IHP 310 -Cardiovascular and Hematopoietic Drug Treatment

IHP 310 -Cardiovascular and Hematopoietic Drug Treatment

IHP 310 -Cardiovascular and Hematopoietic Drug Treatment

Consider the following scenario:

At age 63, Ms. Breene lived a sedentary life as a clerk in a small insurance company. She would joke that , since her dog died, her only exercise was walking back and forth to her car. She had talked with friends about joining the local health club, and it was on her to-do list, perhaps when she retired in a couple of years.

Shortly before lunch one morning, someone at work found Ms. Breene at her desk in a confused and unresponsive state. A colleague drove her to the emergency room, where elevated cardiac markers and EKG changes showed that Ms. Breene had suffered a myocardial infarction.

The ER doctor prescribed oxygen by mask, anticoagulants, a thrombolytic, analgesics, and a bronchodilator.

In a short paper, the following critical elements must be addressed:

 

• Identify the incorrect medication/drug classification/treatment and explain why it is incorrect.

Incorrect medication:  bronchodilator.  Bronchodilator’s put patient’s more at risk for a heart attack.  They increase the heart rate and while there are anticoagulants and thrombolytic medications working to prevent more blood clots and dissolve the ones that are existing, increased heart rate would move any existing too fast through the body.  One thing that needs to be carefully monitored is the administration of an anticoagulant a thrombolytic and an analgesic.  The question needs to be asked what is the analgesic?  If all three are working towards blood thinner/anticlotting then three may be too many and may put the patient at risk for a major bleeding incident.

 

• What drug classification would you use instead? Why?

Instead of a bronchodilator to increase oxygen to the blood vessels and the heart I would choose a nitrate drug such as nitroglycerin.  This drug would be effective in increasing the amount of oxygen to the heart by dilating the blood vessels.  This in turn decreases the workload of the heart, allowing it to in essence rest and repair.  One of the reasons I know this is my mother had a heart attack a year and a half ago, one of the drug treatments given immediately, and throughout her stay in the hospital was IV nitroglycerin.

 

• Provide an example of a generic medication from each drug classification.

How would each of the medications/treatments in the scenario act on the patient’s body?

Anticoagulants:  Heparin.  “Anticoagulant drugs are used to prevent a blood clot from forming in patients with arteriosclerosis of the arteries, atrial fibrillation, acute coronary syndrome (unstable cardiac chest pain and heart attack), a history of a previous myocardial infarction (heart attack) or stroke, or an artificial heart valve.”  (Turley, 2016, pg 245)

Thrombolytic:  alteplase.  Thrombolytic drugs are used to dissolve blood clots.  “These drugs are given at the time of a myocardial infarction, stroke, or pulmonary embolism to dissolve a blood clot that has already formed in the coronary artery or within arteries to the brain or lungs.”  (Turley, 2016, pg 251)

Analgesics:  Aspirin, Morphine “analgesic drugs are used to treat pain associated with any disease or trauma.”  (Turley, 2016, pg 427) Analgesics can be non-narcotic, over the counter medications such as Aspirin or prescription medications such as non-narcotic Fioricet (aspirin, caffeine, butalbital) or narcotic Morphine.  On a side note, while aspirin is an analgesic, it is also used (low dose) as an anticoagulant for cardiac patients.  Patients that have had a heart attack are often put on low dose aspirin for the rest of their lives.

Bronchodilator:  Albuterol is probably one of the best-known bronchodilators.  Bronchodilators “relax the smooth muscle layer around the bronchioles, allowing them to dilate, which increases air flow to the lungs.  Bronchodilator drugs are used to prevent or treat asthma and bronchospasm, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema.   (Turley, 2016, pg 199)

Nitrate:  Nitroglycerin.  “Dilate the coronary arteries to the heart muscle and increase the flow of oxygenated blood.  They also dilate the arteries and veins throughout the circulatory system.  This decreases the amount of work the heart must do and decreases its need for oxygen.”  (Turley, 2016, pg 234)

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References

Turley, S. M. (2016). Understanding pharmacology for health professionals (Fifth ed.). Upper Saddle River, NJ: Pearson Education.