Discussion: 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.

Consider the following case studies:

Case Study 1:

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

Case Study 2:

Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:

· Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun

· Aspirin 81 mg daily

· Metformin 1000 mg po bid

· Glyburide 10 mg bid

· Atenolol 100 mg po daily

· Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Case Study 3:

Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following: 

· Glipizide 10 mg po daily

· HCTZ 25 mg daily

· Atenolol 25 mg po daily

· Hydralazine 25 mg qid

· Simvastatin 80 mg daily

· Verapamil 180 mg CD daily

To prepare:

· Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text.

· 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.

With these thoughts in mind:

Post 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.

Link to Media:

https://class.waldenu.edu/bbcswebdav/institution/USW1/201930_27/MS_NURS/NURS_6521/adobePresenter/Week03/media2/index.htm

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Assignment:
                              Antimicrobial Agents                            

Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.

To prepare:

• Review this week’s media presentation on principles of antimicrobial therapy, as well as Chapter 8 of the Arcangelo and Peterson text.
• Consider the categories of antimicrobial agents.
• Think about differences between viral and bacterial infections.
• Reflect on why proper identification of the infection is key to selecting the proper antimicrobial agent.

Write a 2- to 3- page paper that addresses the following:

• Describe the categories of antimicrobial agents.
• Describe differences between viral and bacterial infections.
• Explain why proper identification of viral and bacterial infections is key to selecting the proper antimicrobial agent.

 

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Assignment:
Asthma and Stepwise Management 

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To prepare:

· Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children.

· Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.

· Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

Write a 2- to 3- page paper that addresses the following:

· Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.

· Explain the stepwise approach to asthma treatment and management.

· Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

 

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Assignment:
The Ethics and Legalities of Medication Error Disclosure 

American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to the error that counts” (Goodreads, 2012). Whenever you make an error when writing a prescription, you must consider the ethical and legal implications of your error—no matter how seemingly insignificant it might be. You may fear the possible consequences and feel pressured not to disclose the error. Regardless, you need to consider the potential implications of non-disclosure. How you respond to the prescription error will affect you, the patient, and the health care facility where you practice. In this Assignment, you examine ethical and legal implications of disclosure and nondisclosure of personal error.

Consider the following scenario:

· You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.

To prepare:

· Consider the ethical implications of disclosure and nondisclosure.

· Research federal and state laws for advanced practice nurses. Reflect on the legal implications of disclosure and nondisclosure for you and the health clinic.

· Consider what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error.

· Review the Institute for Safe Medication Practices website in the Learning Resources. Consider the process of writing prescriptions. Think about strategies to avoid medication errors.

Write a 2- to 3- page paper that addresses the following:

· Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to reference laws specific to your state.

· Describe what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error. Provide your rationale.

· Explain the process of writing prescriptions including strategies to minimize medication errors.

Link:

https://www.ismp.org/recommendations/error-prone-abbreviations-list

 

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While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?

To prepare:

• Review Chapter 49 of the Arcangelo and Peterson text, as well as the Montaner et al (2014) articles in the Learning Resources.
• Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.
• Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.
• Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

With these thoughts in mind:

Post an explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.Then, explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease. Finally, describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

 

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