Assignment: Write a 750-850-word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease.
Assignment: Write a 750-850-word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease.
Select a disease or condition, such as sepsis, CAD, HCAP, HAP, hypertension, CHF, atrial fibrillation, depression, Parkinson’s disease, hyperlipidemia, COPD, asthma, or febrile neutropenia.
Write a 750-850-word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease. Include the following in your paper:
Discuss monitoring and identifying significant adverse effects and drug-drug interactions, as well as desired outcomes of the pharmacological agents used in the treatment of the disease. Use evidence-based, peer-reviewed research to support the pharmacological decisions you made.
Determine an appropriate pharmaceutical treatment plan for the disease or condition.
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Incorporate considerations for various populations (geriatrics, pediatrics) depending on the disease you have selected.
Discuss how, as a practitioner, you would facilitate difficult conversations regarding treatment for your patient.
You are required to cite three to five sources to complete this assignment. Sources must be published within the past 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide.
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Advanced Pharmacotherapy
Hypertension is a non-communicable disease with increasing prevalence globally. Hypertension acts as a source of significant disease burden to the affected populations and their significant others. One in every three adults in America has hypertension, with about two million people diagnosed yearly. Effective management of hypertension is crucial for improved health, wellbeing, and productivity. Therefore, this paper explores the pharmacological management of hypertension, monitoring adverse events and drug-drug interactions, and facilitating difficult conversations with patients with hypertension.
Monitoring and Identifying Significant Adverse Effects and Drug-Drug Interactions
Lifestyle modifications and pharmacotherapy are the main approaches to hypertension management. Pharmacotherapy is recommended in situations where lifestyle interventions fail to bring the blood pressure to the desired goal. The first-line drugs used in treating hypertension include angiotensin-converting enzyme inhibitors, beta-blockers, diuretics, and calcium channel blockers. The use of these drugs predisposes patients to adverse events and drug-drug interactions that increase the need for close patient monitoring. Home blood pressure monitoring, office blood pressure, or 24 hours ambulatory blood pressure can be used to achieve the monitoring of patients on antihypertensive drugs. Patients should be educated adequately on blood pressure monitoring before enrolling them on any of the monitoring to increase adherence and treatment outcomes (Mengden & Weisser, 2021). Telemedicine interventions might be incorporated to enhance the monitoring of the patients.
Antihypertensive drugs have low risk of adverse effects and drug-drug interactions among the prescribed patients. However, patients may develop adverse effects such as edema, increased urination, headache, flush, wheezing, dizziness, and rapid pulse, which affect the use of the prescribed drugs (Gebreyohannes et al., 2019). Providers can easily identify these events by educating the patients about their predisposed risks and interventions to be taken should they experience them. In addition, close patient follow-up and use of technologies such as telehealth could help providers to detect early potential adverse events with the prescribed treatments. Health organizations have also moved to the use of algorithms to detect and identify patients at risk of developing adverse reactions and drug-drug interactions. (Mengden & Weisser, 2021) The algorithms help providers to prescribe patient-specific drugs with the lowest possible risk of harm to the patient.
The desired outcomes of using antihypertensive drugs in treating hypertension are varied. One of the outcomes is the reduction of the blood pressure to the target level of less than 130/80 mmHg. The other outcome is to prevent organ damage from hypertension. Hypertension increases the risk of renal damage and cardiac complications such as cardiomegaly and stroke. Effective management of blood pressure using antihypertensive medications also improves quality of life and prolongs life for the affected populations (Park, 2019). Therefore, the drugs lower the overall disease burden in the population.
Appropriate Pharmaceutical Treatment Plan
As noted initially, the appropriate pharmaceutical treatment plan for hypertension entails the use of different classes of drugs. They include diuretics, angiotensin receptor blockers, calcium channel blockers, and beta-blockers. In some cases, patients might require two or more antihypertensive medications to help in achieving their desired blood pressure target (Park, 2019). The prescribers often ensure that the second drug used in treating hypertension has complementary effects to reduce the risk of side and adverse effects.
