NURS 6521 Week 3 DP Pharm

NURS 6521 Week 3 DP Pharm Case Study #3: Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following: 1. Glipizide 10 mg po daily 2. HCTZ 25 mg daily 3. Atenolol 25 mg po daily 4. Hydralazine 25 mg QID 5. Simvastatin 80 mg daily 6. Verapamil 180 mg CD daily In this case study my patient will be an African-American male, aged 63. Diabetes is the 7th leading cause of death in the United States that is often associated with co-morbid conditions, that includes hypertension, dyslipidemia, kidney disease, hypo/hyperglycemia, cardiovascular disease, heart attack, and stroke. African-Americans have a higher incidence of obesity, hyperlipidemia, hypertension, diabetes mellitus, stroke, renal and cardiovascular disease than other ethnicities (Lackland, 2014). In this population, high salt intake, salt retention, and/or volume overload is the main culprit in hypertension. Several mediators of salt sensitivity are genetically determined (Woods, Mentes, Cadogan, & Phillips, 2017). In general, diabetic patients are prescribed more drugs compared to non-diabetics. Pharmacokinetics and pharmacodynamics changes with diabetes has the potential to affect absorption, distribution, metabolism and excretion of various drugs. Additionally; there is a significant reduction of gastric mucosal blood flow in diabetic patients ,which results in delayed gastric emptying. This has the potential to impact the rate of absorption of orally-administered medications in diabetic patients (Tran & Elbarbry, 2016). Furthermore, as the kidney function declines with diabetics, there is a dysfunctional glomerular filtration rate which can alter the renal clearance of the medications.