BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital. Upon presentation to the hospital:

Upon presentation to the hospital:

PMH:

  • HTN x 7 years
  • Type II DM
  • CAD s/p angioplasty 2 years ago
  • MI 3 years ago
  • EF = 60%
  • PVD s/p left femoral to posterior bypass
  • Hx of A Fib x 4 years

Medications:

  • Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD
  • Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD
  • Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache
  • Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD
  • Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID
  • HCTZ 12.5 mg QD Humalog 8u with meals

PE:

  • BP 110/50 Pulse 38 bpm Resp 14/min
  • Rest of physical exam unremarkable

Labs:

  • K+ 6.9 WBC 5,800/mm3
  • Na+ 135 Hct 35%
  • Cr 1.9 Dig 2.78
  • BUN 35 INR 2.3
  • Gluc 102

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Pharmacotherapy for Cardiovascular Disorders

Introduction 

According to van den Anker et al. (2018), pharmacokinetics is the process that a drug is subjected to when it is taken and it includes the absorption process, the metabolic activities, excretion of the drug, or the distribution of the drug in the body. On the other than the effects that a drug will have on the body are referred to as pharmacodynamics. Pharmacodynamics and pharmacokinetic impact the elements such as the history of the health of the patient and other features such as the age of the patient. The case presented is for a 74-year-old African American patient who has been presented to the health setting due to the complaint of having his heart not beating right as she feels that it is going slow. This paper focuses on the pharmacodynamics and pharmacokinetics of the patient in the scenario. 

Patient factor

Many factors affect the pharmacokinetics and pharmacodynamics of patients and hence influencing the healing process of the patient. One of the factors that affect this is the behavior of the patient. Sahinovic, Struys, and Absalom (2018) depict that for a patient who is suffering from heart-related conditions such as hypertension and diabetes the behavior of the patient has a great influence. As such, behavior such as the diet and the actions of having physical activities is of importance in the determination of the quality of health of a patient who is suffering from heart-related conditions….

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