Impact of Age on Pharmacotherapy for Cardiovascular Disorders

Pharmacotherapy for Cardiovascular Disorders
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June 10, 2023
Cardiovascular disorders remain a leading cause of mortality in the United States, affecting a significant portion of the population. As an advanced practice nurse, it is essential to recommend appropriate treatment options for patients with cardiovascular disorders. However, to ensure the safety and effectiveness of drug therapy, it is crucial to consider various factors that may influence pharmacokinetic and pharmacodynamic processes. This paper aims to explore in depth the impact of age on these processes in the case of BN, a 74-year-old African American male, evaluate the potential influence on his recommended drug therapy, and propose improvements to optimize treatment outcomes.
Impact of Age on Pharmacokinetic and Pharmacodynamic Processes
As mentioned in the case, BN, a 74-year-old African American male, presents to his primary care provider with palpitations, dizziness, and a slow heart rate. He has a history of hypertension, type II diabetes, coronary artery disease, myocardial infarction, peripheral vascular disease, and atrial fibrillation. Analyzing the impact of age on BN's pharmacokinetic and pharmacodynamic processes will help determine the appropriateness of his current drug therapy.
Pharmacokinetic Processes
1 Absorption: Age-related gastrointestinal changes, such as reduced blood flow and altered epithelial function, may influence drug absorption in BN. These changes could result in delayed onset of action for orally administered medications (Chanvillard et al., 2022).
2 Distribution: Age-related changes in body composition, such as increased adipose tissue and decreased lean body mass, may affect the volume of distribution of drugs in BN. Additionally, reduced albumin levels may lead to increased unbound drug concentrations, potentially increasing the risk of drug toxicity.
3 Metabolism: BN's age may contribute to a decline in hepatic enzyme activity, leading to reduced drug metabolism. This decline may result in prolonged drug half-lives, increasing the risk of drug accumulation and adverse effects.
4 Excretion: Aging is associated with a decline in renal function, affecting drug excretion in BN. Decreased glomerular filtration rate and tubular secretion may result in a prolonged drug elimination half-life, necessitating dose adjustments to prevent drug accumulation (Maher et al., 2021).
Pharmacodynamic Processes
1 Altered receptor sensitivity: Age-related receptor density and affinity changes may influence BN's response to drugs targeting specific receptors. For example, the reduced sensitivity of β-adrenergic receptors in the elderly may require higher doses of β-blockers, like metoprolol, to achieve the desired therapeutic effect (Beaman et al., 2023).
2 Cellular response: Aging can affect intracellular signaling pathways and enzymatic activity, potentially altering the cellular response to drug therapy in BN. These changes can impact the effectiveness of drugs targeting specific mechanisms of action, such as calcium channel blockers like diltiazem.
Impact on BN's Recommended Drug Therapy
Considering the impact of ag...