PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS

Assignment

Write a 3+ page paper that addresses the following:

· Explain how the factor (i.e. genetics, gender, ethnicity, age or behavior) you selected might influence the pharmacokinetic and pharmacodynamic  processes in the patient from the case study you were assigned.

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

· Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. Would you discontinue any medications, change the dosage, and/or add medications to the patient’s regimen? DISCUSS EACH MEDICATION.

 

Case study assigned.

LM is an 89-year-old female resident of a long-term care facility who has been experiencing multiple falls, some resulting in injuries such as bruising and skin tears. Over the last 6 months, her ambulation status has declined from independent to wheelchair level. She complains of pain in her legs when walking more than short distances across the nursing unit.

 

PMH:

· HTN

· Alzheimer’s disease

· Hypothyroidism

· Osteoarthritis

· Diabetes

 

MEDICATIONS:

· Amlodipine 10 mg QD

· Donepezil 10 mg QHS

· Levothyroxine 88 mcg QAM

· Celecoxib 200 mg QD

· Furosemide 40 mg QAM

· Metformin 500mg, 1 BID

· Glyburide 5mg, 1 BID

 

ALLERGIES: NKA

 

SOCIAL HISTORY:

Widowed with 2 adult children living in town, retired photographer and owner of an art supply store

 

VITALS:                                              LABS:

Weight: 129 lbs                               TSH 2.45, Free T4 0.98

Height: 64 inches                            Na 135, K+ 3.4, Cl 99, CO2 25,

BP: Supine = 177/82                       Glucose 101

HR: 78 bpm                                      WBC 7.0, RBC 4.5, Hgb 11.9, Hct 34.1, Plt 255

                                                          BUN 42, Cr 1.6, UA Clear

                                                          eGFR: 45 ml/min

PE:

· HEENT: Normocephalic, no evidence of trauma, PERRLA, EOMI

· CV: RRR

· Respiratory: Clear to auscultation bilaterally

· Abdomen: Soft, non-tender, no masses or guarding

· G/U: Skin intact, assisted with toileting and personal hygiene by staff

· Extremities: Bilateral 2+ edema to lower extremities; skin dry, dark bruising and skin tear to right elbow and forearm

· Neuro: Alert and oriented to person only. MMSE 18/30, stable over last 12 months

 

PAIN ASSESSMENT:

Faces pain scale: No pain occurs at rest, upon walking, pain is moderate to severe

RUBRIC FOR GRADING

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. = The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.

This criterion is linked to a Learning OutcomeDescribe how changes in the processes might impact the patient's recommended drug therapy. Be specific and provide examples. = The response accurately and completely describes in detail how changes in the processes might impact the patient's recommended drug therapy. … Accurate, complete, and aligned examples are provided to support the response.

Explain how you might improve the patient's drug therapy plan, and explain why you would make these recommended improvements. = The response accurately and clearly explains in detail how to improve the patient's drug therapy plan. … The response includes an accurate and detailed explanation to support the recommended improvements.

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. = Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation. = Uses correct grammar, spelling, and punctuation with no errors

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. Uses correct APA format with no errors.