A criterion for prescribing antihypertensives has been developed to guide prescribers. For example, patients with chronic kidney disease or diabetes should be treated with drug therapy and lifestyle modifications to lower blood pressure to below 130/80 mmHg. If a patient has stage 1 hypertension, the recommended treatment entails the use of a thiazide diuretic with a possible consideration of angiotensin converting enzyme inhibitors, beta-blockers, calcium channel blockers or combination. In stage 2 hypertension, treatment should include a combination of a thiazide type diuretic with ARB, or ACE inhibitor, or ARB, beta-blocker, or calcium-channel blocker (Al-Makki et al., 2022; Flack & Adekola, 2020). The dosages should be optimized if the desired blood pressure target is not attained alongside the need for consultation with hypertension specialist.
Prescribers should be cautious when selecting antihypertensive medications for special populations such as geriatrics and pediatrics. Geriatrics patients have issues such as weakened organ function, multiple comorbidities, and polypharmacy. As a result, the dosage for the drugs should optimize organ function and minimize the risk of drug-drug interactions from polypharmacy (Delavar et al., 2020). The dosage of the drugs is reduced as compared to those of other populations to minimize the risk of organ damage.
Facilitating Difficult Conversations
Practitioners should explore a range of strategies to facilitate difficult conversations regarding patient treatments. One of the strategies is encouraging open communication. Practitioners should create an environment that encourages free sharing of information with their patients. The focus should be on building trust and honesty between the patient and healthcare provider. The other strategy is facilitating shared decision-making. Patients should be actively involved in making decisions that relate to the treatment of their conditions (Delavar et al., 2020). The decisions should align with their preferences, values, and practices for treatment adherence and patient empowerment.
Conclusion
In conclusion, hypertension is a crucial public health concern with considerable disease burden to the population. Antihypertensive drugs used in hypertension should be monitored for adverse effects and drug-drug interactions. Different types of antihypertensive drugs may be prescribed depending on the stage of hypertension and targets for blood pressure. Practitioners should be able to facilitate difficult conversations about hypertension with their patients and their significant others.
References
Al-Makki, A., DiPette, D., Whelton, P. K., Murad, M. H., Mustafa, R. A., Acharya, S., Beheiry, H. M., Champagne, B., Connell, K., Cooney, M. T., Ezeigwe, N., Gaziano, T. A., Gidio, A., Lopez-Jaramillo, P., Khan, U. I., Kumarapeli, V., Moran, A. E., Silwimba, M. M., Rayner, B., … Khan, T. (2022). Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary. Hypertension, 79(1), 293–301. https://doi.org/10.1161/HYPERTENSIONAHA.121.18192
Delavar, F., Pashaeypoor, S., & Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient Education and Counseling, 103(2), 336–342. https://doi.org/10.1016/j.pec.2019.08.028
Flack, J. M., & Adekola, B. (2020). Blood pressure and the new ACC/AHA hypertension guidelines. Trends in Cardiovascular Medicine, 30(3), 160–164. https://doi.org/10.1016/j.tcm.2019.05.003
Gebreyohannes, E. A., Bhagavathula, A. S., Abebe, T. B., Tefera, Y. G., & Abegaz, T. M. (2019). Adverse effects and non-adherence to antihypertensive medications in University of Gondar Comprehensive Specialized Hospital. Clinical Hypertension, 25(1), 1. https://doi.org/10.1186/s40885-018-0104-6
Mengden, T., & Weisser, B. (2021). Monitoring of Treatment for Arterial Hypertension. Deutsches Ärzteblatt International, 118(27–28), 473–478. https://doi.org/10.3238/arztebl.m2021.0158
Park, S. (2019). Ideal Target Blood Pressure in Hypertension. Korean Circulation Journal, 49(11), 1002–1009. https://doi.org/10.4070/kcj.2019.0261
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Assignment: Write a 750-850-word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease.
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