is increased sensitivity to several classes of drugs including anticoagulants, cardiovascular medications, and psychotropic drugs (Brenes-Salazar et al., 2015). Enhanced drug sensitivity for HM could affect his care because the best way to treat atrial fibrillation is through an anticoagulant, a drug that could result in an adverse reaction.
How the Changes Affect Patient’s Recommended Drug Therapy
The increased age of the patient indicates that he might not be an ideal candidate for anticoagulants which can complicate his model of care especially because he is suffering from AF. Sherzai and Elkind (2015) indicate that anticoagulants are proven stroke prevention medications specifically for individuals diagnosed with AF. Unfortunately, as a person ages, the increase in lipids and sensitivity to cardiovascular medications and anticoagulants reduces the effectiveness of drug therapy to the body. For patient HM, this could mean that he needs a different model of care which might not be as effective in the management of the highlighted conditions. In addition, alteration of medication could result in stroke or myocardial infarction which could further impair the patient’s ability to operate normally. On the other hand, the low absorption rates resulting from slowed metabolism indicate that the caregiver can reduce the patient’s dose without necessarily affecting the treatment outcome. Due to the patient's age, some of the medications could be excluded from the patient's care, and the dosage for others altered to effectively produce intended results. An inclusion of lifestyle changes as part of the patient's care would also go a long way in ensuring that HM attains healthy lives a normal life even with changes in his medication therapy.
How to Improve the Patient’s Drug Therapy
The conditions affecting the patient, namely hypertension, type II diabetes, AF, and ischemic heart disease puts HM at a higher risk of developing congestive heart failure and myocardial infarction. To prevent the occurrence of these diseases, I would retain the client's atenolol dose but include a loop diuretic in the regiment to increase health outcomes and reduce the rate of mortality. For the loop diuretic, I would use hypochlorothiazide 25 mg PO daily. Tsujimoto and Kajio (2020) argue that thiazides are effective in preventing cardiovascular diseases in patients receiving intensive hypertensive treatment. In addition, I would prefer to include an ACE inhibitor in the patient’s regiment for type II diabetes and hypertension, specifically Lisinopril 2.5 mg PO daily. The inclusion of this drug would improve the patient’s kidney protection and provide adequate hypertension