Case Scenario: Patient JJ has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia.
Drugs currently prescribed include the following:
- Glipizide 10 mg po daily
- Metformin 500 mg po daily
- HCTZ 25 mg daily
- Atenolol 25 mg po daily
- Hydralazine 25 mg qid
- Simvastatin 80 mg daily
- Verapamil 180 mg CD daily
Use peer reviewed scholarly reference articles, provider/clinician based, not patient based, from peer reviewed, current US based journals. Use of non-scholarly references, especially patient based, is absolutely not acceptable at post-graduate, clinician level education. No pub med, mayo clinic, cdc, or NIH
- Scholarly references are:Peer-reviewed A Clinical Practice Guideline (CPG)Intended for providers/Clinicians (MDs, DOs, NPs)No more than 5 years old (unless it is a clinical practice guideline’s most recent update)U.S. based journals Intended for the primary care population Graduate level (Clinician Level) education is being able to do review and research.
INFORMATION AS SHORT PARAGRAPHS, READABLE. All information & presentation have to be at advanced clinician level.
1. Discuss pharmacology of existing agents briefly, molecular mechanism of action, therapeutic & adverse effects, & relevant kinetics, all as short paragraphs, readable.
2. Talk about what modifications are needed, what drugs are not at the best interest.
3. Follow a guideline, preferably JNC 8 and its current modifications (also ACC/AHA 2019 guidelines).
4. Talk about the drugs you have substituted or added, & their key pharmacology.
5. Address any specific questions that you are asked for in this case.
Example, here are some questions you may want to address in your assignment:
Does this patient need both verapamil & atenolol at the same time, since both have similar actions?
Recent guidelines do not recommend beta blockers for hypertension. But it was possibly added for the best therapeutic outcome? Why beta blockers? (example, he had strokes?).
Is there a drug to be added for stroke prevention?
What are the major adverse effects of Statins (muscle related), Hydralazine (many, lupus like syndrome), glipizide (hypoglycemia) HCTZ (hypokalemia) etc.
Why can\\\’t this patient be a candidate for metformin, the best used diabetes drug, efficacious, no hypoglycemic attacks etc.?
- 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.
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.