Pharmacodynamics and pharmacokinetics of Atorvastatin in relation Ischaemic heart disease and hypertension to
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The essay is to look at the pharmacodynamics and pharmacokinetics of the drug Atorvastatin in relationa to a patient (Simon) with a past medical history of Ischaemic heart disease and hypertension. The essay is also to explore/discuss the anatomy & physiology, pathophysiology associated with the drug’s action. Furthermore, what would this mean to you as a nurse in relation to the patient.
SAMPLE ANSWER
Pharmacodynamics and pharmacokinetics of Atorvastatin
Ischemic heart disease is one of the common chronic ailments identified among a large percentage of individuals in different countries around the world. It refers to an illness characterized by minimal blood supply to the human heart. This heart complication is one of the key causes of demise among the citizens of such western nations as the United States. The coronary arteries are responsible for supplying blood to the muscles situated within the heart. For this reason, a blockage in these blood vessels will reduce blood supply to the heart and the subsequent attainment of the ischemic heart disease (Parker & Parker 2003, p 39). A large number of such health-related cases occur due to atherosclerosis, which is observable despite the normal appearance of the artery lumens. The narrowing of these blood vessels results in rupturing and a subsequent heart attack.
Another common health complication related to the crucial functioning of the human heart is high blood pressure. This ailment, which is also referred to as hypertension, is a chronic disease caused by the elevation of the blood pressure within the arteries. The blood pressure of a normally functioning heart ranges between 100 and 140 mmHg and 60-90 mmHg systolic and diastolic respectively. Hypertension occurs when the readings surpass 140/90 mmHg (Grundy 2007, p 114). Owing to the severity of this health condition, patients suffering from high blood pressure often exhibit other complications including the coronary artery disease or the hypertensive heart ailment. High blood pressure is also one of the key factors that put patients at the risk of suffering from stroke, chronic kidney illness, or the peripheral arterial ailment. Nonetheless, there exists certain treatment approaches used to improve the health condition of patients suffering from high blood pressure or the ischemic heart disease.
One of these effective treatments that may be applicable in Simon’s case entails Atorvastatin as part of the prescription. This drug is a calcium salt branded as Lipitor. It belongs to the class of statins and is used to reduce blood cholesterol in addition to the prevention of such heart complications as the cardiovascular disease. Similar to other drugs under this classification, Atorvastatin functions by interfering with the capability of the HMG-CoA reductase (Atorvastatin Global Investigators Meeting, Larosa & Pedersen 2004, p 27). This is an enzyme situated with the liver tissue, which is crucial in the production of cholesterol within the human body. In line with its efficacy in handling such health complications as those exhibited by Simon in this case study, Atorvastatin is used as a primary medical approach of preventing stroke, heart disease, and the requirement for certain revascularization proceedings on patients with such risk factors as high blood pressure, a family history of heart complications, or a developed coronary heart ailment (Mohammad 2012, p 55). In line with the health condition of Simon, such a drug will aid in preventing further bodily complications associated with hypertension and the ischemic heart disease.
With reference to Simon’s health condition and the pharmacodynamics of Atorvastatin, the key site of action of this drug is the liver. This is because the liver is the main site for the production of cholesterol and clearance of LDL. However, medical practitioners focus on the dosage of Atorvastatin as opposed to the systemic drug concentration in order to attain a significant reduction of LDL-C (Purcell & Schachter 2007, p 61). The absorption aspect of the drug’s pharmacokinetics is also a crucial element that highlights the effectiveness of Atorvastatin with reference to improving Simon’s health condition. This drug undergoes hasty absorption when administered orally with the period of maximum plasma concentration being between 1 and 2 hours. Atorvastatin’s absolute bioavailability and the systematic accessibility for the activity of HMG-CoA reductase is 14 % and 30 % correspondingly (Wong 2005, p 15). The main trigger for the reduced systemic availability entails the drug’s high intestinal clearance as well as its fast-pass metabolism. Although food stuffs do not have a noteworthy effect on the drug’s efficacy of lowering LDL-C, administering this prescription with food results in 25 % and 9 % of its rate and extent of absorption respectively. In addition, administering the drug in the evening lowers by AUC and Cmax by 30 % correspondingly (Wong 2005, p 20). With reference to the drug’s distribution, the mean distribution volume of this medication is 381 liters. Since it is substantially protein-bound, it is often released through human breast milk. Furthermore, its metabolism is often through cytochrome P450 3A4 hydroxylation in order to produce ortho, parahydroxylated, and beta-oxidation metabolites. It is mainly excreted through hepatic biliary with approximately 2 5 being identifiable in urine (Wong 2005, p 23).
Owing to the key elements regarding the action of Atorvastatin and my skills as a nurse, I would recommend Lipitor to Simon in order to improve his health condition. This is addition to the consideration of other key factors such as exercise, healthy diets, and the avoidance of obesity (Ebdrup 2008, p 44). This will not only be useful in lowering the patient’s blood pressure and managing the ischemic heart disease but it will also be a valuable approach of preventing other heart complications and stroke. For this reason, it is rational for most medical practitioners to recommend this form of medication to such patients as Simon.
References
Atorvastatin Global Investigators Meeting, Larosa, J. C, & Pedersen, T. R, 2004, Second Atorvastatin Global Investigators Meeting, Paris, France, April 28-30, 2002, New York, EscardioContent.org.
Ebdrup, L, 2008, LPS-induced acute inflammation in a large animal model and the impact of atorvastatin treatment: PhD thesis, [Aarhus], Faculty of Health Sciences, University of Aarhus.
Grundy, S, 2007, Atorvastatin in the management of cardiovascular risk: from pharmacology to clinical evidence, Auckland [u.a.], Adis Internat.
Mohammad, M, 2012, Rosuvastatin versus a combination of Atorvastatin and Ezetimibe The Better Choice in Metabolic Syndrome, Saarbrücken, LAP LAMBERT Academic Publishing.
Parker, J. N, & Parker, P. M, 2003, Atorvastatin a medical dictionary, bibliography, and annotated research guide to internet references, San Diego, CA, ICON Health Publications.
Purcell, H., & Schachter, M, 2007, Amlodipine and atorvastatin in the treatment and prevention of cardiovascular disease, Edgbaston, Sherborne Gibbs Limited.
Wong, V. S. C, 2005, Mechanisms of insulin sensitization by omapatrilat, a vasopeptidase inhibitor, and atorvastatin, a 3-hydroxyl-3-methylglutaryl coenzyme A reductase inhibitor, Thesis (M. Sc.)–University of Toronto, 2005.
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