Pharmacotherapy
Assignment Instructions
- Review the Resources for this module and consider the impact of potential pharmacotherapy 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.
By Day 7 of Week 2
Write a 2- to 3-page pharmacotherapy 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.
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
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.
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.
Written Expression and Formatting – The paper follows correct APA format for title page, conclusion, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
References have to be within the last 5 years
SAMPLE ANSWER
Pharmacotherapy for Cardiovascular Disorders
Advanced practice nurses are responsible for ensuring that patients receive quality and safe care. One of the ways to ensure safety and quality of care is understanding how various factors can impact the patient’s pharmacokinetics (PK) and pharmacodynamics (PD) processes when they are prescribed medications (Rosenthal & Burchum, 2021). The authors note that knowledge on PK and PD processes of medications can help advanced practice nurses prescribe safe medications for patients to use.
Nurses can also understand drugs’ various uses and side effects by knowing their PK and PD processes (Rosenthal & Burchum, 2021). This assignment presents a patient with a history of atrial fibrillation and transient ischemic attack (TIA). The patient was diagnosed with hypertension, hyperlipidemia, type 2 diabetes, and ischemic heart disease. The study aims to determine how age can influence the PK and PD processes in patient HM.
Impact of Age on HM’s Pharmacokinetics and Pharmacodynamics Processes
The patient’s PD and PK processes can be highly impacted by age. As people age, they experience significant functional impairment of many regulatory processes that offer practical amalgamation between organs and cells (Drenth‐van Maanen et al., 2020). Hence, the body may fail to maintain hemostasis at an advanced age because the body is often under physiological stress. Drenth‐van Maanen et al. (2020) note that significant PK and PD changes occur as people advance in age. One of the PK processes affected by age is drug adsorption. Absorption is when a drug moves from the administration site into the systemic circulation. Drug absorption in older adults can be impacted by decreased gastric acid production.

Gastric acid production can lead to impaired drug dissolution, which causes decreased bioavailability of drugs. First-pass metabolism also reduces as one ages, which causes increased absorption of high-clearance drugs leading to increased plasma concentration (Drenth‐van Maanen et al., 2020). Some of the drugs affected by decreased first-pass metabolism include lidocaine, Morphine, and verapamil. Age also impacts the distribution of drugs. For instance, as one ages, they experience an increased proportion of body fat which causes the increased distribution of lipid-soluble drugs. As a result, the half-life of these medications can be increased. Age also leads to decreased total body water, which decreases the distribution of water-soluble drugs and thus increases plasma concentration (Shendre et al., 2018). Lastly, age can impact drug metabolism.
As one age, their liver function reduces, decreasing the first pass effect of prodrug because of reduced cytochrome P450 enzyme activity and hepatic mass and blood flow. Age also impacts the PD processes. Shendre et al. (2018) note that as one ages, the sedition effect of antipsychotics increases, and thus dosing should be reduced in old age. The authors also note that in dosage of Benzodiazepines in older people can lead to high sedation and memory loss. Beta-blocking agents decrease target tension antihypertensive and vasoconstrictive effects.
Impact of the Changes in the Process on Patient HM’s Recommended Drug Therapy
As noted above, age significantly impacts the PK and PD processes. One of the drugs recommended to the patient is warfarin. The drug reacts more with patients above the age of 65, and thus its dosage should decrease with age to reduce side effects (Shendre et al., 2018). The patient has also been prescribed aspirin. The side effects of the drug increase with age. Hence, dosing for older adults should be reduced. The patient has also been prescribed Metformin and Glyburide. Shuster et al. (2020) note that older adults with kidney problems should not start Metformin. The authors also found that as one ages, the risk of developing kidney problems while using Metformin and Glyburide is high. Therefore, the patient should be highly monitored for Glyburide and Metformin side effects. Atenolol with antihypertensive and vasoconstrictive effects and its dosage should be increased slowly based on its impacts (Drenth‐van Maanen et al., 2020). Motrin is a painkiller, and older adults are more sensitive to painkillers, and thus dosing for this age group should reduce.
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Improving Patient’s Plan
I would improve the patient’s drug therapy plan by reducing the warfarin dosage to 4.0mg daily to reduce the side effects of the medication (Shendre et al., 2018). The patient should also be monitored closely. I would also decrease the aspirin dose to 70mg daily to reduce potential side effects. If the patient is older, I would also decrease the atenolol dosage to 50mg PO to reduce side effects and increase it slowly based on its impacts. I would also decrease the dosage of glyburide to 2.5 mg orally once a day and monitor for hypoglycemia and long-term cardiovascular problems (Khunti et al., 2020). I would remove Metformin and prescribe Acarbose because Metformin might negatively impact the patient’s kidney if he is older (Shuster et al., 2020; Yakaryılmaz & Öztürk, 2017). Lastly, would swap Motrin with acetaminophen. The 2019 American Geriatrics Society Beers Criteria recommends that Motrin should be avoided in older people.
Conclusion
Age is a significant factor in PD and PK processes. Therefore, healthcare professionals should consider the age of patients before prescribing medications. For instance, if prescribing a drug such as Metformin, the nurse should ensure that the patient does not have kidney problems. Metformin is discouraged in older adults because their kidney functions are relatively impaired. Generally, advanced nurse practitioners should prescribe low dosages for most medications for older people to reduce side effects and improve distribution and absorption.
References
Drenth‐van Maanen, A. C., Wilting, I., & Jansen, P. A. (2020). Prescribing medicines to older people—How to consider the impact of ageing on human organ and body functions. British Journal of Clinical Pharmacology, 86(10), 1921-1930. https://doi.org/10.1111/bcp.14094
Khunti, K., Hassanein, M., Lee, M. K., Mohan, V., & Amod, A. (2020). Role of gliclazide MR in the management of type 2 diabetes: report of a symposium on real-world evidence and new perspectives. Diabetes Therapy, 11, 33-48. https://doi.org/10.1007/s13300-020-00833-x
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) Elsevier.
Shendre, A., Parmar, G. M., Dillon, C., Beasley, T. M., & Limdi, N. A. (2018). Influence Of Age On Warfarin Dose, Anticoagulation Control, And Risk Of Hemorrhage. Pharmacotherapy: The Journal Of Human Pharmacology And Drug Therapy, 38(6), 588-596. Https://Doi.Org/10.1002/Phar.2089
Shuster, D. L., Shireman, L. M., Ma, X., Shen, D. D., Flood Nichols, S. K., Ahmed, M. S., … & Quinney, S. K. (2020). Pharmacodynamics Of Glyburide, Metformin, And Glyburide/Metformin Combination Therapy In The Treatment Of Gestational Diabetes Mellitus. Clinical Pharmacology & Therapeutics, 107(6), 1362-1372.
Yakaryılmaz, F. D., & Öztürk, Z. A. (2017). Treatment of type 2 diabetes mellitus in the elderly. World Journal of Diabetes, 8(6), 278–285. https://doi.org/10.4239/wjd.v8.i6.278