pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an
alternative treatment option for the patient.
Write a 2- to 3-page paper that addresses the following:
• Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in
the patient from the case study you were assigned.
• Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific
and provide examples.
• Explain how you might improve the patient’s drug therapy plan and explain why you would make these
recommended improvements.
CASE STUDY TO USE:
Patient JJ has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and
hyperlipidemia.
Drugs currently prescribed include the following:
1. Glipizide 10 mg po daily
2. Metformin 500 mg po daily
3. HCTZ 25 mg daily
4. Atenolol 25 mg po daily
5. Hydralazine 25 mg qid
6. Simvastatin 80 mg daily
7. Verapamil 180 mg CD daily
Facilitator/Professor help:
INFORMATION AS SHORT PARAGRAPHS, READABLE. All information & presentation have to be at
advanced clinician level.
1. Discuss pharmacology of existing agents briefly, molecular mechanism of action, therapeutic & adverse
effects, & relevant kinetics, all as short paragraphs, readable.
2. Talk about what modifications are needed, what drugs are not at the best interest.
3. Follow a guideline, preferably JNC 8 and its current modifications (also ACC/AHA 2019 guidelines).
4. Talk about the drugs you have substituted or added, & their key pharmacology.
5. Address any specific questions that you are asked for in this case.
Example, here are some questions you may want to address in your assignment:
Does this patient need both verapamil & atenolol at the same time, since both have similar actions?
Recent guidelines do not recommend beta blockers for hypertension. But it was possibly added for the best
therapeutic outcome? Why beta blockers? (example, he had strokes?).
Is there a drug to be added for stroke prevention?
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What are the major adverse effects of Statins (muscle related), Hydralazine (many, lupus like syndrome),
glipizide (hypoglycemia) HCTZ (hypokalemia) etc.
Why can’t this patient be a candidate for metformin, the best used diabetes drug, efficacious, no hypoglycemic
attacks etc.?
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