NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

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NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders – Step-by-Step Guide

The first step before starting to write the NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders Example 1

Pharmacokinetic and Pharmacodynamic Processes

The selected factor, genetics, can significantly influence the pharmacokinetic and pharmacodynamic processes in the patient from the provided case study. Starting with pharmacokinetics, genetic variations can impact drug metabolism, absorption, distribution, and elimination. For instance, in this case, the patient’s genetic variations in the CYP2C9 gene can influence the metabolism of warfarin. Reduced enzymatic activity due to specific genetic variants can lead to slower warfarin metabolism, resulting in higher blood levels of the drug. This can increase the risk of bleeding and necessitate lower initial doses of warfarin. Genetics also influence drug transporters (Rosenthal & Burchum, 2021).

NURS 6521 Week 2 EmmaGarcia Pharmacotherapy For Cardiovascular Disorders

The patient’s genetic variations in the ABCB1 gene, encoding P-glycoprotein, can affect the function of this transporter. Reduced P-glycoprotein activity due to genetic variants can lead to higher concentrations of digoxin, a medication transported by P-gp, in the body. This elevated concentration increases the risk of digoxin toxicity and may require lower initial doses of digoxin in patients with such genetic variations (Wojtyniak et al., 2021).

In terms of pharmacodynamics, genetic variants might affect the targets and receptors of drugs. In this case, the patient’s genetic polymorphisms in the ADRB1 gene, coding for beta-1 adrenergic receptors, may impact the sensitivity of these receptors to metoprolol, a beta-blocker (Rosenthal & Burchum, 2021). Specific genetic variants can alter the response to metoprolol, potentially requiring different doses or alternative medications to achieve the desired heart rate control in atrial fibrillation.

Changes

Changes in the pharmacokinetics and pharmacodynamics processes can profoundly impact the recommended drug therapy for the patient described in the case study. One notable area where these changes can influence treatment is drug metabolism. For instance, the patient is prescribed warfarin, an anticoagulant primarily metabolized by the cytochrome P450 enzyme CYP2C9. However, genetic variations in the CYP2C9 gene can alter warfarin’s metabolism rates (Rosenthal & Burchum, 2021).

Patients with specific genetic variants, such as CYP2C92 or CYP2C93, may exhibit reduced enzymatic activity, leading to slower metabolism of warfarin. As a result, their blood levels of warfarin may increase, putting them at a higher risk of bleeding. In such cases, the recommended drug therapy may involve starting with lower initial doses of warfarin and closely monitoring the patient’s International Normalized Ratio (INR) to ensure appropriate anticoagulation.

Additionally, changes in drug transporters can affect drug absorption and distribution. The patient is taking digoxin, a medication transported by the P-glycoprotein (P-gp) transporter. Genetic variations in the ABCB1 gene, which encodes P-gp, can impact its function. Some individuals may have genetic variants that result in reduced P-gp activity, leading to higher concentrations of digoxin in the body. This increased concentration raises the risk of digoxin toxicity. To address this, the recommended drug therapy for patients with such genetic variations may involve starting with lower initial doses of digoxin and monitoring serum digoxin levels to avoid adverse effects.

Furthermore, genetic variations in drug targets can impact drug response. The patient has atrial fibrillation (A.F.) and is prescribed metoprolol, a beta-blocker, to manage her heart rate. However, genetic polymorphisms in the ADRB1 gene, which codes for beta-1 adrenergic receptors, can affect the sensitivity of these receptors to medications like metoprolol (Hirota et al., 2020). Individuals with specific ADRB1 variants may require different doses or alternative medications to achieve the desired heart rate control in A.F.

Improving the Patient’s Drug Therapy Plan

Based on the provided case study, several recommended improvements can be made to improve the patient’s drug therapy plan. Firstly, conducting a comprehensive medication review would be beneficial considering the patient’s age, the potential for polypharmacy, and the presence of delirium.

This review would assess the appropriateness of each medication, evaluate potential drug interactions, and identify any medications that may contribute to or exacerbate the patient’s delirium (Wojtyniak et al., 2021). Considering the patient’s altered level of consciousness, an alternative oral anticoagulant, such as a direct oral anticoagulant (DOAC), could be considered instead of warfarin. DOACs have a more predictable pharmacokinetic profile, fewer interactions, require less monitoring, and have a lower risk of major bleeding.

Adjusting the dose or considering an alternative medication with a more favorable cardiovascular profile may be necessary to manage the patient’s low blood pressure and heart rate while still effectively controlling her heart rate. Lastly, dosage adjustments for medications undergoing renal elimination, such as digoxin, should be considered due to the patient’s chronic kidney disease (CKD).

Close monitoring of renal function and drug levels can help ensure appropriate dosing to minimize the risk of drug toxicity (Wojtyniak et al., 2021). These recommended improvements aim to enhance safety, effectiveness, and patient outcomes. Conducting a medication review, considering alternative anticoagulants, adjusting cardiovascular medications, and accounting for CKD-related dosage adjustments can optimize the medication regimen to better suit the patient’s needs, minimize adverse effects, and improve overall therapeutic outcomes.

Conclusion

Improving the patient’s drug therapy plan based on the case study involves conducting a medication review, considering alternative anticoagulants, adjusting cardiovascular medications, and accounting for CKD-related dosage adjustments. These recommendations are crucial to enhance safety, effectiveness, and overall patient outcomes. Conducting a comprehensive medication review ensures the appropriateness of each medication and minimizes the risk of adverse effects.

