Pharmacotherapy for Cardiovascular Disorders

�Select one of the three case studies, as well as 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.

Pharmacotherapy for Cardiovascular Disorders

HM client is diagnosed with hypertension, atrial fibrillation and TIA. This puts the
patient at risk of developing stroke. There are various aspects which should be put into
consideration during the decision making process. These include age, gender, genetics, and
ethnic group. This article selects age as the key factor. Age causes modification in the

Running Head: Pharmacotherapy for Cardiovascular Disorders

3
metabolism process of the drug and the elimination process. This is due to altered body pH,
water content level, and hepatic metabolism. This interferes with the patient’s ability to clear
drugs; which results to toxicity and exacerbation of the disease (Kaufman, 2013).
Warfarin 5mg po daily and 2.5mg in an alternating pattern is appropriate. The patient
INR must be monitored to guide the dosage. This dosage is most appropriate to cover thrombo-
embolic stroke associated with atrial fibrillation. Aspirin 81mg dosage is high putting into
consideration that the patient had previously suffered from TIA, and could result to bleeding. In
this case, Plavix 75mg (clopiogrel) could be used instead. Glyburide 10mg could interact with
warfarin and could lead to hypoglycemia. Therefore, the patient should be monitored closely.
Metformin dosage is appropriate to maintain the right blood sugar level. Atenolol 100mg (beta
blocker) is normally discouraged for use in diabetic patients, and thus the patient should be
changed to ACE inhibitor such as Lisinopril 5mg daily. If pain reduces, discontinue Motrin
200mg (Arcangelo & Peterson, 2013).
The most important aspect is to empower the patient. This is through patient education
on ways to control blood sugar levels, hypertension and cholesterol. The patient would be
advised warning signs of stroke so as to seek medication as soon as possible. Patients should also
be advised of lifestyle modification process (Kaufman, 2013).

Running Head: Pharmacotherapy for Cardiovascular Disorders

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Reference list
Arcangelo, V. P., & Peterson, A. M. (2013). Pharmacotherapeutics for advanced practice: A
practical approach. Philadelphia, PA: Lippincott Williams & Wilkins
Kaufman, G. (2013). Prescribing and medicines management in older people. Nursing Older
People, 25(7), 33-41.

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