Advanced Pharmacology: Cardiovascular and Renal Pharmacotherapy Case Study (2026)

Safe management of cardiovascular and renal disorders in advanced nursing practice depends on a clear grasp of cardiac and renal pathophysiology, precise drug selection, and consistent use of current hypertension and heart failure guidelines. Evidence-based use of ACE inhibitors, ARBs, beta-blockers, and diuretics can significantly reduce cardiovascular events and slow renal decline when tailored to a patient’s comorbidities, labs, and social context. Integrating pharmacokinetics, pharmacodynamics, and pharmacogenomic considerations allows nurse practitioners to individualize therapy, minimize adverse effects, and recognize when guideline-directed therapy must be adapted. Careful documentation of clinical reasoning, monitoring plans, and patient education is central to safe prescribing and aligns with contemporary expectations in graduate-level advanced pharmacology courses.

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Assessment 2: Cardiovascular and Renal Pharmacotherapy Case Study

Course context

Course: Advanced Pharmacology for Advanced Practice Nurses (e.g., NURS 6521, NUR-635, or equivalent at a graduate nursing program in the U.S., Canada, UK, or Australia). Assessment 2 focuses on applying cardiovascular and renal pharmacology concepts to a realistic clinical scenario that mirrors expectations in contemporary MSN/APRN curricula.

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Assessment overview

You will complete a written case study analysis that applies advanced cardiovascular and renal pharmacology to a complex adult patient with hypertension and early chronic kidney disease. Work will require you to integrate pathophysiology, pharmacokinetics, pharmacodynamics, pharmacogenomics where applicable, and current clinical guidelines to develop a rational, safe, and patient-centered pharmacotherapy plan.

https://www.ncbi.nlm.nih.gov/books/NBK594995/

Assignment length: 1,200–1,500-word paper (excluding title page and references). Use current APA format for headings, citations, and reference list.

https://www.studocu.com/en-us/course/walden-university/advanced-pharmacology/4065103

Case scenario

You are an advanced practice nurse in a primary care clinic. A 58-year-old patient presents for follow-up of uncontrolled hypertension and type 2 diabetes. The patient has stage 2 chronic kidney disease, hyperlipidemia, and a strong family history of premature coronary artery disease. Current medications include a thiazide diuretic, metformin, and a moderate-intensity statin. Blood pressure remains above target despite lifestyle counseling and current pharmacologic therapy.

Recent guidelines recommend more intensive blood pressure control for high-risk patients, with preference for RAAS-blocking agents and specific combinations where renal and cardiovascular protection are priorities. Laboratory findings, social determinants of health (including access and cost), and potential pharmacogenomic factors must be considered as you optimize this treatment plan for both cardiovascular and renal outcomes.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11399577/

Assignment instructions

Write a 1,200–1,500-word paper that addresses the following components using scholarly, evidence-based support. Use clear headings that align with each main section below.

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I. Pathophysiology and clinical context

1. Briefly summarize the relevant pathophysiology of hypertension and early chronic kidney disease in this patient, including how these conditions interact to increase cardiovascular risk.
2. Explain how alterations in the cardiovascular and renal systems influence pharmacokinetic and pharmacodynamic responses to antihypertensive medications.
3. Discuss at least two patient-specific factors (e.g., age, comorbidities, renal function, ethnicity, social determinants) that should shape pharmacotherapy choices for this case.

II. Guideline-based pharmacotherapy plan

1. Identify current, evidence-based hypertension and chronic kidney disease guidelines you will use to guide pharmacologic decision making (e.g., ACC/AHA, ESH, KDIGO, or equivalent national guidelines appropriate to your practice context).
2. Propose an initial or revised antihypertensive regimen using at least two drug classes with known benefit for cardiovascular and renal protection (e.g., ACE inhibitor or ARB, thiazide-like diuretic, calcium channel blocker, beta-blocker if indicated).
3. Justify your drug choices, dosing, and sequence of therapy with reference to guideline recommendations and current evidence, including expected therapeutic effects on blood pressure and renal function.

