Case Study:
Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been
diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the
following:
Atenolol 12.5 mg daily
Doxazosin 8 mg daily
Hydralazine 10 mg qid
Sertraline 25 mg daily
Simvastatin 80 mg daily
- Select one of 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.
** Write an explanation of how the factor you selected might influence the
pharmacokinetic and pharmacodynamic processes in the patient from the case study you
selected. Then, describe how changes in the processes might impact the patient’s
recommended drug therapy. Finally, explain how you might improve the patient’s drug
therapy plan.
Pharmacotherapy for Cardiovascular Disorders
There are age-related physiological transformations that change the manner in which the
body handles drugs. Usually, the elderly suffer from a number of diseases and in this case,
obesity, hyperlipidemia, and hypertension. Age affects the pharmacokinetic and
pharmacodynamic processes in that the mechanisms involved are different. There are differences
in plasma proteins. Therefore, there are detrimental challenges with protein-bound medications
(Wooten, 2012). Blood levels vary and hence, there should be consistent dosing and food intake.
There is also reduced cardiac output and considering that the patient is suffering from chronic
diseases, the result is reduced intramuscular and subcutaneous drug absorption. This affects
PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS
injectable medications’ pharmacokinetics. The subcutaneous fat absorbs transdermal
medications, but this efficiency reduces with aging (Wooten, 2012).
The discussed changes in the two processes can impact the recommended drug therapy
since the altered biophysiology effects might make the elderly unable to tolerate recommended
doses and medications (Wooten, 2012). This is because the receptor sites and receptors in the
elderly, particularly those with chronic diseases, are limited or reduced in function. As a result
the effect of reducing or increasing drug action sensitivity.
Based on the changes, there is a need to modify or change the patient’s drug therapy.
Otherwise, even though the patient can be given the recommended medications, there is a need
to consider dosing and regular food intake (Wooten, 2012). The method of administration is
important since with age, the absorption, distribution, metabolism, and excretion of drugs
change. Therefore, the administration method should ensure that there are no or minimal changes
on how the drug acts on the body or how the body is affected.
PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS
Reference
Wooten, J. M. (2012). Pharmacotherapy Considerations in Elderly Adults. South Med
J.,105(8):437-445.