Pharmacology Assignment 3: Mr. D's Medication and Health Teaching

This assignment provides a detailed analysis of various medications, including Losartan, Amlodipine, Atorvastatin, Morphine, Aspirin, Nitroglycerin, and Fluoxetine, focusing on their pharmacological classes, mechanisms of action, side effects, and drug interactions. The assignment also addresses patient-specific considerations, such as health promotion teaching for individuals with hypertension, type 2 diabetes, and hyperlipidemia, as well as cultural requirements, specifically for a patient with an Aboriginal background. Strategies for promoting drug compliance and adherence are also explored. The assignment covers the administration of emergency medication, health teaching related to medications, and the implications of drug interactions, emphasizing the importance of patient education and culturally sensitive healthcare practices. The student demonstrates an understanding of pharmacology principles and their application in clinical scenarios.

Running Head: ASSIGNMENT 3 1
Assignment 3
Author’s Name
Institution
Date

ASSIGNMENT 3 2
TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
Introduction..................................................................................................................................3
PART 1............................................................................................................................................3
Losartan......................................................................................................................................................................3
Amlodipine.................................................................................................................................................................4
Atorvastatin................................................................................................................................................................5
References..................................................................................................................................................................6
PART 2...........................................................................................................................................................................7
Morphine....................................................................................................................................................................7
Aspirin........................................................................................................................................................................7
Nitroglycerin/GTN (Anginine....................................................................................................................................7
Health Promotion Teaching on Diabetes....................................................................................................................8
Hypertension and Hyperlipidemia..............................................................................................................................8
Cultural Requirement of Mr D Aboriginal Background............................................................................................9
References................................................................................................................................................................10
PART 3.........................................................................................................................................................................11
Fluoxetine.................................................................................................................................................................11
Drug Interactions......................................................................................................................................................11
Drug Compliance/Adherence...................................................................................................................................12
Desvenlafaxine and Conclusion...............................................................................................................................14
References................................................................................................................................................................15

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INTRODUCTION
Nursing practice involves upholding of the quality principles through proper analyzation
of all the important aspects of the drug. Medications can have pharmacodynamic,
pharmacokinetic, microbial and biomedical influences on the body of an individual (Rägo,
World Health Organization & Council for International Organizations of Medical Sciences,
2012). The nursing professional administering the medication should consider the ethical and
cultural implications involved in drug administration and all the legislative requirements and
obligations. Through answering the short answer questions below, one is able to extensively
apply the principles above.
PART 1
a) Pharmacological Class Of Losartan And Its Mechanism Of Action
Class
Losartan is an oral drug belonging to a class of drugs referred to as Angiotensin Receptor
Blockers (ARBs) (Heerspink et al. 2012).
Mechanism of Action
Losartan blocks the angiotensin receptors hence hindering the action of angiotensin
leading to muscle relaxation and dilatation of blood vessels, therefore, decreasing blood pressure
(Tripathi, 2013). Addition of Losartan to Mr D’s medication regimen will reduce his high blood
pressure.
b) Pharmacological Class Of Amlodipine And Its Mechanism Of Action
Class

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Amlodipine belongs to the class of medicine called calcium channel blockers (Mir et al.
2012).
Mechanism of Action
Amlodipine is an enantioselective calcium channel blocker which denied movement of
calcium ions into cardiac muscle cells and vascular smooth muscles hence inhibiting contraction
of these muscles hence relaxing blood vessels so that the heart does not need to pump hard hence
helps in lowering blood pressure (Phan, Dayspring & Toth, 2012).
c) Side effects of Losartan and Amlodipine
Amlodipine
1. Swelling of the leg and ankles – This swelling is brought about by the reduced pressure that
causes edema.
2. Tiredness and experiencing extreme sleepiness – This can be attributed to the fact that low
pressures lead to less muscle and tissue perfusion hence reduced functionality (Mir et al. 2012).
Losartan
1. Muscle cramps – Muscle cramps are due to the breakdown of skeletal muscle tissue which
results in renal failure.
2. Flu-like symptoms such as a dry cough, fever, sore throat, sneezing and stuffy nose – Due to
its effects on the ACE enzymes (Heerspink et al. 2012).
d) Pharmacological Class And Mechanism Of Action Of Atorvastatin
Class

