NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders …heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease… —Murphy et al., 2018 Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. Photo Credit: Getty Images/Science Photo Library RF As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS To Prepare Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece. Review the case study assigned by your Instructor for this Assignment. Select one the following factors: genetics, gender, ethnicity, age, or behavior factors. Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes. Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. By Day 7 of Week 2 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. Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open . If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database . Click on the Submit button to complete your submission. Grading Criteria To access your rubric: Week 2 Assignment Rubric Check Your Assignment Draft for Authenticity To check your Assignment draft for authenticity: Submit your Week 2 Assignment draft and review the originality report. Submit Your Assignment by Day 7 of Week 2 To participate in this Assignment: NURS_6521_Week2_Assignment_Rubric Grid View List View Excellent Good Fair Poor Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. 23 (23%) – 25 (25%) The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders 20 (20%) – 22 (22%) The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. 18 (18%) – 19 (19%) The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. 0 (0%) – 17 (17%) The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing. Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. 27 (27%) – 30 (30%) The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy. Accurate, complete, and aligned examples are provided to support the response. 24 (24%) – 26 (26%) The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy. Accurate examples may be provided to support the response. 21 (21%) – 23 (23%) The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy. Inaccurate or vague examples are provided to support the response. 0 (0%) – 20 (20%) The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing. Inaccurate and vague examples may be provided to support the response, or is missing. Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. 27 (27%) – 30 (30%) The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan. The response includes an accurate and detailed explanation to support the recommended improvements. 24 (24%) – 26 (26%) The response accurately explains how to improve the patient’s drug therapy plan. The response may include an accurate explanation to support the recommended improvements. 21 (21%) – 23 (23%) The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan. The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders 0 (0%) – 20 (20%) The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing. The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors 0 (0%) – 3 (3%) Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors 0 (0%) – 3 (3%) Contains many (? 5) APA format errors Total Points: 100 Week 2 Assignment Sample Approach Submitted by a Student Pharmacotherapy for Cardiovascular Disorders Case Study Details: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5mg daily Doxazosin 8mg daily Hydralazine 10mg QID Sertraline 25mg daily Simvastatin 80mg daily Provide an explanation of how the factor you selected may influence the pharmacokinetic and pharmacodynamic process in the patient from the case study provided. Patient Factor – Obesity Obesity is a risk factor which can directly impact both hypertension and hyperlipidemia, as well as increasing the risk of diabetes, and impacting the potential of successful treatment of various cardiovascular disorders (Arcangelo & Peterson, 2013). Focusing attention on the behavioral factors that impact the patient’s obesity, can help to ensure that one has a higher chance of success as the other conditions are treated. Two factors identified in this patient that can impact the pharmacokinetics for this patient are both poor nutrition, and reduced blood circulation (Arcangelo & Peterson, 2013). Assumptions can be made surrounding the poor nutrition component as this is related to documented cases of obesity. Obesity also results in limited physical activity, which impacts circulation levels seen in the patient. Hypertension is accompanied by vasoconstriction, and the potential for plaque build-up because of hyperlipidemia (CDC, 2020). An assessment of these risk factors, as well as their impact on the effectiveness to prescribed medication regimen is an essential component to the proper assessment and subsequent treatment of the patient. With an assessment and consideration of the risk factor related to obesity it would be most beneficial to suggest that patient focus on modification of diet and activity/exercise behaviors. One such adjustment that could result in successful change is the use of the DASH diet plan (Arcangelo & Peterson, 2013). This would help to minimize pharmacokinetics impacts seen in this patient. Drug Therapy Plan Upon review of the patient’s medications there are several areas of improvement available in the drug therapy plan. First, and most important is consideration that beta-blockers have been shown to directly contribute to the development of hyperlipidemia (Arcangelo & Peterson, 2013). Even though beta-blockers are most used as the first line of defense in treatment of hypertension, with the additional concerns involving hyperlipidemia the Atenolol should be discontinued. With this change in discontinuing Atenolol, the Hydralazine should also be discontinued since most often this is