Posted: January 12th, 2022

Week 2: Cardiovascular System

NURS 6521: Advanced Pharmacology
Week 2: Cardiovascular System

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.
Learning Objectives

Students will:

Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes
Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies
Evaluate drug therapy plans for cardiovascular disorders

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Assignment: 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.

Photo Credit: Getty Images/Science Photo Library RF

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
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.
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Advanced Pharmacology- Cardiovascular System

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Introduction
The cardiovascular system is the body’s organ system that comprises the heart, blood vessels, and blood, and the system plays an essential role in transportation. The cardiovascular system allows the blood to circulate within the entire body and move nutrients from one body organ to another. Cardiovascular disorders are the health challenges facing the cardiovascular system, and these cardiovascular disorders can result in severe implications in the body. Early medical intervention is usually the better solution to cardiovascular disorders compared to late intervention. However, the medical intervention practices to the cardiovascular system may result in more severe health challenges. Some of these health challenges that may arise from cardiovascular medical treatment include pharmacokinetic and pharmacodynamic processes.
Pharmacokinetic effects are the health impacts after altering blood or blood tissues, and these effects affect the absorption, metabolism, and distribution of blood. On the other hand, pharmacodynamic interactions entail the relationship between the drug, the entire body, and the main causative of the disorder affecting the patient (Reeve, Trenaman, Rockwood & Hilmer, 2017). However, some factors determine whether a patient is prone to pharmacokinetic or pharmacodynamic effects. These factors include genetics, gender, ethnicity, age, or behaviors. The following discussion will focus on how gender influences a patient’s likeliness of having pharmacokinetic or pharmacodynamic effects after undergoing a cardiovascular medical intervention.
One way gender influences the pharmacokinetics and pharmacokinetic and pharmacodynamic processes is the differences in the rate at which drugs are absorbed in males and females. There is a difference in how the female body absorbs drugs from how the male body absorbs drugs (Cai, Li, Liang, Xiang, Wang, Shi & Liang, 2018). Drug absorption in males is higher than drug absorption in females; therefore, males may have high chemical concentrations than females, exposing them to a higher chance of experiencing the pharmacokinetics and pharmacodynamic processes.
The difference in the body composition between men and women also influences an individual’s likeliness to experience the pharmacokinetics and pharmacodynamic processes. Physical characteristic differences in terms of weight where females have more body weight compared to men. This situation accounts for why women have a high chance of experiencing pharmacokinetic or pharmacodynamic processes (Cai, Li, Liang, Xiang, Wang, Shi & Liang, 2018). Another physiological difference that exposes women to experiencing pharmacodynamic processes is the menstrual cycles, which interfere with the blood composition and plasma protein binding.
Changes in the pharmacokinetic and pharmacodynamic process can influence and change the therapy recommended to a patient with a cardiovascular disorder. A good example is where pharmacokinetics interaction changes may affect drug processing and metabolism, especially in older adults (Lu, Zhao, Chen & Wu, 2020). Therefore, medical experts should offer non-pharmaceutical therapy to a person experiencing changes in pharmacokinetic processes. On the other hand, pharmacodynamic processes determine the motion in which drugs reach the target tissue. Therefore, a change in the pharmacodynamic processes will require a modification in the therapy process a cardiovascular patient receives.
Developing other plans to improve the cardiovascular patient therapy plan is essential to help the patient recover fully from the disorder. One of the approaches that I can use to ensure the cardiovascular patient recovers fully is educating and informing the patient on what to expect from the drug therapy. Informing the cardiovascular patient about the drug therapy is essential as it helps prepare the patient mentally concerning the outcomes. Another approach that I can apply to allow a cardiovascular patient to recover fully from the disorder is through creating a nurturing relationship with the patient. A nurturing relationship with the patient will facilitate open communication with the patient, knowing whether the medical therapy is adequate. Changes in the pharmacokinetic and pharmacodynamic processes can influence and alter the therapy prescribed to a patient suffering from a cardiovascular disorder. A good example is how pharmacokinetic interaction changes can affect drug processing and metabolism, particularly in older people (Lu, Zhao, Chen & Wu, 2020). As a result, medical professionals should recommend non-pharmaceutical therapy to anyone experiencing changes in pharmacokinetic processes. Pharmacodynamic processes, on the other hand, govern how drugs travel to the target tissue. As a result, a change in the pharmacodynamic processes will necessitate a change in the therapy process that a cardiovascular patient receives.
Conclusion
Cardiovascular disorders present a potential threat to patients, which may be long-term, and some may even lead to death. Early medical intervention is essential to a patient experiencing cardiovascular disorders, but many patients do not realize they have cardiovascular diseases until the first symptom appears. However, medical interventions to cardiovascular patients may result in other health implications such as pharmacodynamics and pharmacokinetics. Therefore, before a health specialist can recommend a medical therapy to a cardiovascular patient, it is essential to determine whether the medical treatment may have any side effects.

References
Cai, Z. Y., Li, X. M., Liang, J. P., Xiang, L. P., Wang, K. R., Shi, Y. L., … & Liang, Y. R. (2018). Bioavailability of tea catechins and its improvement. Molecules, 23(9), 2346.
Lu, D., Zhao, M., Chen, M., & Wu, B. (2020). Circadian Clock–Controlled Drug Metabolism: Implications for Chronotherapeutics. Drug Metabolism and Disposition, 48(5), 395-406.
Reeve, E., Trenaman, S. C., Rockwood, K., & Hilmer, S. N. (2017). Pharmacokinetic and pharmacodynamic alterations in older people with dementia. Expert opinion on drug metabolism & toxicology, 13(6), 651-668.
Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., … & Townsend, N. (2017). European cardiovascular disease statistics 2017.

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