Need ONE Response Per Each Discussion Total 3 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion
butterflyl
casestudyweek8.docxMuller Sanon
Advanced Pharmacology
ACC/AHA guidelines and the American College of Cardiology Foundation (ACCF) have jointly produced guidelines in the area of cardiovascular disease since 1980. The ACCF/AHA Task Force on Practice Guidelines (Task Force), recommends Angiotensin-converting enzyme inhibitors (ACE inhibitors). ACE inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cannot tolerate ACE inhibitors. Ms. Allen may be prescribed one of the following: benazepril (Lotensin), captopril (Capoten), or enalapril (Vasotec) to name a few (Song-Kong, Pei-En & Tao-Hsin, 2019).
|
Muller Sanon, ARNP Miami, FL |
|
Patient Name: Mrs. Allen Age: 68 years Wt. 198 lbs |
|
Hydrochlorothiazide 12.5 mg Sig: 1 tablet daily by mouth Disp: 30 Tablets No refill Muller Sanon, ARNP Date: 02/25/2020 |
The ACCF/AHA practice guidelines are intended to assist clinicians in clinical decision making by describing a range of generally acceptable approaches to the diagnosis, management, and prevention of specific diseases or conditions. The guidelines attempt to define practices that meet the needs of most patients in most circumstances. This patient is eligible for pharmacological treatment for her previous MI; namely, drugs such as Ticagrelor. This agent is indicated to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS)—that is, unstable angina, non-ST elevation MI (NSTEMI), or ST-elevation MI (STEMI) (Saar, Marandi & Eha, 2018).
References
Saar, A., Marandi, T., & Eha, J. (2018). The risk-treatment paradox in non-ST-elevation myocardial infarction patients according to their estimated GRACE risk. International Journal of Cardiology, 272, 26–32. https://doi.org/10.1016/j.ijcard.2018.08.015.
Song-Kong, H., Pei-En, C., & Tao-Hsin, T. (2019). Different treatments for acute myocardial infarction patients via outpatient clinics and emergency department. Medicine, (2), e13883. https://doi.org/10.1097/MD.0000000000013883.
Dailyn Gonzalez
Advanced Pharmacology
The ultimate judgment regarding care of a particular patient with CHF and prior MI must be made by the clinician and patient in light of all the circumstances presented by that patient, for example, Ms. Allen’s obesity and other comorbidities must be examined when treatment her primary diagnosis. Clinical decision making should involve consideration of the quality and availability of pharmacological agents to help with her condition (Akodad & Lattuca, 2017). When these guidelines are used as the basis for regulatory or payer decisions, the goal should be improvement in quality of care.
The following prescriptions can be considered for Ms. Allen
Dailyn Gonzalez, FNP
Miami, FL 33175
NAME: Mrs. Allen DATE: 02/25/2020
ADDRESS: Miami, FL DOB: 03/13/1950
Lisinopril 5 mg
Disp. # 3
Sig: 1 tablet daily
RF: 2
Lasix 20 mg
Disp. # 60
Sig: 1 tablet twice daily
RF: 1
Lopressor 12.5 mg
Disp. # 30
Sig: 1 tablet daily
RF: 2
SIGNATURE OF PRESCRIBING PRACTITIONER: Dailyn Gonzalez, FNP
NPI Number: 7894578
Prescribed courses of treatment in accordance with these recommendations are effective only if followed for patients with prior MI. Because lack of patient understanding and adherence may adversely affect outcomes, clinicians should make every effort to engage the patient’s active participation in prescribed medical regimens and lifestyles (Wise & Davies, 2016). In addition, patients should be informed of the risks, benefits, and alternatives to a particular treatment and be involved in shared decision making whenever feasible, particularly for COR IIa and IIb, for which the benefit-to-risk ratio may be lower.
References
Akodad, M., Lattuca, B., (2017). Clinical Research: CHF and MI for patient education. Archives of Cardiovascular Diseases, 110, 395–402. https://doi.org/10.1016/j.acvd.2016.10.004.
Wise, P., Davies, N. H., (2016). Efficacy for the treatment of acute myocardial infarction. International Journal for Numerical Methods in Biomedical Engineering, 32(12), n/a-N.PAG. https://doi.org/10.1002/cnm.2772
February 26, 2020
The medications to be prescribed to the patient based on the ACC/AHA guidelines
The first medication to prescribe is the ACE inhibitor to help in the management of heart failure. These drugs are helping in the relaxation of the blood vessels and lowering blood pressure. It also helps in the improvement of the blood flow since the heart will be able to pump more blood to the rest of the body without working so much hard. It is also important to start the Lisinopril 5 mg PO daily, Lasix 20 mg PO daily, and the potassium supplement 10 meq PO daily. Other medications will include Xopenex 0.63 percent as an inhaler treatment after 4 to 6 hours when the need arises (Wang, Hess, Hiatt, & Goldfine, 2016).
Whether the patient needs the medication based on the history of the MI
The medications are required by the patient since they will help in the improvement of the MI condition of the patient. For example, the ACE inhibitor will help in the relaxation of the blood vessels and the lowering of the blood pressure. The Lisinopril is helping in the reduction of the complication of the CHF such as the possibility of death. The use of Lasix 20 mg PO daily is helping in bringing the aspects of the diuretic and the natriuretic effect on the patient. These effects can be observed in patients after 1 to 2 hours. Lasix also forms an important drug for the patients since it can be used for maintenance therapy in managing the congestive heart failure of the patient. The potassium supplement 10 meq PO daily is helping the heart to squeeze the blood throughout the body as well as helping in the movement of the muscles, working of the nerves, and improvement of the kidney function to filter the blood (Horwich & Fonarow, 2017).
References
Horwich, T. B., & Fonarow, G. C. (2017). Prevention of Heart Failure. JAMA Cardiology, 2 (1), 116.
Wang, L. C., Hess, C. N., Hiatt, W. R., & Goldfine, A. B. (2016). Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes – Mechanisms, Management, and Clinical Considerations. Circulation, 133 (24), 2459-2502.
