Pharmaceutical Treatment Plan

Pharmaceutical Treatment Plan

 

Pharmaceutical Treatment Plan

Congestive heart failure (CHF) is a condition that develops over time and results in the loss of the heart’s ability to pump blood to all parts of the body. The pumping power of the heart depends on muscle strength and elasticity.CHF refers to the phase where the fluids build up in the heart and limit its ability to pump blood to all body parts. Congestive heart failure remains a major public health concern, especially for people with hypertension and the aging population (Koshy et al., 2020). The healthcare providers ought to understand the pathophysiology and presentation of the condition and use the information to guide the treatment options and recommendations for the patients. The patient’s treatment options vary depending on their health conditions, the possibility of co-morbidity, and history of medication interactions. The purpose of this paper is to explore the prescription and non-prescription medications for the treatment of CHF, the monitoring and significant adverse effects, drug interactions, the desired outcomes, and the appropriate pharmaceutical treatment plan for the general and special populations.

Prescription and Non-prescription Medication

Furosemide is one of the most commonly prescribed medications for congestive heart failure (Caples et al., 2020). The drug belongs to the diuretic class and it works by increasing the amount of water and salt excreted by the kidneys and thus improving the pumping force of the heart. Furosemide is a loop diuretic and may be prescribed alongside other classes of medications depending on the patient’s symptoms. Diuretics relieve dyspnea and distress caused by the heart’s inability to pump blood to various body organs (Ivey-Miranda et al., 2021). Edema in the cardiac muscles causes much strain that limits the contractibility and efficiency in the functioning of the heart. The non-pharmacological medication for heart failure includes sodium and fluid restriction. People with congestive heart failure already have extra fluid in the body. Therefore, they are recommended to limit the sodium intake to at most 2,500mg/day (Ivey-Miranda et al., 2021).

Medication Monitoring, Adverse Effects, and Drug-Drug Interactions, and Desired Outcomes

Patients with CHF already present with an inability to supply enough oxygen to all parts of the body and this is harmful to their health. As a result, THEY must be monitored closely. The patients initiated on furosemide must be closely monitored by taking their blood pressure frequently. Furosemide is a diuretic that results in low water retention and so could lead to hypotension. Patients experience increased urinary frequency, acute thirst, and dizziness (Caples et al., 2020). The patients are also at high risk of developing electrolyte imbalance due to the high levels of sodium loss. Furosemide interacts with cyclosporine, lithium, digoxin, and hypertensive drugs. Also, the drug is not recommended in pregnancy. The desired outcome in the management of the CHF using furosemide is to lose excess water and prevent the fluid build-up in the myocardium that reduces its pumping abilities. On the other hand, the treatment should not cause adverse outcomes in the patient and that is why the blood pressure and kidney function tests need to be performed to help monitor the patient’s progress.

The non-pharmaceutical intervention involves the fluid intake restriction which must also be monitored. The patient must take enough fluid to hydrate the body while avoiding fluid build-up. The monitoring for the pharmacological and non-pharmacological interventions are similar.

Pharmaceutical Treatment Plan

A comprehensive treatment for CHF requires multiple medications. According to McDonagh et al. (2021), the survival rates of the CHF patients increases when the patients are initiated on renin-angiotensin-aldosterone (RAA), angiotensin-converting enzyme inhibitor (ECE-1)or angiotensin receptor-neprilysin inhibitor (ARNI), and the mineralocorticoid receptor agonists (MRA) as the first-line treatment. However, the choice of the medication also depends on how the patient responds to them. In case the patient is contraindicated for MRA, they should be given ACE-1. The recommended starting dose for Valsartan (ARNI) is 49mg BD, Bisoprolol (beta-blocker) 1.25mg O.D and spironolactone (MRA) 25mg O.D. The furosemide is administered to patients with edema. The dose administration varies depending on the severity of the patient’s condition. Commonly, patients may be given 80mg OD.

