When prescribing medicines to patients, primary care physicians need to know the most effective medication to administer to the patient. More to this, the primary care physician ought to know the medication history of their patients and the types of drugs they are using. The physician needs to take into account several other factors, including demographics and any disease history. In the case of patient AO, a comprehensive patient assessment needs to be conducted. During the assessment, it is vital to consider the patient’s genetic history, weight history, behavioral factors, and diagnosis of cardiovascular diseases (CVDs).
CVDs continue to be the leading cause of death across the globe. CVDs affect the structure of the structure or functions of the heart. There are numerous types of CVDs, but the most common ones include stroke, heart failure (HF), heart valve problems (Woodward, 2019). In the case of the patient, the primary care physician has diagnosed patient AO with hypertension and hyperlipidemia. More to this, we are informed that the patient has a history of obesity. Therefore, it is very important to understand the genetic history of patient AO because it will help in the diagnosis as well as in the treatment of CVDs. More to this, primary care physicians should understand the pharmacokinetic (PK) and pharmacodynamics (PD) process of CVD. This is because it will help them improve therapy plans for their patients.
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How Genetics Influence PK and PD Processes
Treatment for CVDs can be very challenging due to the presence of co-morbidities, the diverse neuroendocrine, immunological mechanisms involved, and the use of multiple therapies (Pazoki, Dehghan, Evangelou, Warren, Gao, Caulfield, ... & Tzoulaki, 2018). To add to this, physiological parameters that affect the PK and PD of a drug tend to be altered in patients with CVD. Therefore, there is a need to plan trials for CVD drugs carefully. To ensure a drug's clinical utility, it is vital to understand PK and PD differences between CVD patients (Pazoki et al. 2018). Also, due to the complex traits presented by CVDs, it is important to understand the genetics of CVDs. This is because genetics affects the PK and PD process of CVD. More specifically, genetics controls all features of the cardiovascular system (Pazoki et al. 2018). Genetic variations tend to influence the way proteins work in the body. Because of this, cholesterol may accumulate in the arteries. Hypertension and hyperlipidemia are sometimes genetically predisposed, as there are some factors that affect blood pressure. This is because these factors tend to control the balance of fluids and salts in the body. If a family has a history of CVD, other family members are susceptible to the condition and therefore have to go for screening. People with genetic risk ought to be identified early in life as well as be encouraged to undergo lifestyle changes.
Impact of PK and PD Processes
Prescribing the right medicine to a patient is critical in the treatment of CVDs. Due to changes in PK and PD processes, primary care physicians or advances nurses recommend starting dosages and then changing the dose gradually in order to enhance blood control as well as to reduce the adverse effects of the drugs. The changes in PK and PD processes is because CVDs are capable of transforming receptor binding. More to this is that CVDs are capable of adjusting to binding proteins and reducing receptor sensitivity.
To manage cardiovascular disorders, patient AO was prescribed with the following drugs: Atenolol 12.5 mg daily, doxazosin 8 mg daily, hydralazine 10 mg gid, sertraline 25 mg daily, and simvastatin 80 mg daily. According to Wiysonge, Bradley, Volmink, Mayosi, & Opie (2017), atenol is usually used as a first-line treatment for hypertension. Doxazosin and hydralazine are mainly used to calm arterial pressure (Wiysonge et. Al., 2017). Simvastatin is used primarily to lower the level of cholesterol in the body. Sertraline is an antidepressant (Wiysonge et al., 2017). We are informed that patient AO has a history of obesity. More to this, the patient has gained 9 pounds. Simvastatin will help the patient in reducing fats. The medications prescribed to patient AO are likely to change the PK and PD processes within the patient’s body. As a result, the patient can recover from CVDs.
Improving Patient’s AO Drug Therapy
Patient AO is already under medications. However, the patient may need improved drug therapy. This can help the patient detect as well as prevent drug-related issues. Primary care physicians or advanced nurses ought to improve the drug therapy of their patients. They can do this by educating their patients on the therapy prescribed to them, the adverse effects of the medications, and the actions to take in case an issue emerges. Additionally, there is a need to evaluate the drug therapy of the patient. More specifically, there is a need to check if the patient is taking the medicines as prescribed. Most medication ought to be used with caution because of the age-related changes PK. If the drug therapies result in many problems, the severity and acuteness of the problem should be assessed.
Nurses should also adjust drug therapies if there is a need to. The complications of hypertension, especially those which are genetically determined, should be managed through adopting a healthy lifestyle. Therefore, Patient AO should be advised to adopt a healthy lifestyle. A healthy lifestyle is one that encourages physical activity and healthy eating. This will help the patient avoid the complications associated with hypertension and hyperlipidemia.
References
Pazoki, R., Dehghan, A., Evangelou, E., Warren, H., Gao, H., Caulfield, M., ... & Tzoulaki, I. (2018). Genetic predisposition to high blood pressure and lifestyle factors: associations with midlife blood pressure levels and cardiovascular events. Circulation , 137 (7), 653-661.
Woodward, M. (2019). Cardiovascular disease and the female disadvantage. International Journal of Environmental Research and Public Health, 16 (1165): 1-13.
Wiysonge, C. S., Bradley, H. A., Volmink, J., Mayosi, B. M., & Opie, L. H. (2017). Beta ‐ blockers for hypertension. Cochrane database of systematic reviews , (1).
