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Introduction
A 72-year-old African American middle-class retiree, Tina used to have no major health concerns apart from a mild osteochondritis and frequent edemas. However, over the past few years, Tina has developed CHD due to a change in lifestyle towards a more sedentary one, which resulted in an even more severe pulmonary edema.
Apart from convincing the patient to undergo a coronary artery bypass surgery, the doctor suggested that the latter should abandon the menopausal hormone therapy suggested by the gynecologist, change her diet towards a healthier one and introduce exercises into her daily routine. In order to address the edema, the patient was prescribed with Furosemide (25 mg intravenously). Though Tina has no bad habits, she leads a sedentary life without any physical exercises.
Pharmacokinetics
When it comes to identifying the effects, which the specified drugs have had on Tina, one must admit that age is clearly the most significant factor in the specified case. Defining the changes in the patient’s pharmacokinetics, one must address the issue of edema first. Tina has developed a serious edema issue, which is quite typical of the patient of her age (Mangoni & Jackson, 2004). Gender does not seem to be an issue here, though it could be argued that, being predisposed to congestive heart disease as much as men, post-menopausal women risk getting CHD-related effects (Piyanuttapull, Sutarapanakit & Pongsuthana, 2014), edemas being the key ones.
In addition, Tina has been showing a rather predictable reaction to such diuretics as Thiazide. Prescribed to address Tina’s edema, the specified drug has triggered an increase in Tina’s blood pressure. Moreover, it should be noted that Tina’s African American heritage seems to be an issue here, since, according to the official statistics, people of African American descent are predisposed to CHD to a greater extent than the rest of ethnicities (American Heart Association, 2013).
Pharmacodynamics
Much like with parmacodynamics, age is the key to understanding the pharmacokinetics of the patient. Being 72, Tina seems to have developed quite a resistance to diuretics. Consequently, an increase in the doze of the drug followed, which was quite a predictable step for the healthcare specialist to take (Arcangelo & Peterson, 2013), and a sharp rise in Tina’s blood pressure ensued. As a result of the increased blood pressure and the following heart problems, a lot of pressure was put on Tina’s kidneys, which has triggered edemas.
Personalized Plan of Care
The therapist must consider an increase in the dosage of diuretics and switch to prescribing potassium-sparing diuretics, particularly, Midamor and Dyrenium (Larsen, 2010). Seeing that the medicine chosen may trigger negative effects when abused, a change in the type of a diuretic may be a possibility. More to the point, the patient must reconsider their diet, putting more emphasis on the consumption of magnesium and calcium rich food, including raw spinach, fish, beans, whole grains, and dairy products.
Conclusion
The development of CHD and the following edema issue is quite common in patients of Tina’s age. Therefore, no drastic measures need to be undertaken to address the patient’s case; instead, a mild change towards a more adequate lifestyle must be made. With the adoption of a more active lifestyle, Tina will be able to get rid of most of the current health concerns. However, abandoning the menopausal hormone treatment is the most important step to be made at present, since the specified therapy affect her health negatively, increasing the risk of a pitting edema.
Reference List
American Heart Association. (2013). African Americans & cardiovascular diseases. American Heart Association. Web.
Arcangelo, V. P., & Peterson, A. M. (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Larsen, H. R. (2010).The importance of potassium. Victoria, BC: AFIB Report.
Mangoni, A. A. & Jackson, S. H. D. (2004). Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Journal of Clinical Pharmacology, 57(1), 6–14.
Piyanuttapull, S., Sutarapanakit, P. & Pongsuthana, S. (2014). Prevalence of myocardial infarction in congestive heart failure patient at emergency room of Rajavithi Hospital. Journal of Nursing Education and Practice, 4(9), 111–118.
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