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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

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

 

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

  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. Stick to ONE factor! Describe the effect of the factor on PK/PD in general
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. Describe the pharmacokinetics/pharmacodynamics of EACH drug in the patient’s list. Research the effect of the factor you selected on EACH drug in the drug list provided as part of the patient case. You can use primary research articles and a drug reference for information
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. Use bullet points for your recommendations. Include one bullet point for each drug. Be specific. For example:
  • decrease atenonol to 50mg daily because bioavailibilty…
  • stop metformin. Start….at XXmg because bioavailibilty…

While grading, I noticed some common mistakes from the work you submitted in Week 1.

  • Read the question carefully. Some of you provided great information in the discussion posts, but you did not answer the question. Use the guidance provided in the announcement on Monday of each week
  • This is a pharmacology class. When discussing a patient case, focus on the drugs. Use a drug reference and primary research articles (randomized controlled trials and systematic reviews are preferred) evaluating effects and side effects of the drugs
  • Use generic names for drugs. If you want to you can add the brand name in parenthesis – e.g. furosemide (Lasix®)
  • References should fit the patient e.g.
  • an article on metformin use in oncology patients can only be cited if your patient is taking metformin and has cancer. In addition, the type of cancer and cancer treatments used in the research and in your patient should match
  • an article on pharmacokinetics in a diabetic patient taking metformin can only be used if your patient has diabetes and is on metformin
  • APA style – review the basic checklist and be sure to look at examples on citations and references

 

Required Readings

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 33, “Review of Hemodynamics” (pp. 285–289)
  • Chapter 37, “Diuretics” (pp. 290–296)
  • Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
  • Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
  • Chapter 40, “Vasodilators” (pp. 313–317)
  • Chapter 41, “Drugs for Hypertension” (pp. 316–324)
  • Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
  • Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
  • Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
  • Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
  • Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)

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