Week 3 pharm answers

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please respond to each discussion post with apa references  Thank you!

Discuss the practice patterns for controlling dyslipidemia, the expected health outcomes, and the outcomes for different populations.

Dyslipidemia is a disorder of lipoprotein metabolism including overproduction or deficiency. The practice patterns for controlling dyslipidemia first occur by changing one’s lifestyle. Adams & Holland (2016) state that individuals with borderline laboratory values should have a goal to reduce dyslipidemia nonpharmalogically first with lipid reduction lifestyle modifications because the medications used have potential adverse effects. If the lifestyle modifications do not work, then the patient will have to take the prescribed medications to decrease their risk of atherosclerotic cardiovascular disease (ASCVD).

The expected health outcome is to decrease the risk of developing ASCVD which includes coronary heart disease, stroke, and peripheral artery disease (Adams & Holland, 2016). Patients with underlying health conditions such as diabetes, alcoholism, obesity, current cigarette smoking,  or other cardiovascular diseases are at the highest risk for developing dyslipidemia and should be educated on the risk of not following the plan of care provided by their primary care physician. Dyslipidemias are a result of genetic and environmental factors (Adams & Holland, 2016)

Adams, M. P., Holland, N., & Urban, C. Q. (2017). Pharmacology for nurses. A

pathophysiologic approach.  (5th ed.). Pearson Education.

      
https://online.vitalsource.com/books/9780134255378

Dyslipidemia is a well-known risk factor for cardiovascular disease. If left unchecked, it can increase the risk of significant early death due to cardiovascular disease (Thongtang et al., (2022). Dyslipidemia itself is often multifactorial. Heredity plays a large role as well as a plethora of modifiable risk factors such as diet and obesity (Hill and Bordoni, 2022). Controlling dyslipidemia initially begins with adequate screening. Routine screening of lipid profiles should be completed at least annually due to its asymptomatic nature (Thongtang et al., 2022). Lifestyle changes in conjunction with statin therapy is the usual course of action for treating dyslipidemia. Controlling diet, increasing physical activity as well as limiting alcohol consumption and ceasing smoking are geared towards modifiable risk factors (Hill, 2022). Statins work to decrease plasma concentration of LDL as well as improve the endothelial lining and stabilize existing plaques (Singh et al, 2020). With addressing modifiable risk factors combined with statin therapy, reducing LDL can acquire a reduction of a significant cardiovascular event by 20-25% for every mmol/L reduced in the first five years (Thongtang et al., 2022). Differences in populations yields interesting results as Asian countries have surpassed the rate of dyslipidemia when compared to western cultures (Thongtang et al., 2022). Countries such as China, Malaysia, Indonesia and Thailand. It is thought that recent urbanization along with genetics, diabetes and the prevalence for smoking has influenced the rise in dyslipidemia among Asians (Thongtang et al., 2022).

 

Hill, M.F., Bordoni, B., Hyperlipidemia. (2022). Available from In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: 

https://www.ncbi.nlm.nih.gov/books/NBK559182/ 


Links to an external site.

Singh B.M., Lamichhane H.K., Srivatsa S.K., Adhikari P., Kshetri B.J., Khatiwada S., Shrestha D.B (2020). Role of statins in the primary prevention of atherosclerotic cardiovascular disease and mortality in the population with mean cholesterol in the near-optimal to borderline high range: a systematic review and meta-analysis.
Advances in Preventive Medicine. https://doi.org/10.1155/2020/6617905

Thongtang, N., Sukmawan, R., Llanes, E. J. B., & Lee, Z.-V. (2022). Dyslipidemia management for primary prevention of cardiovascular events: Best in-clinic practices. 
Preventive Medicine Reports
27. https://doi.org/10.1016/j.pmedr.2022.101819


Reply

Discuss medications to treat congestive heart failure (CHF). What medications are used to treat CHF? What specifically should patients be taught about CHF medications to prevent adverse side effects?

There are different medications to treat congestive heart failure (CHF) depending on the severity. Pharmacological management will depend on the classification of heart failure as defined by the New York Heart Association (NYHA). The different drugs can relieve HF through different mechanisms of action including reducing the preload, afterload, and the inhibition of the renin-angiotensin-aldosterone system (RAAS), and vasoconstrictor mechanism of the sympathetic nervous system (Adams & Holland, 2016).

It is important to note the medications that reduce preload and afterload such as ACE inhibitors and ARBs are for symptomatic relief only and do not reverse the progression of the disease. Medications that can reduce morbidity and mortality from HF are diuretics, beta-adrenergic blockers, and cardiac glycosides (Adams & Holland, 2016).

Patients with HF should be specially educated on the reason they are taking the drug and how it helps with HF. The patient should be educated to take the medication at the same time every day and not double up on doses. The brand should not be changed without first consulting with their primary doctor. Dietary changes will need to take place such as limiting salt intake. Patients should be educated on the importance of standing up slowly to prevent a fall. The patient should also purchase a blood pressure machine to take their blood pressure at home if they are feeling tired or weak. Patients should be educated to call 911 if they feel their airway closing up or have severe shortness of breath (Common ​side effects of heart failure medications n.d.)

 

Adams, M. P., Holland, N., & Urban, C. Q. (2017). Pharmacology for nurses. A

      pathophysiologic approach.  (5th ed.). Pearson Education.

      
https://online.vitalsource.com/books/9780134255378


Links to an external site.

 

Common ​side effects of heart failure medications. Heart Care Heart Failure Medication Side

      Effects. (n.d.). Retrieved January 23, 2023, from
https://www.floyd.org/medical-services/heart-


Links to an external site.

Heart failure in the United States has a 50% mortality rate within 5 years of initial diagnosis (Shah et al., 2017). As such, it is important to understand pharmaceutical treatments and how to best prepare patients for success. ACE inhibitors work to reduce afterload on the heart by decreasing peripheral resistance (Shah et al., 2017). Adverse side effects include hypotension, cough, headache and dizziness (Shah et al., 2017). Patients should be taught to monitor their blood pressure and to hold their dose and consult with their physician if their blood pressure is too low to prevent further hypotension as well as dizziness. Regarding cough, some individuals have a sensitivity to ACE inhibitors resulting in cough. As such, Angiotensin receptor blockers (ARBs) may be used instead as they have less prevalence in inducing persistent cough (Shah et al., 2017). Adverse effects of ARBs include hyperkalemia, so patients should be instructed to follow up with routine blood work as directed by their physicians (Shah et al., 2017). Beta blockers work to lower afterload of the heart through vasodilation as well as block beta 1 adrenergic receptors on the heart leading to slower heart rates and decreases ventricular remodeling (Shah et al, 2017). Similar to ACE and ARBs, patients with beta blockers should be taught to monitor their blood pressure as adverse effects include hypotension, dizziness as well as bradycardia. Diuretics are the only medications which can resolve fluid retention in conjunction with heart failure (Shah et al., 2017). They work by inhibiting sodium reabsorption within the kidneys, adverse reactions include hypotension, electrolyte imbalances and dehydration (Shah et al., 2017). Patients should again be taught to monitor their blood pressure and maintain blood work monitoring as directed.

 

Shah, A., Gandhi, D., Srivastava, S., Shah, K. J., & Mansukhani, R. (2017). Heart Failure: A Class Review of Pharmacotherapy. P & T : a peer-reviewed journal for formulary management, 42(7), 464–472.

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