NURS 6521 – Advanced Pharmacology Essay

A solid foundation in the concepts and principles of drug therapy across the lifespan is essential to the work of advanced practice nurses. Students in this course apply the advanced principles of pharmacology, including pharmacogenomics, pharmacokinetics and pharmacodynamics, by analysis of common drug classes prescribed by advanced practice nurses across the lifespan. Factors influencing successful therapy such as effectiveness, safety, acceptability, cost, genetic/environmental influences, complementary regimens, and patient behaviors are considered. Through this course, students prepare to examine complex decisions in the management and treatment of selected acute and chronic diseases across the lifespan through pharmacologic and nonpharmacologic agents. Advanced practice nursing students will have a more in-depth understanding of drug legislation and regulation for prescribing drugs. NURS 6521 – Advanced Pharmacology Essay Paper

Diabetes is an endocrine system disorder that affects millions of children and adults (ADA, 2011). If left untreated, diabetic patients are at risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations. In this Assignment, you compare types of diabetes including drug treatments for type 1, type 2, gestational, and juvenile diabetes. NURS 6521 – Advanced Pharmacology Essay Paper

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A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient’s drug regimen and the patient has asked about the potential side e±ects of treatment. How should the nurse best respond? Response Feedback: Targeted therapies are generally considered to be less toxic than traditional chemotherapy drugs. However, adverse reactions to targeted therapies can occur such as severe skin reactions, GI toxicities, skin reactions, and thrombosis.  Question 2 1 out of 1 points Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an e±ort to prevent infection, Mr. Singh has been prescribed ²lgrastim (Neupogen). Which of the nurse’s following assessment questions most directly addresses a common adverse e±ect of ²lgrastim? Response Feedback : Medullary bone pain is a consistently observed adverse e±ect that can be attributed to drug therapy with ²lgrastim; it is mild to moderate in severity and is reported in 56% of patients taking the drug. Shortness of breath, mucosal bleeding, and cool, clammy skin are not adverse e±ects typical of ²lgrastim.  Question 3 1 out of 1 points An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identi²ed potential bene²ts of imatinib. Which of the following characteristics of this patient’s current health status may preclude the use of imatinib? NURS 6521 – Advanced Pharmacology Essay Paper
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Response Feedback : Imatinib may be associated with edema. Patients should be weighed regularly and assessed for signs of ±uid retention that could be severe. The risk of edema increases with higher doses of imatinib and age greater than 65 years. Previous strokes, orthopedic surgery, or well-controlled diabetes may not contraindicate the use of imatinib.  Question 4 1 out of 1 points An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient’s chemotherapy. Which of the following cancerous cells is most susceptible to the e²ects of chemotherapeutic drugs? Response Feedback : Cells that have a short generation time or rapid mitotic rate are most sensitive to antineoplastic agents. All cells (both cancerous and noncancerous) have a blood supply. A lack of contact inhibition is characteristic of cancer, but this is not associated with susceptibility to chemother. NURS 6521 – Advanced Pharmacology Essay Paper

Asthma is one of the most common lung disorders in the United States and is classified as an obstructive lung disease (Huether & McCance, 2012). Asthma can affect people of any age, although most cases are diagnosed by the 25-years of age and those born prematurely are at higher risk for developing asthma (Huether & McCance, 2012). Asthma is a chronic inflammatory disease that affects the bronchial mucosa, causing hyper responsiveness and airway constriction (Huether & McCance, 2012). Asthma is serious and can be life threatening if not managed properly (American Lung Association [ALA], 2012). Unfortunately, there is no cure for asthma, however proper management can allow those affected to live a normal and healthy life (ALA, 2012). Asthma has a strong genetic influence (Huether & McCance, 2012). The purpose of this paper is to: describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation, explain changes noted in arterial blood gas results during an exacerbation, explain how genetics impact the pathophysiology of both chronic and acute asthma, describe how diagnosis and treatment will be completed based on the genetic factor, and present two mind maps that will depict in detail the disease information on both disorders. Acute Asthma Exacerbation In acute asthma the airways will remain relatively normal between exacerbations (New Medical Information and Health Information [NMIHI], 2012). Exacerbations can occur at any given time and are initiated by something the airway is sensitive to; this is referred to as a “trigger” (ALA, 2012). The severity of each exacerbation is determined by the presenting signs and symptoms of the individual and lung assessment findings (Camargo, Rachelefsky, & Schatz, 2009). The classifications of severity include: mild, moderate, severe, and life threatening (Camargo, Rachelefsky, & Schatz, 20009). Treatment is based on the severity of the exacerbation. NURS 6521 – Advanced Pharmacology Essay Paper
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ASTHMA: CHRONIC AND ACUTE 3 (Depner et al. 2013). The strong genetic predisposition of asthma, when combined with environmental factors can affect the pathophysiology and will be discussed in detail (McPhee & Hammer, 2010). Pathophysiology of Acute Asthma In an acute asthma exacerbation, the person with asthma will unknowingly breathe in a “trigger”, which in turn causes inflammation to the bronchial mucosa and hyper responsiveness of the airways (Huether & McCance, 2012). When an exacerbation first begins, B-cells are activated to produce IgE that is antigen-specific. IgE molecules cross-link with the antigen on the mast cell surface, resulting in mast cell degranulation along wit the release of several inflammatory mediators (Huether & McCance, 2012). Once released these mediators cause vasodilation, increased capillary permeability, mucosal edema, bronc. NURS 6521 – Advanced Pharmacology Essay Paper

