Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay
Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay
The Influence of Age on the Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes in the patient with Cardiovascular Disease (CVD)
In common layman’s language, cardiovascular disease is what is referred to as heart disease. It includes several disease conditions that affect the heart itself and the vessels originating from or supplying it. Most of these conditions forming cardiovascular disease are brought about by the cumulative deposition of fatty occlusive plaques in the inner walls of the blood vessels, especially arteries. This process is known as atherosclerosis. Conditions such as myocardial infarction (heart attack), angina, arrhythmia, and coronary artery disease (CAD) all fall under cardiovascular disease (Hammer & McPhee, 2018; Huether & McCance, 2017). Because atherosclerosis becomes worse with age, most cardiovascular disease understandably affects older persons (Brenes-Salazar et al., 2015). As a result, it is them that are mostly on cardiovascular medication. However, there are age-related alterations in these older persons that significantly affect the pharmacokinetics and pharmacodynamics of the cardiovascular medications that they are given. This Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay paper looks at these changes and their impact on the drug therapy of these older cardiovascular patients.
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How Age Influences the Pharmacokinetic and Pharmacodynamic Processes in Older Cardiovascular Patients on Medication
In older persons, the pharmacokinetics and pharmacodynamics of cardiovascular medications are altered significantly. This is especially true for particular medications. Pharmacokinetics refers to how the body processes the drug after it is administered. It involves absorption, distribution, metabolism, and excretion (ADME). Pharmacodynamics, on the other hand, is what the drug does to the body or its mechanism of action (Brenes-Salazar et al., 2015; Katzung, 2018). Since most of the cardiovascular medications are taken orally, gastrointestinal changes that occur with old age will affect their absorption (PK). For instance, in older patients with heart failure and accumulation of fluid in the body, oral furosemide is not properly absorbed because of fluid in the intestinal mucosa. Another example is digoxin. This cardiac drug is given as per the lean body weight. However, lean body weight is known to decrease with old age. Because of this, dose adjustment of the medication is necessary in older patients (Brenes-Salazar et al., 2015).
Changes in metabolism also occur with aging of the liver. Efficacy of the cytochrome isoenzymes therefore reduces. Therefore, drugs such as atorvastatin that depend on this pathway for their hepatic first pass metabolism are bound to accumulate in the bodies of older patients. Lower dosages are therefore mandatory in old age (Brenes-Salazar et al., 2015) Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay.
How Changes in Pharmacokinetics and Pharmacodynamics Impact the Older Patient’s Drug Therapy
The main impact of the changes in these processes is the change in doses. For instance, in the case of oral furosemide, a slightly higher daily dose may be needed in order to achieve the same plasma concentrations (poor absorption). In the case of digoxin and atorvastatin, a reduction in dosage is required because of a lower lean body weight and ageing of the liver (slowing down of the metabolic hepatic CYP450 isoenzymes).
Improving the Patient’s Drug Care Plan
The older patient will only get drugs that are absolutely necessary. This avoidance of polypharmacy is to allow the aged liver time to work at a less stressful pace. Medications whose dosages require reduction will be reduced (like digoxin and atorvastatin), while those that need increasing (like furosemide) will be increased to achieve the optimum plasma concentrations. I would make these recommended improvements because drug efficacy and effectiveness are dependent on proper dosing and an appreciation of PK Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay.
References
Brenes-Salazar, J.A., Alshawabkeh, L., Schmader, K.E., Hanlon, J.T. & Forman, D.E. (2015). Clinical pharmacology relevant to older adults with cardiovascular disease. Journal of Geriatric Cardiology, 12(3), 192–195. Doi: 10.11909/j.issn.1671-5411.2015.03.018
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. New York, NY: McGraw-Hill Education.
Huether, S.E. & McCance, K.L. (2017). Understanding pathophysiology, 6th ed. St. Louis, MO: Elsevier, Inc.
Katzung, B.G. (Ed) (2018). Basic and clinical pharmacology, 14th ed. New York, NY: McGraw-Hill Education.
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. Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay.
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.
RUBRIC:
-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.
-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.
-Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation–
-Written 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 Pharmacokinetic (PK) and Pharmacodynamic (PD) Processes Age Influence Cardiovascular Disease (CVD) patient Essay
