NUR 600 Module 3 Discussion Drug Therapy & Treatments for Cardiovascular and Hematologic Disorders
Describe the goals of drug therapy for hypertension and the different antihypertensive treatments.
Antihypertensive medication aims to decrease cardiovascular morbidity and death linked to high blood pressure by focusing on reducing blood pressure and managing other cardiovascular risk factors. According to Verdecchia et al. (2022), the ideal blood pressure range is systolic pressure less than 120 and diastolic pressure less than 80. The therapy of hypertension includes many categories of antihypertensive drugs, with the most often suggested first categories being angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), thiazide-type diuretics, and angiotensin II receptor blockers (ARBs). Thiazide diuretics are the primary therapy for hypertension, while chlorthalidone is the preferred option for elderly individuals with osteoporosis. Calcium channel blockers are suggested for all individuals with hypertension except those with chronic renal disease. Dihydropyridines are more effective as vasodilators and are mostly used in the treatment of hypertension. For patients with cardiac failure and prolonged renal illness, ACE inhibitors, along with ARBs, are the recommended antihypertensive drugs. Both groups have similar therapeutic indications and efficacy. As a first line of therapy for hypertension, beta-blockers cannot be utilized until there is a clear sign of heart failure or myocardial infarction.
Describe types of arrhythmias and their treatment.
Arrhythmias are irregular heartbeats resulting from aberrant electrical impulses. They might manifest in the atria or ventricles. Common types of heart rhythm abnormalities include bradycardia (resting heart rate slower than 60 beats per minute), tachycardia (heart rate faster than 100 beats per minute), and supraventricular arrhythmias such as atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia (Stavrakis et al., 2020). Ventricular arrhythmias originating in the ventricles may be hazardous and need prompt medical attention. Ventricular tachycardia is a rapid and consistent contraction of the ventricles that may last for a short period or an extended duration. Prolonged duration may result in severe arrhythmias, such as ventricular fibrillation, leading to cardiac arrest and death in a matter of minutes.
Treatments for arrhythmias include medications, surgical interventions, and other techniques aimed at regulating cardiac rhythms. It is crucial to implement healthy lifestyle modifications and seek medical advice if symptoms deteriorate to avoid exacerbating arrhythmias. Typical treatments consist of atropine for bradycardia, adenosine for tachycardia, beta-blockers for fatigue, calcium channel blockers for gastrointestinal problems, digoxin for atrial fibrillation, potassium channel blockers for hypotension, and sodium channel blockers for sudden cardiac arrest (Stavrakis et al., 2020). Treatments such as cardioversion, catheter ablation, implanted cardioverter defibrillators (ICDs), and pacemakers may be required if medications are ineffective. Treatments may restore normal cardiac rhythms and prevent or repair arrhythmias.
Discuss Atrial Fibrillation
Atrial fibrillation is a prevalent heart condition characterized by irregular electrical impulses in the heart’s upper chambers, leading to fast and irregular heartbeats. This arrhythmia may be paroxysmal or chronic, resulting in turbulent blood flow and an elevated risk of blood clot development, potentially leading to a stroke. Advanced age, high blood pressure, underlying respiratory and cardiovascular diseases, congenital heart abnormalities, and excessive alcohol use are risk factors. The symptoms include chest discomfort, palpitations, tachycardia, dyspnea, nausea, disorientation, diaphoresis, and weariness. Treatment options include anticoagulation, rhythm, rate control drugs, cardioversion, ablation, and other cardiac interventional therapies. According to current guidelines, individuals with atrial fibrillation with a CHA2DS2-VASc score of two or above should take oral anticoagulants (Chung et al., 2020). Except for those with moderate to serious mitral stenosis and artificial heart valves, non-vitamin K anticoagulants taken orally are favored over warfarin. Individuals with low CHA2DS2-VASc scores should not use aspirin. Percutaneous left atrial appendage ligation is recommended for patients with atrial fibrillation who are at high risk of stroke.
Discuss types of anemia, causes, symptoms, and treatment options.