only prescribed when patient is prescribed a beta-blocker and diuretic in their drug therapy plan (Arcangelo & Peterson, 2013). With these changes it would be beneficial to prescribe a dose of 12.5mg Hydrochlorothiazide daily as a starting point in the treatment of hypertension through the use of stand along diuretic. Hydrochlorothiazide is safe for use in patients who have diagnosed diabetes and have been linked to its ability to reduce heart disease and stroke mortality rates (Arcangelo & Peterson, 2013). The obesity levels of the patient indicate a higher risk of diabetes so this approach takes a more proactive method assuming that diabetes is a risk factor that may soon be documented in this patient (National Institute…, 2018). Simvastatin based on the information provided is an appropriate treatment for hyperlipidemia. While cholesterol levels were not provided in the scenario information this first line of defense against this condition appears to be appropriate. Conclusion Assessment of factors which can impact the pharmacokinetics in patients drug therapy plan is essential to finding the most effective and efficient way in which one can find success in the treatment of patients. For many these factors can often be simple to address and yet the impact is great. Drug therapy opens numerous methods in which to treat certain conditions but factors that impact that success must also be addressed to see highest level of success. It is important to note as well that these factors must often be reassessed as changes occur. This allows for one to often eliminate drugs from regimen and focus on drug free treatment plans. References Arcangelo, V.P., & Peterson, A.M., 2013. Pharmacotherapeutics for advanced practice: A practical approach (3 rd Edition). Ambler, P.A.: Lippincott Williams & Wilkins Centers for Disease Control and Prevention. (2020, April 11). The health effects of overweight and obesity . https://www.cdc.gov/healthyweight/effects/index.html National Institute of Diabetes and Digestive and Kidney Diseases. (2018, February 28). Health risks of overweight & obesity . https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks Feedback to Learner I expected a much more specific pharmacological management discussion in an Advanced Pharm course. I think for this case it is important to be familiar with HF and antihypertensive guidelines. Realizing the cognitive and other negative effects of BB and reserving this for HF or rate control.versus hypertension. Also recognizing that hydralazine should be reserved for severe HTN and should be prescribed along with a diuretic and BB. Beta blockers can also exacerbate depression due to the cognitive effects which may necessitate sertraline i this patient. Finally, recognizing the. very important counseling point with alpha blockers causing orthostatic hypotension. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders …heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease… —Murphy et al., 2018 Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. Photo Credit: Getty Images/Science Photo Library RF As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS To Prepare Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece. Review the case study assigned by your Instructor for this Assignment. Select one the following factors: genetics, gender, ethnicity, age, or behavior factors. Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes. Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. By Day 7 of Week 2 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. Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open . If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database . Click on the Submit button to complete your submission. Grading Criteria To access your rubric: Week 2 Assignment Rubric Check Your Assignment Draft for Authenticity To check your Assignment draft for authenticity: Submit your Week 2 Assignment draft and review the originality report. Submit Your Assignment by Day 7 of Week 2 To participate in this Assignment: NURS_6521_Week2_Assignment_Rubric Grid View List View Excellent Good Fair Poor Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. 23 (23%) – 25 (25%) The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders 20 (20%) – 22 (22%) The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. 18 (18%) – 19 (19%) The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. 0 (0%) – 17 (17%) The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing. Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. 27 (27%) – 30 (30%) The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy. Accurate, complete, and aligned examples are provided to support the response. 24 (24%) – 26 (26%) The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy. Accurate examples may be provided to support the response. 21 (21%) – 23 (23%) The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy. Inaccurate or vague examples are provided to support the response. 0 (0%) – 20 (20%) The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing. Inaccurate and vague examples may be provided to support the response, or is missing. Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. 27 (27%) – 30 (30%) The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan. The response includes an accurate and detailed explanation to support the recommended improvements. 24 (24%) – 26 (26%) The response accurately explains how to improve the patient’s drug therapy plan. The response may include an accurate explanation to support the recommended improvements. 