Review the Hilmer et al. article in the Learning Resources.
As an advanced practice nurse, lisinopril, prednisone, & metoprolol might be prescribe to geriatric patients for cardiovascular and endocrine disorders.
Consider how changes in the pharmacokinetic and pharmacodynamic processes of geriatric patients might impact the effects of these drugs.
Consider the harm versus benefits ratio of treatment with these drugs.
Write a brief description of the three drugs that you might prescribe to geriatric patients for cardiovascular and endocrine disorders. Then, explain how changes in the pharmacokinetic and pharmacodynamic processes of geriatric patients might impact the effects of these drugs. Finally, describe the harm versus benefits ratio of treatment with these drugs.
Hilmer, S. N., McLachlan, A. J., & Le Couteur, D. G. (2007). Clinical pharmacology in the geriatric patient. Fundamental & Clinical Pharmacology, 21(3), 217–230.
Use additional current resource.
Pharmacokinetics and Pharmacodynamics of Geriatric Patients
Advanced practice nurses often prescribe lisinopril, prednisone, and metoprolol to geriatric patients for endocrine and cardiovascular disorders.
Lisinopril
This is in the ACE (angiotensin converting enzyme) inhibitors group. It treats congestive heart failure, hypertension (high blood pressure, and improves survival chances after a heart attack. Pregnant women and hereditary angioedema patients should not use the drug. Diabetic patients should also not use it with medicines with aliskiren (Hilmer, McLachlan & Le Couteur, 2007).
Prednisone
This is a corticosteroid and prevents the body from releasing substances that cause inflammation. In addition, it suppresses the immune system. Normally, prednisone is utilized as an immunosuppressant or anti-inflammatory medication (Kristin, Robert & Bruce, 2013). It also treats various conditions including skin conditions, allergic disorders, arthritis, ulcerative colitis, psoriasis, lupus, and breathing disorders. People with a fungal infection can also take it.
Metoprolol
This medication can be used alone or with other medications in treating high blood pressure, which helps prevent heart attacks, strokes, and kidney problems. It belongs to the beta blockers class of drugs. Metoprolol functions by blocking particular natural chemicals’ action including epinephrine on the blood vessels and heart. Such an effect lowers blood pressure, heart rate, and tension on the heart. The drug can also be prescribed in cases of migraine headache prevention, heart failure, irregular heart beats, and tremors (Kristin, Robert & Bruce, 2013).
Changes in the pharmacodynamic and pharmacokinetic processes in geriatric patients can influence the impacts of the drugs. The elderly undergo through physiologic changes in their organ functions and body composition as a result of the specific disease processes and aging. These changes normally affect the drug pharmacodynamics in the elderly (Hilmer, McLachlan & Le Couteur, 2007). The most significant pharmacodynamic variation with age as far as cardiovascular agents are concerned is the reduced effect of beta-adrenergic agents. The reduced response of pulmonary, cardiac, and vascular tissue is as a result of the reduced Gs protein interactions. There are changes in the absorption, distribution, metabolism, and excretion of the three drugs.
Benefits versus harm ratio following treatment with the drugs; lisinopril is beneficial in the treatment of various diseases and improving survival chances. However, it is associated with side effects such as blurred vision, cloudy urine, confusion, sweating, unusual weakness and tiredness, dizziness, and reduced urine output. When taking lisinopril, it is important to avoid combinations since the interaction risk outweighs the benefit. The benefits of prednisone are evident from its various uses. However, some people are allergic to the medication and this may be characterized by difficult breathing, hives, and swelling on the throat, tongue, lips, and face. Some people also experience side effect such as critically high blood pressure, low potassium levels, pancreatitis, tarry or bloody stools, severe depression, swelling, rapid weight gain, and blurred vision. Another challenge is that many drugs interact with prednisone; St. John’s Wort, digoxin, cyclosporine, amphotericin, antibiotic and antifungal medication, blood thinner, and insulin among many others (Hilmer, McLachlan & Le Couteur, 2007). Despite treating many disorders, mitoprolol is associated with immense side effects and drug interactions. The drug causes tiredness, diarrhea, dizziness, drowsiness, slowed heartbeat, decreased sexual ability. There are drug interactions with fingolimod, propafenone, lumefantrine, quinidine, and St. John’s wort (Kristin, Robert & Bruce, 2013).
In a nutshell, among the elderly, aged-related changes in pharmacodynamics and pharmacokinetics should be anticipated. It is important to know that other factors such as drug-drug interactions, co-morbidity with medical conditions, and nutritional status also contributes to the drug action complexity in the elderly.
References
Hilmer, S. N., McLachlan, A. J., & Le Couteur, D. G. (2007). Clinical pharmacology in the geriatric patient. Fundamental & Clinical Pharmacology, 21(3), 217–230.
Kristin, L. B., Robert, R. B., & Bruce, G. P. (2013). Pharmacokinetics and Pharmacodynamics in Late Life. New York: Allen & Unwin.