Anemia is characterized by a decrease in the proportion of red blood cells, often indicative of an underlying medical condition. The symptoms of anemia can be influenced by various factors, such as its cause, how quickly it develops, and other existing health conditions, especially cardiovascular disease. The primary etiological factor of anemia is erythropoietin (EPO), a renally synthesized hormone that initiates the erythrocyte production process. The typical range of hemoglobin levels in males is 13.5 to 18.0 g/dL, whereas in females, the range is 12.0 to 15.0 g/dL. The normal range for pediatric patients is 11.0 to 16.0 g/dL (Wiciński et al., 2020). Anemia can arise from hyperproliferative or hyperproliferative factors, with the etiology contingent upon whether the corrected reticulocyte count is below 2% or above 2%. Anemias characterized by diminished red blood cell production is categorized into three groups according to the dimensions of the cells: normocytic anemia (MCV 80-100 Fl), macrocytic anemia (MCV>100 Fl), and microcytic anemia (MCV 80-100 Fl). Hemolytic anemia can be caused by many factors, including drug-induced hemolysis, hemoglobinopathies, enzymopathies, membrane defects, and hemolysis occurring both within and outside of blood vessels. Anemia may also result from infections, including PNH, AIHA, and venom from serpent wounds.
Anemia care includes addressing the root causes, such as acute blood loss, dietary inadequacies, bone marrow and stem cell abnormalities, chronic illnesses, and heightened red blood cell breakdown. Treatment includes intravenous fluids, oxygen therapy, and ensuring hemoglobin levels remain above seven g/dL (Wiciński et al., 2020). Oral and intravenous iron supplements are the primary methods used to replenish iron levels, with intravenous iron being advantageous for patients needing a quick rise in levels. Treatment options include hemoglobinopathies like sickle cell anemia, which may need exchange transfusions, blood transfusions, hydroxyurea treatment, bone marrow transplants, and chronic illness management. Antifibrinolytic medicines are used to treat severe bleeding that poses a risk to life.
References
Chung, M. K., Refaat, M. M., Shen, W., Kutyifa, V., Cha, Y., Di Biase, L., Baranchuk, A., Lampert, R., Natale, A., Fisher, J. D., & Lakkireddy, D. (2020). Atrial fibrillation. Journal of the American College of Cardiology, 75(14), 1689–1713. https://doi.org/10.1016/j.jacc.2020.02.025
Stavrakis, S., Kulkarni, K., Singh, J. P., Katritsis, D. G., & Armoundas, A. A. (2020). Autonomic modulation of cardiac arrhythmias. JACC: Clinical Electrophysiology, 6(5), 467–483. https://doi.org/10.1016/j.jacep.2020.02.014
Verdecchia, P., Cavallini, C., & Angeli, F. (2022). Advances in the Treatment Strategies in Hypertension: Present and Future. Journal of Cardiovascular Development and Disease, 9(3), 72. https://doi.org/10.3390/jcdd9030072
Wiciński, M., Liczner, G., Cadelski, K., Kołnierzak, T., Nowaczewska, M., & Malinowski, B. (2020). Anemia of Chronic Diseases: Wider Diagnostics—Better Treatment? Nutrients, 12(6), 1784. https://doi.org/10.3390/nu12061784
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Based on Module 3: Lecture Materials & Resources and experience, please answer the following questions:
Describe the goals of drug therapy for hypertension and the different antihypertensive treatment.
Describe types of arrhythmias and their treatment
Discuss Atrial Fibrillation
Discuss types of anemia, causes, symptoms, and treatment options
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Each question must be answered individually as in bullet points. Not in an essay format.
Example: Question 1, followed by the answer to question 1; Question 2, followed by the answer to question 2; and so forth.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
Your response should be at least 150 words.
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
Discussion Rubric
Discussion Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning Outcome Identification of Main Issues, Problems, and Concepts
5 ptsDistinguished
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
4 ptsExcellent
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
2 ptsFair
Identifies and demonstrate an an acceptable understanding of most of issues, problems, and concepts.
1 ptsPoor
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
5 pts
This criterion is linked to a Learning Outcome Use of Citations, Writing Mechanics and APA Formatting Guidelines
3 ptsDistinguished
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
2 ptsExcellent
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
1 ptsFair
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
0 ptsPoor
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
3 pts
This criterion is linked to a Learning Outcome Response to Posts of Peers
2 ptsDistinguished
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
1 ptsFair
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.
0 ptsPoor
Student provided no response to a peer’s post.
2 pts
Total Points: 10