21 (21%) – 23 (23%) The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan. The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders 0 (0%) – 20 (20%) The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing. The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors 0 (0%) – 3 (3%) Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors 0 (0%) – 3 (3%) Contains many (? 5) APA format errors Total Points: 100 Week 2 Assignment Sample Approach Submitted by a Student Pharmacotherapy for Cardiovascular Disorders Case Study Details: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5mg daily Doxazosin 8mg daily Hydralazine 10mg QID Sertraline 25mg daily Simvastatin 80mg daily Provide an explanation of how the factor you selected may influence the pharmacokinetic and pharmacodynamic process in the patient from the case study provided. Patient Factor – Obesity Obesity is a risk factor which can directly impact both hypertension and hyperlipidemia, as well as increasing the risk of diabetes, and impacting the potential of successful treatment of various cardiovascular disorders (Arcangelo & Peterson, 2013). Focusing attention on the behavioral factors that impact the patient’s obesity, can help to ensure that one has a higher chance of success as the other conditions are treated. Two factors identified in this patient that can impact the pharmacokinetics for this patient are both poor nutrition, and reduced blood circulation (Arcangelo & Peterson, 2013). Assumptions can be made surrounding the poor nutrition component as this is related to documented cases of obesity. Obesity also results in limited physical activity, which impacts circulation levels seen in the patient. Hypertension is accompanied by vasoconstriction, and the potential for plaque build-up because of hyperlipidemia (CDC, 2020). An assessment of these risk factors, as well as their impact on the effectiveness to prescribed medication regimen is an essential component to the proper assessment and subsequent treatment of the patient. With an assessment and consideration of the risk factor related to obesity it would be most beneficial to suggest that patient focus on modification of diet and activity/exercise behaviors. One such adjustment that could result in successful change is the use of the DASH diet plan (Arcangelo & Peterson, 2013). This would help to minimize pharmacokinetics impacts seen in this patient. Drug Therapy Plan Upon review of the patient’s medications there are several areas of improvement available in the drug therapy plan. First, and most important is consideration that beta-blockers have been shown to directly contribute to the development of hyperlipidemia (Arcangelo & Peterson, 2013). Even though beta-blockers are most used as the first line of defense in treatment of hypertension, with the additional concerns involving hyperlipidemia the Atenolol should be discontinued. With this change in discontinuing Atenolol, the Hydralazine should also be discontinued since most often this is only prescribed when patient is prescribed a beta-blocker and diuretic in their drug therapy plan (Arcangelo & Peterson, 2013). With these changes it would be beneficial to prescribe a dose of 12.5mg Hydrochlorothiazide daily as a starting point in the treatment of hypertension through the use of stand along diuretic. Hydrochlorothiazide is safe for use in patients who have diagnosed diabetes and have been linked to its ability to reduce heart disease and stroke mortality rates (Arcangelo & Peterson, 2013). The obesity levels of the patient indicate a higher risk of diabetes so this approach takes a more proactive method assuming that diabetes is a risk factor that may soon be documented in this patient (National Institute…, 2018). Simvastatin based on the information provided is an appropriate treatment for hyperlipidemia. While cholesterol levels were not provided in the scenario information this first line of defense against this condition appears to be appropriate. Conclusion Assessment of factors which can impact the pharmacokinetics in patients drug therapy plan is essential to finding the most effective and efficient way in which one can find success in the treatment of patients. For many these factors can often be simple to address and yet the impact is great. Drug therapy opens numerous methods in which to treat certain conditions but factors that impact that success must also be addressed to see highest level of success. It is important to note as well that these factors must often be reassessed as changes occur. This allows for one to often eliminate drugs from regimen and focus on drug free treatment plans. References Arcangelo, V.P., & Peterson, A.M., 2013. Pharmacotherapeutics for advanced practice: A practical approach (3 rd Edition). Ambler, P.A.: Lippincott Williams & Wilkins Centers for Disease Control and Prevention. (2020, April 11). The health effects of overweight and obesity . https://www.cdc.gov/healthyweight/effects/index.html National Institute of Diabetes and Digestive and Kidney Diseases. (2018, February 28). Health risks of overweight & obesity . https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks Feedback to Learner I expected a much more specific pharmacological management discussion in an Advanced Pharm course. I think for this case it is important to be familiar with HF and antihypertensive guidelines. Realizing the cognitive and other negative effects of BB and reserving this for HF or rate control.versus hypertension. Also recognizing that hydralazine should be reserved for severe HTN and should be prescribed along with a diuretic and BB. Beta blockers can also exacerbate depression due to the cognitive effects which may necessitate sertraline i this patient. Finally, recognizing the. very important counseling point with alpha blockers causing orthostatic hypotension. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10