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Atorvastatin is classified under the group of drugs known as HMG CoA inhibitors of
reductase or statins (Masadeh, Mhaidat, Alzoubi, Al-azzam, & Alnasser, 2012).
Mechanism of Action
Atorvastatin is a selective and competitive HMG-CoA reductase inhibitor hence limiting
the amount of cholesterol and triglycerides that circulate in the body (Masadeh et al. 2012).
e) Adverse Effects That Are Important To Inform Mr D Regarding Taking Atorvastatin
1. Muscle pain, weakness and tenderness – This is as a result of the breakdown of muscle
tissue caused by the drug.
2. Confusion and memory loss – As a result of blockage of some blood vessels carrying blood
to the brain leading to hypoperfusion of the brain hence leading to brain cognitive functions
(Rang, Ritter, Flower & Henderson, 2014).
Interventions Used To Minimize Or Prevent These Side Effects Caused By Atorvastatin
1. To reduce Muscle pain, weakness and tenderness, Mr D will have to do stretching exercises,
keep extremities warm, wear compression stockings and take magnesium supplements.
2. To reduce confusion and memory loss effects caused by Atorvastatin Mr D should stop
taking the medication for a few days and then take coenzyme Q10 in those days. Restating
atorvastatin will not cause the return of these symptoms (Robertson, Maibach, Katzung &
Trevor, 2015).
f) How Oral Hypoglycemic Medications Reduce Blood Sugar Levels That Differs From
The Action Of Insulin

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Oral Hypoglycemic drugs reduce blood sugar levels by their action the calcium and
potassium channels through their effects on the adenosine triphosphate (ATP) while insulin
increases glucose uptake by body cells.
References
Heerspink, H. J. L., Holtkamp, F. A., Parving, H. H., Navis, G. J., Lewis, J. B., Ritz, E., ... & De
Zeeuw, D. (2012). Moderation of dietary sodium potentiates the renal and cardiovascular
protective effects of angiotensin receptor blockers. Kidney international, 82(3), 330-337.
Masadeh, M., Mhaidat, N., Alzoubi, K., Al-azzam, S., & Alnasser, Z. (2012). Antibacterial
activity of statins: a comparative study of atorvastatin, simvastatin, and
rosuvastatin. Annals of clinical microbiology and antimicrobials, 11(1), 13.
Phan, B. A. P., Dayspring, T. D., & Toth, P. P. (2012). Ezetimibe therapy: mechanism of action
and clinical update. Vascular health and risk management, 8, 415.
Robertson, D., Maibach, H. I., Katzung, B., & Trevor, A. (2015). Basic and clinical
pharmacology.
Tripathi, K. D. (2013). Essentials of medical pharmacology. JP Medical Ltd.

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PART 2
a) Morphine
Class
Morphine is classified as an opiate (narcotic) analgesic.
Purpose For Emergency Giving Morphine To Mr D
Morphine is administered to Mr D by the emergency team to relieve the sharp pain he has
on the left side of his chest.
Mechanism Of Action Of Morphine
Morphine causes analgesia by acting on the opioid receptors (mu, delta and kappa) that are
located on the neuronal cell membranes by inhibiting the release of neurotransmitters endorphins
(Robertson et al. 2015).
b) Reason For The Administration Of Aspirin
Oral aspirin that is given to Mr D to reduce the severe pain that is being caused by
angina. Therefore, Mr D should be encouraged to take the aspirin given.
c) Nitroglycerin/GTN (Anginine)

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Health Teaching
To enable Mr D to understand why he is taking Nitroglycerin/GTN (Anginine), he should
be informed that this medication dilates blood vessels hence making the flow of blood easier and
makes the work of the heart easier hence reducing the pain caused by angina.
Mechanism Of Action Of Nitroglycerin/GTN (Anginine)
Nitroglycerin/GTN (Anginine) acts by producing nitric oxide which increases the cGMP (cyclic
guanosine phosphate) levels within the body cells hence stimulates the dephosphorylation of
myosin that causes relaxation of smooth muscle cells in all the blood vessels hence allowing free
flow of blood to reduce pressure and stop chest pain (Robertson et al. 2015).
Two (2) Side Effects That Mr D May Experience That Is Important In This Health Teaching
The side effects of Nitroglycerin/GTN (Anginine) that are important for Mr D to be
aware of include the fact that this disease may cause bradycardia and hypotension. This is
because these two adverse effects may lead to risky outcomes such as heart attack therefore,
there should be cautious when administering the drug to Mr D.
Hypotension - Nitroglycerin/GTN (Anginine) causes vasodilation, reduced venous return and
causes arterial resistance to cause a certain degree of hypotension. The hypotension causes a
baroreceptor-mediated reflex that stimulates the vasomotor centre.
Bradycardia – Due to the hypotension, both vascular tone and the heart rate decreases hence
resulting in bradycardia (Julien, 2013).
(d) Use Of Medical History To Develop Management Plan

