Cardiovascular System Assignment: Pharmacotherapy for Cardiovascular Disorders

Cardiovascular System Assignment: Pharmacotherapy for Cardiovascular Disorders

Pharmacokinetics and pharmacodynamics describe the interaction of the drug with the body and its consequent effect on the body. Pharmacokinetics and pharmacodynamics vary from one patient to another because of various factors that affect the processes. For example, old age manifests with profound biological changes that influence pharmacokinetics and pharmacodynamics processes. For instance, old people maybe more susceptible to side effects of certain medications than the younger population. Hence, understanding such factors as the age that influence these processes is critical in prescribing and effectively managing a patient’s pharmacotherapy. The purpose of this paper is to describe how age influences the pharmacokinetics and pharmacodynamics processes using the case study of LM.

Influence of Age on the Pharmacokinetics and Pharmacodynamics

The patient, LM, is 89 years-old, meaning she is old age. Age is one of the factors that might influence the pharmacokinetics and pharmacodynamic processes in LM. According to Maanen et al. (2019), physiological body changes occur in old age that affectsdrug absorption, activity, and elimination. Aging is associated with reduced drug absorption because of reduced gastric emptying, splanchnic blood flow, and gastric acid secretion. Similarly, aging leads to a reduction in blood flow and body mass that affects first-class metabolism. As a result, the first-class metabolism of drugs that take place in the liver becomes reduced while the bioavailability of medications that under extensive first-pass metabolism increases, for example, propranolol. Aging also affects drug distribution as water-soluble drugs tend to present with smaller volumes of distribution (Maanen et al., 2019). As a result, a dose reduction in such cases might be necessary to accommodate the new requirements. Similarly, lipid-soluble drugs tend to have a longer half-life and increased volume of distribution in old people.Aging patients also experience reduced renal functioning and other organs involved in the elimination of drugs from the body. As a result, drug elimination is often slow in older adults such as LM.

How Changes Affect the Patient’s Drug Therapy

LM is taking various drugs for hypertension, hypothyroidism, diabetes, and other minor issues, making her case complex. The effectiveness of these medications depends on several factors including age, affecting the absorption, distribution, metabolism, or excretion of certain medications. Changes in organs and body functioning at old age might alter the pharmacokinetics and pharmacology of LM’s medication therapy (Lim et al., 2018).The alteration can lead to adverse event occurrence. For example, Donepezil is safe for use in the elderly population, but care must be taken because of the risk of gastrointestinal and neurological adverse events. Reduced functioning of body organs can cause cholinergic action, causing an adverse reaction. Similarly, Levothyroxine is effective drug therapy for overt hypothyroidism. However, when using the drugs with the elderly population, caution must be taken especially in patients with cardiovascular issues.

In elderly patients as demonstrated in LM’s case, disease comorbidity is common complicating the diagnosis and management of diseases. For example, Levothyroxine can cause cardiac ischemia increasing the risk of mortality (Effraimidis et al., 2021). Similarly, improper functioning of the kidneys, stomach, and heart can impact the safety of the patient’s medication therapy. For example, elderly patients with kidney or heart-related problems are not advised to take Celecoxib. In addition, reduced kidney functioning may cause inefficient excretion of Furosemide, causing a buildup and toxicity (Lim et al., 2018). Another example of a medication that demonstrates how age factors influence pharmacokinetic and pharmacodynamic processes of drugs is Glyburide. While the medication is well-tolerated in younger adults, with the elderly, it presents the risk of hypoglycemia. The American Geriatrics Society strongly recommends avoiding the use of the drug for the elderly population because of potential risks (Greenberg, 2021).

Plan for Improvement

I would adjust the patient’s drug therapy to reduce the risk of harm. For example, I would recommend replacing Glyburide with insulin glargine because it is well-tolerated by older people and has a lower risk of hypoglycemia. I would also prescribe a lower dose of Levothyroxine than the standard dose for younger adults. Lowering the dose reduces the risk of adverse events (Kim, 2020). Further, I will apply caution and constant monitoring for any reactions that might arise from Donepezil, Furosemide, and Celecoxib. I will also exercise caution if there is a need to increase the dosage of Amlodipine.