The treatment varies depending on the age, possible co-morbidity, and the signs presented by the patients (Kao et al., 2020). Therefore, the first step in the treatment plan will be to perform an ECG test, determine the other underlying causes and initiate furosemide 80mg O.D for an adult withedema. The first-line treatment for CHF as indicated above will also be initiated and adjusted with time depending on the patient’s progress. The furosemide dose should be reduced in pediatric patients because of the small body weight. Also, the dosage for the geriatric populations should be reduced because of the reduced functioning in their renal system which could hamper the excretion process. Long-term management should include digoxin to reduce the sympathetic tone and improve the growth among pediatric patients. A diuretic such as furosemide should only be used to manage symptoms of edema.

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Conclusion

The case describes the management protocols for chronic heart failure. Furosemide is a diuretic medication used to manage CHF and improve the pumping force of the heart. Patients should be monitored closely for possible signs of hypotension following the drug administration. Also, comprehensive treatment for CHF involves multiple drugs as discussed in this study. Finally, the treatment composition varies depending on the patient’s signs and symptoms, age, and underlying conditions.

References

Caples, N., Gorry, C., Hennessy, A., Regan, A., Burke, M., Collier, D., Asgedom, S., & Owens, P. (2020). Integrating intravenous frusemide treatment into the community for heart failure patients. European Heart Journal, 41(Supplement_2). https://doi.org/10.1093/ehjci/ehaa946.1240

Ivey-Miranda, J. B., Almeida-Gutierrez, E., Herrera-Saucedo, R., Posada-Martinez, E. L., Chavez-Mendoza, A., Mendoza-Zavala, G. H., Cigarroa-Lopez, J. A., Magaña-Serrano, J. A., Rivera-Leaños, R., Treviño-Mejia, A., Revilla-Matute, C., Flores-Umanzor, E. J., Espinola-Zavaleta, N., Orea-Tejeda, A., Garduño-Espinosa, J., Saturno-Chiu, G., Rao, V. S., Testani, J. M., & Borrayo-Sanchez, G. (2021). Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial. Cardiology Journal. https://doi.org/10.5603/cj.a2021.0098

Kao, D. P., Trinkley, K. E., & Lin, C. (2020). Heart failure management innovation enabled by electronic health records. JACC: Heart Failure, 8(3), 223-233. https://doi.org/10.1016/j.jchf.2019.09.008

Koshy, A. O., Gallivan, E. R., McGinlay, M., Straw, S., Drozd, M., Toms, A. G., Gierula, J., Cubbon, R. M., Kearney, M. T., & Witte, K. K. (2020). Prioritizing symptom management in the treatment of chronic heart failure. ESC Heart Failure, 7(5), 2193-2207. https://doi.org/10.1002/ehf2.12875

McDonagh, A., Metra, M., Adamo, M., Garder, R. (2021). Faculty opinions recommendation of ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2021: The task force for the diagnosis and treatment of acute and chronic heart failure 2021 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Heart Journal, 42,3599-3726. https://doi.org/10.1093/eurheartj/ehab368

Pharmaceutical Treatment Plan

Select a disease or condition. For example, sepsis, CAD, HCAP, HAP, hypertension, CHF, atrial fibrillation, depression, Parkinson’s disease, hyperlipidemia, COPD, asthma, or febrile neutropenia.

Write a 750-1,000 word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease. Discuss monitoring and identify significant adverse effects and drug-drug interactions, as well as desired outcomes of the pharmacological agents used in the treatment of the disease. Determine an appropriate pharmaceutical treatment plan for the disease or condition. Incorporate considerations for various populations (geriatrics, pediatrics) depending on the disease you have selected.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Pharmaceutical Treatment Plan – Rubric

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Prescription and Nonprescription Medications

27.5 points

Criteria Description

Prescription and Nonprescription Medications

5. Excellent

27.5 points

Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is developed in detail with thoughtful reflection.

4. Good

25.3 points

Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is developed in detail.

