Pharmacotherapy for Cardiovascular Disorders

Pharmacotherapy for Cardiovascular Disorders
As the leading cause of death in the United States for both men and women,
cardiovascular disorders account for 7 million hospitalizations per year (NCSL, 2012). This
is the result of the extensive treatment and care that is often required for patients with
these disorders. While the incidences of hospitalizations and death are still high, the
mortality rate of cardiovascular disorders has been declining since the 1960s (CDC, 2011).
Improved treatment options have contributed to this decline, as well as more knowledge on
patient risk factors. 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.

Running Head: Pharmacotherapy for Cardiovascular Disorders

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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
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. doi:10.7748/nop2013.09.25.7.33.e441

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