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Health Promotion Teaching Is Appropriate For Mr D Before His Discharge Due To
His Medical History Of Hypertension, Type 2 Diabetes, And Hyperlipidemia
Before Mr D leaves the hospital, he should be taught how to manage his chronic
conditions which include hypertension, diabetes and hyperlipidemia. The health promotion
teaching will involve the identification of the problems and recommendations on how to manage
them. The teach-back method should be used to ensure that he understands everything since his
conditions are serious and life-threatening.
Topics To Teach Or Instruct Mr D Which May Improve His Current Health
The two most important topics to teach Mr D so that he can be able to manage his current
health problems include consumption of proper diet and physical education. To manage diabetes
and high blood pressure, he should be advised to maintain a healthy diet, limit his sugar intake,
reduced salt consumption and physical activity. Lipid management for hyperlipidemia
approaches to be taught to Mr D includes making him be familiar with the lipid treatment goals
and the different approaches to reduce cholesterol such as diet, exercises and use of lipid-
lowering medications (Clayton & Willihnganz, 2016).
(e). Mr D’s Aboriginal Cultural Requirements
While developing the teaching method for health promotion, the cultural background of
Mr D should be taken into consideration such as his beliefs and the practices he prefers. Those
cultural elements that are appropriate for instance the involvement of a traditional healer to ask
his ancestors to cure him should be incorporated into the program. However, cultural practices
and beliefs that can hinder healthcare delivery or put his heath at a risk should be highly
discouraged (Russell-Smith et al. 2013).

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References
Clayton, B. D., & Willihnganz, M. (2016). Basic Pharmacology for Nurses-E-Book. Elsevier
Health Sciences.
Julien, R. M. (2013). A primer of drug action: A concise nontechnical guide to the actions, uses,
and side effects of psychoactive drugs, revised and updated. Holt Paperbacks.
Robertson, D., Maibach, H. I., Katzung, B., & Trevor, A. (2015). Basic and clinical
pharmacology.
Russell-Smith, J., Cook, G. D., Cooke, P. M., Edwards, A. C., Lendrum, M., Meyer, C. P., &
Whitehead, P. J. (2013). Managing fire regimes in north Australian savannas: applying
Aboriginal approaches to contemporary global problems. Frontiers in Ecology and the
Environment, 11(s1), e55-e63.

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PART 3
(a). Pharmacological Class Of Fluoxetine And Its Mechanism Of Action
Class
Fluoxetine is classified under the class of medication known as selective serotonin
reactive inhibitors (SSRI) (Hall, 2015).
Fluoxetine Mechanism Of Action
Fluoxetine selectively inhibits serotonin reuptake by inhibiting the serotonin transporter
protein and therefore, increasing the availability of serotonin which leads to reduced depression.
(b). Common Side Effects And Interaction Of Fluoxetine With Other Drugs
Drug interactions
Drug interactions changes how the medicine works hence results in adverse effects.
Fluoxetine stays in the body for many weeks after the last dose due to its high half-life hence
interacts with other medications. Drugs that normally interact with Fluoxetine include those
drugs that are metabolized in the liver such as Losartan, Aspirin, certain antidepressants such as
SSRIs especially citalopram (Rang et al. 2014). Amlodipine among others. Mr D may