3. Satisfactory

24.2 points

Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is adequately developed.

2. Less than Satisfactory

22 points

Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is missing relevant information.

1. Unsatisfactory

0 points

Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is not given.

Medication Monitoring, Adverse Effects and Drug-Drug Interactions, and Desired Outcomes

22 points

Criteria Description

Medication Monitoring, Adverse Effects and Drug-Drug Interactions, and Desired Outcomes

5. Excellent

22 points

Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is developed in detail with thoughtful reflection.

4. Good

20.24 points

Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is developed in detail.

3. Satisfactory

19.36 points

Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is adequately developed.

2. Less than Satisfactory

17.6 points

Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is missing relevant information.

1. Unsatisfactory

0 points

Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is not given.

Pharmaceutical Treatment Plan

22 points

Criteria Description

Pharmaceutical Treatment Plan

5. Excellent

22 points

A pharmaceutical treatment plan is presented. The plan presents a clear and effective course of pharmaceutical treatment for the disease or condition. Strong detail and evidence are presented that demonstrate support for the plan. The plan illustrates insight into pharmaceutical treatment for the disease or condition.

4. Good

20.24 points

A pharmaceutical treatment plan is presented. The plan presents an effective course of pharmaceutical treatment for the disease or condition. Some detail or evidence is required to demonstrate support for the plan.

3. Satisfactory

19.36 points

A pharmaceutical treatment plan is presented. Aspects of the treatment plan are unclear; or, the plan does not present the most effective course of pharmaceutical treatment for the disease or condition.

2. Less than Satisfactory

17.6 points

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An incomplete pharmaceutical treatment plan is presented. The treatment plan is not relevant for the disease or condition presented in the paper. The plan does not incorporate considerations for the various populations affected by the condition or disease.

1. Unsatisfactory

0 points

A pharmaceutical treatment plan for the disease or condition is not presented.

Required Sources

5.5 points

Criteria Description

Required Sources

5. Excellent

5.5 points

Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

4. Good

5.06 points

Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

3. Satisfactory

4.84 points

Number of required sources is met, but sources are outdated or inappropriate.

2. Less than Satisfactory

4.4 points

Number of required sources is only partially met.

1. Unsatisfactory

0 points

Sources are not included.

Thesis Development and Purpose

7.7 points

Criteria Description

Thesis Development and Purpose

5. Excellent

7.7 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

4. Good

7.08 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

3. Satisfactory

6.78 points

Thesis is apparent and appropriate to purpose.

2. Less than Satisfactory

6.16 points

Thesis is insufficiently developed or vague. Purpose is not clear.

1. Unsatisfactory

0 points

Paper lacks any discernible overall purpose or organizing claim.

Argument Logic and Construction

8.8 points

Criteria Description

Argument Logic and Construction

5. Excellent

8.8 points

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. Good

8.1 points

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

3. Satisfactory

7.74 points

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

2. Less than Satisfactory

7.04 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

1. Unsatisfactory

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5.5 points

Criteria Description

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. Excellent

5.5 points

Writer is clearly in command of standard, written, academic English.

4. Good

5.06 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. Satisfactory

4.84 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. Less than Satisfactory

4.4 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. Unsatisfactory

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Paper Format (Use of appropriate style for the major and assignment)

5.5 points

Criteria Description

Paper Format (Use of appropriate style for the major and assignment)

5. Excellent

5.5 points

All format elements are correct.

4. Good

5.06 points

Template is fully used; There are virtually no errors in formatting style.

3. Satisfactory

4.84 points

Template is used, and formatting is correct, although some minor errors may be present.

2. Less than Satisfactory

4.4 points

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

1. Unsatisfactory

0 points

Template is not used appropriately or documentation format is rarely followed correctly.

Documentation of Sources

5.5 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent

5.5 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. Good

5.06 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. Satisfactory

4.84 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. Less than Satisfactory

4.4 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. Unsatisfactory

0 points

Sources are not documented.

Total 110 points