Advance Pharmacology in Nursing case study

You have a 58 year old African American male that is coming in for a follow-up visit after recently having a Myocardial infarction which was successfully treated via angioplasty. He was started on Metoprolol for his consistently elevated high blood pressure during his hospital stay.

His primary diagnoses include:

  • Coronary Artery Disease
  • Type 2 diabetes controlled with Metformin 1,000 mg BID and HgA1C of 6.7.
  • Asthma- Mild Intermittent- with no recent episodes of wheezing. Albuterol INH as needed.
  • All other pertinent labs Within Normal Limits
  • First consider what clinical guidelines noted below can help us choose the best medication treatment for this patient with diabetes, CAD, Asthma and Hypertension.

Joint National Committee JNC 8 – https://thepafp.org/website/wp-content/uploads/2017/05/2014-JNC-8-Hypertension.pdf

National Center for Biotechnology Information – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092891/table/T1/?report=objectonly

American Heart Association – https://www.ahajournals.org/doi/epub/10.1161/HYPERTENSIONAHA.120.15026

IHS Division of Diabetes https://www.ihs.gov/sites/diabetes/themes/responsive2017/display_objects/documents/algorithms/AlgorithmHypertension.pdf

Answer each questions citing your response from evidence based clinical guidelines. Your response should not be post as “I would recommend”. Example of appropriate reference: The 2020 international Society of Hypertension Global Hypertension Practice Guidelines – recommend the use of selective ß1-receptor agonists in patients diagnosed with coronary heart disease and or heart failure ( Unger, T, et al, 2020).

Reference:
Unger T;Borghi C;Charchar F;Khan NA;Poulter NR;Prabhakaran D;Ramirez A;Schlaich M;Stergiou GS;Tomaszewski M;Wainford RD;Williams B;Schutte AE; (n.d.). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension (Dallas, Tex. : 1979). Retrieved August 1, 2022, from https://pubmed.ncbi.nlm.nih.gov/32370572/

 

Metoprolol is selective for which adrenoceptor? ( pharmacodynamics)
What effects do agents such as metoprolol have on the cardiovascular system? ( pharmacodynamics)
In which organ is metoprolol primarily metabolized? (Pharmacokinetics)
Why would a provider be cautious when ordering a Beta Blocker in a patient with Asthma?