III. Pharmacokinetics, pharmacodynamics, and pharmacogenomics

1. Describe the key pharmacokinetic properties (absorption, distribution, metabolism, elimination) of one RAAS-blocking agent and one additional antihypertensive agent you selected for this patient.
2. Explain the pharmacodynamic mechanisms of these agents and how they modify cardiovascular and renal physiology to achieve blood pressure control and organ protection.
3. Discuss at least one potential pharmacogenomic consideration (e.g., variation in RAAS response or beta-blocker metabolism) that could influence drug choice, dosing, or monitoring in advanced practice nursing.

IV. Safety, monitoring, and patient education

1. Identify key adverse effects, contraindications, and clinically significant drug–drug interactions associated with the selected medications, including RAAS inhibitors and diuretics.
2. Outline a monitoring plan that includes specific laboratory tests, target values, and time frames for follow-up related to blood pressure, renal function, and electrolytes.
3. Describe essential patient education points related to medication adherence, home blood pressure monitoring, lifestyle modifications, and when to seek urgent care.

V. Access, cost, and equity considerations

1. Analyze how cost, insurance coverage, or formulary restrictions may influence the final pharmacotherapy plan for this patient.
2. Discuss at least one strategy to promote equitable access to evidence-based cardiovascular and renal pharmacotherapy (e.g., generic substitution, patient assistance programs, culturally responsive counseling).

VI. Scholarly integration

1. Support your discussion with a minimum of five current, peer-reviewed sources (2018–2026) in addition to foundational pharmacology texts or guidelines.
2. Use current APA format for in-text citations and reference list.

Marking criteria (indicative rubric)

• Pathophysiology and patient context (20%): Accurate, concise explanation of cardiovascular and renal pathophysiology; clear linkage to case details and pharmacologic implications.
• Guideline-based pharmacotherapy plan (30%): Evidence-based regimen aligned with current guidelines; strong rationale for selected drug classes, sequencing, and dosing.
• Integration of PK/PD and pharmacogenomics (20%): Clear, accurate explanation of mechanisms and pharmacokinetics; thoughtful consideration of potential pharmacogenomic influences.
• Safety, monitoring, and patient education (15%): Comprehensive discussion of adverse effects, interactions, monitoring strategies, and patient teaching tailored to the case.
• Access, cost, and equity (5%): Insightful critique of how cost and access shape therapy; practical strategies to support equitable care.
• Scholarly writing and APA (10%): Logical organization, clarity of writing, appropriate academic tone, and accurate APA formatting.

Graduate nursing programs now expect advanced practice nurses to demonstrate not only knowledge of cardiovascular and renal drug classes, but also the ability to synthesize guidelines, patient factors, and pharmacologic principles into defensible prescribing decisions. New research on the renin–angiotensin–aldosterone system and aging highlights how RAAS inhibitors can provide substantial benefit in high-risk patients when lab monitoring and dose titration are carefully managed. Case-based assignments like this one mirror real clinical encounters, helping students practice translating complex evidence into concise, patient-centered pharmacotherapy plans that are safe, affordable, and culturally responsive.

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Scholarly references

Cosarderelioglu, C. et al. (2025) ‘Revisiting renin–angiotensin–aldosterone system in aging’, Journal of Clinical Investigation, 135(22), e195633. Available at: https://www.jci.org/articles/view/195633.

Fountain, J.H. & Lappin, S.L. (2023) ‘Physiology, Renin Angiotensin System’, in StatPearls. Treasure Island, FL: StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470410/.

Cleveland Clinic Journal of Medicine (2019) ‘ACE inhibitors and ARBs: Managing potassium and renal function’, CCJM, 86(9), pp. 601–607. Available at: https://www.ccjm.org/content/86/9/601.

Du, H. et al. (2024) ‘Moving toward a consensus: comparison of the 2023 ESH and 2017 ACC/AHA hypertension guidelines’, Current Hypertension Reports, 26(8), pp. 421–433. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11399577/.

Al-Maqbali, J.S. et al. (2023) ‘A systemic analysis of various ACE inhibitors, their side effects, and drug interactions in hypertension’, Journal of Experimental Pharmacology, 15, pp. 55–72. Available at: https://journals.sagepub.com/doi/10.1155/2023/7890188.