Pharmacotherapy for Cardiovascular Disorder

Pharmacotherapy for Cardiovascular Disorder

• Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.

Aging is a factor with immense impacts on the management of cardiovascular disease. It comes with many other factors resulting from psychological changes and the general changes in the body organs (Alomar  2014). These changes complicate the use of various drugs. Notable effects include the increase of postural hypotension and falls increase in age, electrolyte disturbance, dehydration, and renal injury. Aging also has harmful influences on the use of anticoagulants drugs such as Aspirin, heparin, and warfarin. It increases the prospect of severe bleeding, change in metabolism, and renal impairment (Sera, & McPherson, 2017). These will be the consequences of aging as a factor in the patient in the case study.

• Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.

The effects of aging would force practitioners to change the way they use these drugs. The use of Aspirin would remain at 81 mg daily (Ayan, Pothineni, Siraj, & Mehta, 2016). There is a need, however, to carry out dosage modification and adjustments. In severe use of renal impairment, there is a need to avoid the use of warfarin. Also, there is a need to monitor patients closely as they use drugs. Aging would also demand a reduction in the prescribed dosages. There is also a need to educate patients about postural hypotension (Zastrozhin et al. 2017).

• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.

Aged patients have lower rates of drug absorption. The reduced secretion of gastric acid results in splanchnic blood flow, processes that lead to reduced assimilation of different drugs. Moreover, aged patients altered metabolism rates, leading to a reduction in the hepatic delivery of drugs. Age-related hepatic dysfunction is hugely challenging. Since most drugs are secreted through the kidneys, aging results in a decreased renal blood flow, and hence increase the persistence of various and the circulation of the metabolites. Aging, therefore, has detrimental impacts on the pharmacokinetics and pharmacodynamics of patients.

• Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

To improve patients’ drug therapy plans, clinicians require to be vigilant of the practices that result in adverse effects on the patients. They need to focus on the process of excretion in the elderly. They need to perform dosing based on the estimated rate of glomerular filtration and use more accurate tools to perform the tests necessary. Moreover, there is a need to assess the magnitude of hepatic dysfunction related to aging through careful filtration of dose as well as careful monitoring to circumvent the adverse side effects of these drugs. It is also prudent to monitor closely the process of absorption of drugs and the organs affected in the body as a result of aging. Doing this will permit clinicians to reduce the adverse impacts of the drugs as a result of reduced metabolism. It is also necessary to research to meet several future requirements and to have in the standardized procedure for drug therapy plans for patients with the conditions stated in the case study and the factors that lead to the changes. Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient

References

Alomar M. J. (2014). Factors affecting the development of adverse drug reactions (Review article). Saudi pharmaceutical journal: SPJ: the official publication of the Saudi Pharmaceutical Society, 22(2), 83–94. https://doi.org/10.1016/j.jsps.2013.02.003

Ayan, M., Pothineni, N. V., Siraj, A., & Mehta, J. L. (2016). Cardiac drug therapy-considerations in the elderly. Journal of geriatric cardiology: JGC, 13(12), 992–997. https://doi.org/10.11909/j.issn.1671-5411.2016.12.008

Sera, L. C., & McPherson, M. L. (2017). Pharmacokinetics and pharmacodynamic changes associated with aging and implications for drug therapy. Clinics in geriatric medicine, 28(2), 273-286.

Zastrozhin, M. S., Brodyansky, V. M., Skryabin, V. Y., Grishina, E. A., Ivashchenko, D. V., Ryzhikova, K. A., Savchenko, L. M., Kibitov, A. O., Bryun, E. A., & Sychev, D. A. (2017). Pharmacodynamic genetic polymorphisms affect adverse drug reactions of haloperidol in patients with the alcohol-use disorder. Pharmacogenomics and personalized medicine, 10, 209–215. https://doi.org/10.2147/PGPM.S140700