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Pharmacotherapy for Cardiovascular Disorders

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Pharmacotherapy for Cardiovascular Disorders

Aging is a complex process that results in several changes in the body of an individual.

These changes take place at the molecular, tissue, and cellular levels and this may lead to a

gradual impairment in the several regularity systems of the human body. As people age, they get

several health-related conditions and hence require to take several medications (Crombag et al.,

2016). Aging however influences the pharmacokinetics and pharmacodynamics of the drugs

being taken.

In this case study, a 50-year-old hypertensive African-American male presents with

obesity and has gained nine pounds in the recent past. Successful treatment of hypertension is

possible with limited side effects given the availability of multiple antihypertensive drug classes.

This is the reason why the patient is treated with different medicines. The patient also presents

with dyslipidemia characterized by the presence of too much LDL cholesterol in the blood and

absence of HDL cholesterol (Silverstein-Metzler et al., 2016). The increase in weight that the

patient is experiencing is probably as a result of changes in the body as a result of aging. These

changes influence the pharmacokinetics and pharmacodynamics of the drugs that he is taking

and as a result, impairment in metabolism and consequently weight gain.

In this case, age is an important aspect because it influences the pharmacokinetics and

pharmacodynamics. At 5 years of age, the patient is becoming a senior citizen and therefore

there are changes in his body that are clinically relevant as concerns medication. Aspects of

pharmacokinetics such as the absorption and distribution as well as the metabolism and excretion

may be impaired and this may in turn require a reduction in the dosages. For instance, one of the

drugs that he is taking is associated with weight gain. Sertraline, which is a selective serotonin
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reuptake inhibitor (SSRI is a common antidepressant but has been associated with Acute effects

on body composition and carbohydrate metabolism (Silverstein-Metzler et al., 2016).

Aging may also impact the absorption of drugs especially for this that is taken orally. The

implication is that the absorption of the medication may be either impaired or delayed. Another

impact of age is that it leads to a decrease in the distribution of a wide range of drugs that are

used in the management of the various conditions that affect the elderly. Distribution is the term

used in pharmacokinetics to describe the movement of the drug into body tissues. Drug

distribution is affected by the changes in body composition associated with age. As a result, care

should be taken when managing elderly patients such as this patient in the case study who is

obese. This is because the body composition of an individual and especially the body fat as well

as the intracellular fluid content plays a significant role in influencing the distribution.

The age however may not affect to a large extent the pharmacokinetics of the

Hydralazine drug, which is intended for the management of hypertension. This is because age

does not influence the blood concentration of the medication and neither does it impact the

systemic clearance. However, excretion or elimination of the medication may diminish due to the

reduction in the kidney functions. The decline in renal function is also likely to be experienced

in the use of Atenolol.

In order to improve the health of the patient and ensure efficient utilization of the

medication, several strategies need to be taken. An important point to note is that the elderly are

bound to be taking several medications, a condition known as polypharmacy, as a result of the

different conditions and comorbidities (Frasca et al. 2018). In this case, the patient presents with

dyslipidemia which is a serious risk factor for the development of cardiovascular disorders and

consequently increased morbidity and mortality. The use of statins therapy as is the case in the
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patient’s case where he is given simvastatin is anticipated that the patient will exhibit a greater

reduction in the cardiovascular risk (Westaway et al., 2014). However, these statins, like all other

medications may have adverse effects on the aging body and the age may also influence their

absorption, distribution as well as metabolism and secretion.

As a result, ensuring efficient therapy entails assessing the medication for their ability to

meet the therapeutic goals. This should be weighed on the risk to benefit ratio so as to ensure that

the quality of life of the patient is improved or enhanced and the life expectancy is not interfered

with. According to the patient's condition and their recovery report, the drug treatment plan can

be altered so as to achieve the management goals. The decision to change this plan and make

certain modifications in their doze is totally up to the physician who knows the complete case-

study of the particular patient. In conclusion, pharmacokinetics and pharmacodynamics are

important considerations in drug therapy and especially among the elderly. This is because

advancing in age impacts the functioning of the body at the cellular, tissue as well as molecular

level.
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References

Crombag, M. R., Joerger, M., Thürlimann, B., Schellens, J. H., Beijnen, J. H., & Huitema, A. D.

(2016). Pharmacokinetics of selected anticancer drugs in elderly cancer patients: focus on

breast cancer. Cancers, 8(1), 6. https://doi.org/10.3390/cancers8010006

Frasca, D., Blomberg, B. B., & Paganelli, R. (2017). Aging, Obesity, and Inflammatory Age-

Related Diseases. Frontiers in immunology, 8, 1745.

https://doi.org/10.3389/fimmu.2017.01745

Silverstein-Metzler, M. G., Shively, C. A., Clarkson, T. B., Appt, S. E., Carr, J. J., Kritchevsky,

S. B., Jones, S. R., & Register, T. C. (2016). Sertraline inhibits increases in body fat and

carbohydrate dysregulation in adult female cynomolgus

monkeys. Psychoneuroendocrinology, 68, 29–38.

https://doi.org/10.1016/j.psyneuen.2016.02.012

Westaway, K. P., Frank, O. R., Husband, A. J., Rowett, D., Rossi, S., L. Blanc, T., & Shute, R.

(2014). Safe use of statins in elderly people. Journal of Pharmacy Practice and

Research, 44(3), 138-142. https://doi.org/10.1002/jppr.1022