NURS 6521 Week 3 Pharmacotherapy with Cardiovascular Drugs Essay Assignment Paper

Cardiovascular disease is commonly encountered when caring for patients both within the inpatient and outpatient settings. Advanced practice nurses will often encounter patients with multi-pharmacy and multi-physician requiring medication review as well as medical history review and exam.

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Scenario 2 presents with patient HM who has a history of atrial fibrillation, TIAs, type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease/failure. Current medications include Warfarin 5mg MWF and 2.5mg T, TH, Sat, Sun, Aspirin 81mg/day, Metformin 1000mg BID, Glyburide 10mg BID, Atenolol 100mg/day, and Motrin 200mg 1-3 tablets every 6 hours as needed.

Influencing Factor

Behaviors by individual patients can and do often affect medications and their actions. One such action is the use of over the counter vitamins and minerals. Vitamins and minerals can often compete for receptors or negate an active ingredient or potentiate the effects. For example, calcium products have been documented to affect the serum levels of atenolol and other beta blockers leading to subtherapeutic levels and poor bioavailability (Drugs.com, 2018). Warfarin can also be affected by multiple over the counter vitamins and minerals. Vitamin K is an antagonist to warfarin and can affect therapeutic levels and INR results. Vitamin A, fenugreek, chamomile, cranberry, and Ginkgo Biloba are just a few known to inhibit therapeutic levels of warfarin by interacting with different processes within the pharmacokinetics and pharmacodynamics of the medication (Beikang, Zhen, Zhong, 2014).