NP 6005 week 5 Discussion

Discussion Question 1

What would you add to the current treatment plan? Why?

My addition to the current would include the increase of Atenolol 20mg to 50 mg bid. This is because it would increase his Atenolol and put in control his angina.

Would you discontinue any of the currently prescribed medication? Why or why not?

I do not see nay reason to continue his current medication because they well manage his condition. His current medication, atenolol and Lisinopril, well manages his blood pressure, cholesterol is managed by simvastatin, aspirin for coagulation protection and metformin for diabetes. The current medication serves him well for his treatment and hence I find no reason at all to alter anything.

How does the diagnosis stage 3 chronic kidney disease affect your choices?

Stage 3 chronic kidney disease diagnosis affects a patient’s regimen. Mr. EBR may become toxic through Atenolol Lisinopril excreted through the kidney.

Why is the patient prescribed more than one antihypertensive?

Antihypertensive medication is prescribed more than one to gain control of his blood pressure. The choice of a second drug is influenced by how it might affect the adverse reactions of the first. Some with clinical trial show they work really well together.

What is the benefit of the aspirin therapy in this patient?

Aspirin therapy will help Mr. EBR by reducing ischemia and preventing him from re-infarction.

Discussion Question 2

List three classes of drugs affecting the Hematopoietic System. List the mechanism of action for each class of drug. Choose one medication from the three classes and discuss what disorder the drug is used to treat? How often the medication is given? What labs should get monitored while the patient is taking this medication? Your response should be at least 350 words.

The three classes of drugs affecting the Hematopoietic System are:

Anticoagulants – Inhibiting of thrombin activates anticlotting factors

• Thrombolytics
• Anticoagulants
• Antiplatelets

Antiplatelets – By blocking glycoprotein llb/llla receptor, it inhibits cyclooxygenase and also hinders the binding of fibrinogen to activated platelets and also hinders cyclic nucleotide phosphodiesterase

Thrombolytic – when the mechanism is activated, plasminogen will dissolve blood clot through the formation of plasmin.

Choose one medication from the three classes and discuss what disorder the drug is used to treat?

I have chosen Coumadin (warfarin) for this discussion. Warfarin is normally sold under the brand name Coumadin and is used as a coagulant in medication.

This is used to treat patients with blood clot in different area either in the arteries, lungs or veins. It helps in the prevention of clots for patients who have just undergone a medical procedure such a s fracture. Coumadin decreases the risk of heart attack through prevention of the formation of blood clots that puts stress on arteries and veins. Warfarin is a blood thinner that also aids in the prevention of atrial fibrillations and also pulmonary embolisms (Appelbaum at al 2011).

How often the medication is given?

2.5 mg or 5mg daily Coumadin dosage for patients that have a weight of under 50 kilograms. This dosage may however change depending on PT and INR; dose may be increased or skipped. Dosage should be taken at roughly the same time in order to be at a fair therapeutic range. As for older patient, typically above 75 years of age, they are at a higher chance of bleeding. Older people tend to have weakened body and this should always be taken into consideration then administering the medication. It should be expected care given towards that effect (Appelbaum at al 2011).

What labs should get monitored while the patient is taking this medication?

While taking this medication, the labs that should be monitored is international normalized ratio (INR) and Prothrombin Time (PT). Therapeutic range for mechanical valve is 2.0-3.5, Atrial fibrillation therapeutic range 2.3-3.0, Pulmonary embolism therapeutic range 2.0-3.0, deep vein thrombosis is 2-3.0 INR and Transient ischemic attacks and stroke therapeutic range 2.0-3.0. monitoring them will be of importance since any change in them might indicate the presence of something else that should equally be taken into account.

Reference

Appelbaum, F. R., Forman, S. J., Negrin, R. S., & Blume, K. G. (Eds.). (2011). Thomas’ hematopoietic cell transplantation. John Wiley & Sons.