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experience certain undesired adverse effects due to the interaction of Fluoxetine with other
medications he is taking.
Side effects that result due to drug interactions
Increased Risk Of Bleeding
Fluoxetine interacts with aspirin hence leading to increased risk of bleeding (Robertson et al.
2015). Therefore, care should be taken when prescribing these two drugs to Mr D.
Risk Of Serotonin Syndrome/ Increase In Toxicity
When Fluoxetine is used together with Losartan, there is an increase in the risk of developing the
serotonin syndrome characterized by high toxicity and causes drowsiness (Burgdorf et al. 2013).
(c). Approach That Could Be Used To Promote Antidepressant Drugs Compliance/Adherence
Although any therapeutic benefits of using antidepressants by Mr D are not witnessed for
few weeks, it is important that he continue taking medication since such benefits may delay to
come and therefore the principles of drug compliance and adherence should be applied. Drug
adherence refers to taking medication as directed by the physician through getting the
prescriptions filled, taking medication and following all the availed instructions (Sansone &
Sansone, 2012). Drug compliance refers to the degree to which the patient correctly follows
medical advice given to him such as how to use medical devices, involvement in physical
activities, going for therapy sessions and self-care (Sansone & Sansone, 2012).
An approach to promote Drugs Compliance and Adherence for Mr D is ensuring that he
has access to the required resources such as medications and the availability and access to
physicians. This will ensure that there is no limiting factor that will interfere with his Drugs

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Compliance/Adherence. Mr D’s compliance and adherence will ensure that he is persistent in his
treatment to avoid any cases of relapse and ensure remission.
(d). Two (2) Strategies That Would Be Appropriate To Advice Mrs D Regarding Caring
For Her Depressed Husband Who Is Taking Antidepressants
Availability Of Care And Support To Reduce Suicide
The best thing one can do for someone with depression is always being there and offering
the care support he or she needs so as to eliminate suicide thoughts. Mrs D should always be
there for her husband since just being next to the person you love makes them feel loved and
cared for hence they feel that they are not in this all alone. She should also provide him with any
help he needs such as with his medicines.
Mrs D Should Avoid Tough-Love Approach
Some individuals intentionally become impatient and become tough hoping that their
patients will undo their depression or make them have positive behaviour and eradicate suicidal
thoughts (Miller & Rollnick, 2012). However, this is not the case as these people worsen
therefore Mrs. D should be considerate. The suicidal risks are highest when the course of
treatment is not going well and there are poor outcomes.
(e). Desvenlafaxine Pharmacological Class And The Mechanism Of Action
Class
Desvenlafaxine is classified as an antidepressant of serotonin-norepinephrine reuptake
inhibitor (SNRI) (Clayton et al. 2015).
Mechanism Of Action

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Desvenlafaxine acts by inhibiting the neuronal serotonin reuptake and also inhibits
norepinephrine transporter (Robertson et al. 2015).
Conclusion
Pharmacodynamics and pharmacokinetics of the drug are important aspects. Adverse
effects, contraindications and drug interaction affect the clinical prescription of the drug. There
are determinants of health that affect health care service delivery such as culture and social
determinants of health. Family-centred care is important in improving patient’s outcome.

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References
Burgdorf, J., Zhang, X. L., Nicholson, K. L., Balster, R. L., Leander, J. D., Stanton, P. K., ... &
Moskal, J. R. (2013). GLYX-13, a NMDA receptor glycine-site functional partial
agonist, induces antidepressant-like effects without ketamine-like side
effects. Neuropsychopharmacology, 38(5), 729.
Clayton, A. H., Tourian, K. A., Focht, K., Hwang, E., Cheng, R. F., & Thase, M. E. (2015).
Desvenlafaxine 50 and 100 mg/d versus placebo for the treatment of major depressive
disorder: a phase 4, randomized controlled trial. The Journal of clinical psychiatry, 76(5),
562-569.
Hall, J. E. (2015). Guyton and Hall textbook of medical physiology e-Book. Elsevier Health
Sciences.
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change.
Guilford press.
Rang, H. P., Ritter, J. M., Flower, R. J., & Henderson, G. (2014). Rang & Dale's Pharmacology
E-Book: with STUDENT CONSULT Online Access. Elsevier Health Sciences.

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Robertson, D., Maibach, H. I., Katzung, B., & Trevor, A. (2015). Basic and clinical
pharmacology.
Sansone, R. A., & Sansone, L. A. (2013). Antidepressant adherence: are patients taking their
medications?. Innovations in clinical neuroscience, 9(5-6), 41.

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