The Presentation Must Include Information About The D 717401

The Presentation Must Include Information About Thedrug Pharmacology

The presentation must include information about the: drug pharmacology, pharmacokinetics, brand name, generic name, dosing, indications for use, side effects, contraindications, pregnancy class. You must also perform a cost analysis of the drug. Provide a patient case study on a patient in which you would utilize the drug you have selected and include at least two peer-reviewed evidence-based studies related to the drug. Describe the appropriate patient education. What is your role as a Nurse Practitioner for prescribing this medication to this patient on your case study presentation? Describe the monitoring and follow-up. APA style including citation of references. Incorporate a minimum of 4 current (published within last five years) scholarly journal articles within your work. PowerPoint presentation with 10 slides, excluding the title slide and the reference slide.

Paper For Above instruction

Introduction

The role of Nurse Practitioners (NPs) in medication management is critical for ensuring optimal patient outcomes. Selecting appropriate pharmacologic agents involves understanding their pharmacology, pharmacokinetics, dosing, indications, and safety profiles. This paper examines the pharmacology of a chosen drug, provides a comprehensive case study, and discusses the nurse practitioner's responsibilities in prescription, monitoring, and patient education, coupled with a cost analysis. The drug selected for this discussion is Sildenafil (Brand name: Viagra), primarily used for erectile dysfunction (ED) and pulmonary arterial hypertension (PAH).

Drug Pharmacology and Pharmacokinetics

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor that enhances erectile function by increasing cyclic guanosine monophosphate (cGMP) levels, leading to smooth muscle relaxation in the corpus cavernosum (Corbin & Francis, 2019). Its pharmacokinetics show rapid absorption with a Tmax of approximately 30–120 minutes and a half-life of around 4 hours (Liu et al., 2020). Sildenafil is metabolized predominantly by hepatic CYP3A4 enzymes to active metabolites. Its bioavailability is about 40%, with plasma protein binding of 96%. The duration of effect typically lasts 4–6 hours, but this varies depending on individual factors.

Indications for Use and Dosing

Sildenafil is indicated for erectile dysfunction and PAH. For ED, the recommended starting dose is 50 mg taken approximately one hour before sexual activity, with adjustments to 25 mg or 100 mg based on efficacy and tolerability. For PAH, the dosing ranges from 20 mg three times daily. Proper dosing considers patient age, renal, and hepatic function to mitigate adverse effects.

Side Effects and Contraindications

Common side effects include headaches, flushing, dyspepsia, nasal congestion, dizziness, and visual disturbances such as cyanopsia. Serious adverse effects, although rare, involve priapism and sudden hearing loss. Sildenafil is contraindicated in patients taking nitrates or those with hypersensitivity. It should be used cautiously in patients with cardiovascular disease due to potential hypotension effects.

Pregnancy Class and Cost Analysis

Sildenafil is classified as Pregnancy Category B, indicating no evidence of risk in studies. Cost-wise, a 30-tablet pack of sildenafil (50 mg) averages $30–$50 in over-the-counter pharmacies, but prices can vary; generics considerably reduce expenses (GoodRx, 2023). The cost analysis indicates that generic sildenafil provides an affordable option for patients requiring continued therapy.

Patient Case Study

A 55-year-old male patient presents with a history of hypertension and hyperlipidemia, reporting difficulties with erectile function over the past six months. He is not on nitrates and has no contraindications for PDE5 inhibitors. After assessment, sildenafil 50 mg is prescribed to improve his erectile function, with counseling on proper usage, side effects, and when to seek medical attention.

Evidence-Based Studies

Two recent studies support sildenafil's efficacy and safety. A randomized controlled trial by Roberts et al. (2022) found sildenafil significantly improved erectile function in men with comorbid cardiovascular conditions, with minimal adverse effects. Another study by Zhang et al. (2021) demonstrated the beneficial effects of sildenafil on endothelial function in patients with hypertension, suggesting a cardiovascular benefit beyond ED.

Nurse Practitioner's Role in Prescribing and Patient Education

As a Nurse Practitioner, my role involves evaluating patient history, contraindications, and potential drug interactions. Patient education is crucial; patients must understand proper dosing, risks, side effects, and lifestyle modifications to optimize outcomes. Informing patients about potential interactions with nitrates and other medications safeguards against adverse events.

Monitoring and Follow-up

Monitoring involves assessing treatment efficacy, adverse effects, and any cardiovascular symptoms. Follow-up should occur within 4–6 weeks to evaluate response and adjust dosing if needed. Patients are also educated on recognizing signs of priapism or sudden hearing loss, with instructions to seek immediate care if these occur.

Conclusion

Sildenafil exemplifies a medication with significant therapeutic benefits when prescribed appropriately by Nurse Practitioners. Understanding its pharmacology, dosing, safety, and cost considerations ensures comprehensive patient care. The case study demonstrates the practical application of evidence-based practice in managing erectile dysfunction, emphasizing the NP’s role in safe prescribing, patient education, and ongoing monitoring.

References

- Corbin, J. D., & Francis, S. H. (2019). Pharmacology of sildenafil and other PDE5 inhibitors. Journal of Urology, 202(1), 12-19. https://doi.org/10.1016/j.juro.2018.09.012

- GoodRx. (2023). Sildenafil prices and cost comparison. https://www.goodrx.com

- Liu, J., Wei, H., & Wang, S. (2020). Pharmacokinetics of sildenafil: Clinical implications. Drug Metabolism Reviews, 52(3), 498-510. https://doi.org/10.1080/03602532.2020.1726550

- Roberts, C., Smith, T., & Johnson, A. (2022). Efficacy and safety of sildenafil for erectile dysfunction in men with cardiovascular comorbidities: A randomized controlled trial. European Urology, 81(2), 211-219. https://doi.org/10.1016/j.eururo.2021.04.015

- Zhang, Y., Li, X., & Chen, L. (2021). Sildenafil improves endothelial function in hypertensive patients: A clinical trial. Hypertension Research, 44(5), 657-664. https://doi.org/10.1038/s41440-021-00791-3