Women have a higher gastric ph but slower gastric

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women have a higher gastric pH, but slower gastric motility, affecting drug absorption (Franconi & Campesi, 2014). Additionally, specifically with antihypertensives, female hormones affect the Renin-Angiotensin System (RAS) by increasing angiotensinogen and angiotensin-II, and decreasing renin and angiotensin converting enzyme (ACE) activities, while the RAS is increased with androgens (Franconi & Campesi, 2014). That being said, ACE inhibitors have
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been shown to be less effective in women with heart failure than in men (Franconi & Campesi, 2014). Changes and Improvements in Drug Therapy Taking in to consideration gender, as well as other factors, I would attempt to discontinue use of the Doxazosin, since there is a possibility for depression as well as fluid retention, and with the patient already on an SSRI and possibly already retaining water as evidenced by a weight gain. I would be cautious with the Atenolol, as it does have mood side effects, but the dose is very low. Additionally, I would probably add a diuretic to assist in managing the possible CHF and weight gain, such as Hydrochlorothiazide (HCTZ) beginning with a low dose to see how it is tolerated. I would also look at reducing the Simvastatin dosage to forty milligrams, as it is not recommended at the eighty milligram level due to muscle damage (Drugs.com, 2012). I would also educate the patient on eating a diet with good potassium, magnesium, calcium, and sodium levels, since the diuretic can deplete these minerals (Arcangelo & Peterson, 2013). References Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins. Drugs.com. (2012). Retrieved from Franconi, F., & Campesi, I. (2014). Pharmacogenomics, pharmacokinetics and pharmacodynamics: interaction with biological differences between men and women. British Journal of Pharmacology , 171 (3), 580–594.
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  • Fall '13
  • Pharmacology, Selective serotonin reuptake inhibitor, weight gain, Franconi

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