Hormone Replacement Therapy
In recent years, hormone replacement therapy has become a controversial issue. When prescribing therapies, advanced practice nurses must weigh the strengths and limitations of the prescribed supplemental hormones. If advanced practice nurses determine that the limitations outweigh the strengths, then they might suggest alternative treatment options such as herbs or other natural remedies, changes in diet, and increase in exercise.
Consider the following scenario:
As an advanced practice nurse at a community health clinic, you often treat female (and sometimes male patients) with hormone deficiencies. One of your patients requests that you prescribe supplemental hormones. This poses the questions: How will you determine what kind of treatment to suggest? What patient factors should you consider? Are supplemental hormones the best option for the patient, or would they benefit from alternative treatments?
To prepare: NURS 6521 – Advanced Pharmacology Essay Paper
· Review Chapter 56 of the Arcangelo and Peterson text, as well as the Holloway and Makinen and Huhtaniemi articles in the Learning Resources.
· Review the provided scenario and reflect on whether or not you would support hormone replacement therapy.
· Locate and review additional articles about research on hormone replacement therapy for women and/or men. Consider the strengths and limitations of hormone replacement therapy.
· Based on your research of the strengths and limitations, again reflect on whether or not you would support hormone replacement therapy.
· Consider whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies.
Post A 1 page paper APA format ( no title page)
1. a description of the strengths and limitations of hormone replacement therapy.
2. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy.
3. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why. NURS 6521 – Advanced Pharmacology Essay Paper
Resources
· Holloway, D. (2010). Clinical update on hormone replacement therapy. British Journal of Nursing, 19(8), 496–504.

Retrieved from the Walden Library databases.

This article examines the purpose, components, and administration of hormone replacement therapy (HRT). It also presents benefits, risks, potential side effects, and alternative treatment options of HRT.
· Mäkinen, J. I., & Huhtaniemi, I. (2011). Androgen replacement therapy in late-onset hypogonadism: Current concepts and controversies—A mini-review. Gerontology, 57(3), 193–202.

Retrieved from the Walden Library databases.

This article examines the role of testosterone levels in the development of hypogonadism. It also explores health issues that are impacted by testosterone levels and the role of testosterone replacement therapy.
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 56, “Menopause and Menopausal Hormone Therapy” (pp. 884–895)

As the leading cause of death in the United States for both men and women, cardiovascular disorders account for 7 million hospitalizations per year (NCSL, 2012). This is the result of the extensive treatment and care that is often required for patients with these disorders. While the incidences of hospitalizations and death are still high, the mortality rate of cardiovascular disorders has been declining since the 1960s (CDC, 2011). Improved treatment options have contributed to this decline, as well as more knowledge on patient risk factors. As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. NURS 6521 – Advanced Pharmacology Essay Paper

Consider the following case studies:

Case Study 1:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

Atenolol 12.5 mg daily

Doxazosin 8 mg daily

Hydralazine 10 mg qid

Sertraline 25 mg daily

Simvastatin 80 mg daily

Case Study 2:

Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:

Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun

Aspirin 81 mg daily

Metformin 1000 mg po bid

Glyburide 10 mg bid

Atenolol 100 mg po daily

Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Case Study 3:

Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following: NURS 6521 – Advanced Pharmacology Essay Paper

Glipizide 10 mg po daily

HCTZ 25 mg daily

Atenolol 25 mg po daily

Hydralazine 25 mg qid

Simvastatin 80 mg daily

Verapamil 180 mg CD daily

To prepare:

• Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text.
• Select one of the three case studies, as well as one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. NURS 6521 – Advanced Pharmacology Essay Paper