05 Sep Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
..heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
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.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm
Criteria Ratings Pts
25 pts
30 pts
30 pts
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
25 to >22.5 pts Excellent
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
22.5 to >19.75 pts Good
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
19.75 to >17.25 pts Fair
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
17.25 to >0 pts Poor
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
Describe how changes in the processes might impact the patient's recommended drug therapy. Be specific and provide examples.
30 to >26.7 pts Excellent 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.
26.7 to >23.7 pts Good The response accurately describes how changes in the processes might impact the patient's recommended drug therapy. … Accurate examples may be provided to support the response.
23.7 to >20.7 pts Fair The response inaccurately or vaguely describes how changes in the processes might impact the patient's recommended drug therapy. … Inaccurate or vague examples are provided to support the response.
20.7 to >0 pts Poor The response inaccurately and vaguely describes how changes in the processes might impact the patient's recommended drug therapy, or is missing. … Inaccurate and vague examples may be provided to support the response, or is missing.
Explain how you might improve the patient's drug therapy plan, and explain why you would make these recommended improvements.
30 to >26.7 pts Excellent
The response accurately and clearly explains in detail how to improve the patient's drug therapy plan. …
26.7 to >23.7 pts Good
The response accurately explains how to improve the patient's drug therapy plan. … The response may include an accurate
23.7 to >20.7 pts Fair
The response inaccurately or vaguely explains how to improve the patient's drug therapy plan. … The response may
20.7 to >0 pts Poor
The response inaccurately and vaguely explains how to improve the patient's drug therapy plan, or is missing. … The
Criteria Ratings Pts
5 pts
5 pts
5 pts
The response includes an accurate and detailed explanation to support the recommended improvements.
explanation to support the recommended improvements.
include an inaccurate, vague, or misaligned explanation to support the recommended improvements.
response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.
Written 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.
5 to >4.45 pts Excellent Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4.45 to >3.95 pts Good Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.95 to >3.45 pts Fair Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
3.45 to >0 pts Poor Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.45 pts Excellent Uses correct grammar, spelling, and punctuation with no errors
4.45 to >3.95 pts Good Contains a few (1– 2) grammar, spelling, and punctuation errors
3.95 to >3.45 pts Fair Contains several (3–4) grammar, spelling, and punctuation errors
3.45 to >0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows
5 to >4.45 pts Excellent
Uses correct APA format with no
4.45 to >3.95 pts Good
Contains a few (1– 2) APA format
3.95 to >3.45 pts Fair
Contains several (3–4) APA format
3.45 to >0 pts Poor
Contains many (≥ 5) APA format
Total Points: 100
Criteria Ratings Pts
correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in- text citations, and reference list.
errors errors errors errors
,
PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS
BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital.
Upon presentation to the hospital:
PMH:
· HTN x 7 years
· Type II DM
· CAD s/p angioplasty 2 years ago
· MI 3 years ago
· EF = 60%
· PVD s/p left femoral to posterior bypass
· Hx of A Fib x 4 years
Medications:
· Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD
· Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD
· Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache
· Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD
· Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID
· HCTZ 12.5 mg QD Humalog 8u with meals
PE:
· BP 110/50 Pulse 38 bpm Resp 14/min
· Rest of physical exam unremarkable
Labs:
· K+ 6.9 WBC 5,800/mm3
· Na+ 135 Hct 35%
· Cr 1.9 Dig 2.78
· BUN 35 INR 2.3
· Gluc 10
Write a 2- to 3-page paper that addresses the following:
· Explain how the factor 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
To Prepare
· Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
· Review the case study assigned by your Instructor for this Assignment.
· Select 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.
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