Patient Preference and Adherence Essay

A patient has a history of obesity and recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia and is on the following prescribed medications; Atenolol 12.5mg daily, Doxazosin 8mg daily, hydralazine 10mg four times daily, sertraline 25mg daily and simvastatin 80mg daily. A- Explain how the ethnicity factor might influence the pharmacokinetic and pharmacodynamic processes in this patient? B- Describe how changes in the processes might impact the patient\’s recommeded drug therapy?. Be specific with examples? C- Explain how you might improve the patient\’s drug therapy plan and explain why you would make these recommended improvements?

Case Study

A healthcare professional must conduct a complete review of all health issues in which the client is being managed, including all prescription drugs presently taken to the patient. The assessment details collected from this client’s profile includes his current diagnosis of hyperlipidemia and hypertension, as well as his history of obesity. Patient Preference and Adherence Essay.

Impact of ethnicity factor on pharmacokinetic and pharmacodynamic processes

Pharmacokinetic and pharmacodynamic processes are useful in determining the best treatment plan. The ethnicity factor may influence the pharmacokinetic and pharmacodynamic processes in this patient, as some of the medications that are given could have a predefined effect on specific different races that are not present in the other. An example of a drug that differs in effect is Athenolol, which is a beta blocker that has less effect on African Americans. Simvastatin also has a more profound effect on westerners than on Asians. The ethnicity of the patient is not mentioned.

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Impact on Drug Therapy

In terms of process adjustments and how they might affect the prescribed drug therapy for patients are based on a variety of factors including gender. It is essential to consider if or not AO has any other medical problems. Patient Preference and Adherence Essay. These considerations are crucial to analyze since, for example, beta-blockers cannot be used in patients with COPD or bradycardia (Arcangelo et al., 2017). It is also necessary to track patient adherence to the drug as it is not advised to quit beta blockers immediately (Arcangelo et al., 2017).  Also, the patient is on a medication for depression, so the drugs listed should also be monitored closely as a side effect of the medication can include depression. Simvastatin was as well requested by the patient to diagnose hyperlipidemia from increased cholesterol levels because of genetic or behavioral aspects. Patients should be monitored for the aspects relevant to this drug and for the effects of beta blockers, as secondary aspects that cause elevation of l levels of cholesterol are considered (Johnson, 2018).  The patient should as well inform the provider if there are presences of allergies to the drugs prescribed in the treatment that may change the treatment regimen.

Drug Therapy Improvement

As regards the drug therapy enhancement strategy, I will withdraw the use of atenolol because it could have harmful inotropic effects and therefore decrease contractions in the already distressed heart (Jankowska-Polańska et al., 2016). I would also withdraw the use of beta blocker hydralazine because it may induce fluid accumulation and exacerbate heart failure, but I would gradually reduce the dosage stop drug instead of immediately withdrawing it. (Arcangelo, Peterson et al., 2017).  In addition, based on a case study with a current weight gain of 9 lbs, I would add a diuretic to help manage the possible fluid retention most probably due to the growth of CHF. Patient Preference and Adherence Essay.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V. F., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer.

Jankowska-Polańska, B., Uchmanowicz, I., Dudek, K., & Mazur, G. (2016). Relationship between patient’s knowledge and medication adherence among patients with hypertension. Patient Preference and Adherence, Volume 10, 2437-2447. doi:10.2147/ppa.s117269

Johnson, J. A. (2008). Ethnic Differences in Cardiovascular Drug Response: Potential Contribution of Pharmacogenetics. Circulation, 118(13), 1383-1393. doi:10.1161/circulationaha.107.704023 . Patient Preference and Adherence Essay.