Considering alternative anticoagulants like DOACs can provide a more predictable pharmacokinetic profile and lower bleeding risk. Adjusting cardiovascular medications helps manage the patient’s low blood pressure and heart rate more effectively. Dosage adjustments for drugs undergoing renal elimination account for the patient’s CKD, minimizing the risk of drug toxicity. By implementing these improvements, healthcare providers can optimize the patient’s drug therapy plan, tailor it to her specific needs, and improve her treatment’s overall quality and safety.

NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders References

Hirota, T., Fujita, Y., & Ieiri, I. (2020). An updated review of pharmacokinetic drug interactions and pharmacogenetics of statins. Expert Opinion on Drug Metabolism & Toxicology, 16(9), 809-822. https://doi.org/10.1080/17425255.2020.1801634

Rosenthal, L., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). S.L.: Saunders. https://evolve.elsevier.com/cs/product/9780323554954

Wojtyniak, J. G., Selzer, D., Schwab, M., & Lehr, T. (2021). Physiologically based precision dosing approach for drug‐drug‐gene interactions: A simvastatin network analysis. Clinical Pharmacology & Therapeutics, 109(1), 201-211. https://doi.org/10.1002/cpt.2111

NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders Instructions

WHAT’S HAPPENING THIS MODULE?

Module 2: Cardiovascular and Respiratory Systems is a 2-week module, Weeks 2 and 3 of the course. In this module, you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular and respiratory disorders. You will also explore and suggest drug therapy plans for asthma and analyze the stepwise approach for asthma treatment and management.

INTRODUCTION

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.

LEARNING OBJECTIVES

Students will:

  • Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes
  • Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies
  • Evaluate drug therapy plans for cardiovascular disorders

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.

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.

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

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. All papers submitted must use this formatting.

  When writing your Week 2 Assignment, consider the following scenario:  

 Scenario

AB is an 86-year-old female admitted to the emergency department with delirium. Her spouse is with her and verifies that AB adheres to the medications she is currently prescribed. She does not self-monitor her BP or heart rate at home.  

PMH:  

A fib x 1 month 

HTN x 10 years  

CKD x 5 years  

Osteoarthritis x 7 years  

GERD x 20 years  

Allergies:  

NKDA  

Medications:   

Digoxin 0.25mg once daily  

Metoprolol succinate 25mg once daily 

Warfarin 3 mg once daily 

APAP 650mg three times daily 

Omeprazole 20mg once daily 

MVI once daily 

Social History:  

Married to husband for 57 years  

No smoking, alcohol, limited daily exercise (short walks each morning)  

Family History:  

None reported  

Vitals:                                      

Ht: 5’4” 

Wt: 113 lbs  

HR: 52 bpm 

BP: 101/58  

Labs:  

Gluc 109 

Na 138 

K 4.0 

Cl 99 

CO2 27   

BUN 33 

Scr 1.2  

INR 3.8 

Dig 2.4  

Physical Exam:  

Elderly female with altered level of consciousness 

No signs of bruising, bleeding, or other injury 

NURS 6521 Week 2 Assignment: Pharmacotherapy For Cardiovascular Disorders Example 2

Pharmacotherapy for Cardiovascular Disorders

Cardiovascular diseases continue to pose a significant global health challenge, leading to a substantial number of deaths, particularly in the United States (Murphy et al., 2019). Advanced practice nurses play a critical role in recommending personalized treatment options due to the high prevalence of risk factors such as hypertension, hyperlipidemia, and tobacco use  (Xu et al., 2022).

Patient characteristics like age, gender, ethnicity, and behavior significantly influence medication therapy’s safety and effectiveness for cardiovascular diseases (Piña et al., 2020). The purpose of this paper is to explore the case of an 86-year-old patient with multiple cardiovascular conditions, including atrial fibrillation, hypertension, and chronic kidney disease. The focus will be on examining how the patient’s age impacts pharmacokinetics and pharmacodynamics processes.

Impact of Age on Pharmacokinetic and Pharmacodynamic Processes

The aging process is commonly associated with various simultaneous health conditions, leading to the need for multiple medications to manage these issues. As individuals age, significant physiological changes occur that significantly impact how drugs are processed in the body (pharmacokinetics) and their effects on the body (pharmacodynamics) (Polaka et al., 2022). Changes in renal function related to aging are significant in the case of AB, an 86-year-old patient with several cardiovascular issues. The decrease in kidney function becomes an essential factor, impacting the elimination of medications and potentially resulting in drug buildup, thereby increasing the likelihood of adverse effects.

Various age-related alterations might significantly impact pharmacokinetic processes, intensifying the intricacies linked to medication treatment. A study by Vinarov et al. (2021) links old age to reduced stomach acid secretion and motility, which can lead to slower medication absorption. This delay could impact the initiation of pharmacological activity and require careful deliberation of dosing timing to maximize therapeutic efficacy.

The aging process leads to a decrease in the overall amount of water in the body and an increase in body fat, which can affect how medications are distributed throughout the body. Specifically, medicines soluble in fat may have larger quantities because they are stored more in adipose tissue (Vinarov et al., 2021). This modification in the distribution dynamics can affect both the initiation and length of the pharmacological effect.

In their study, Maanen et al. (2019) established that diminished hepatic enzyme activity associated with aging contributes to a reduced rate of drug metabolism, which may lead to heightened drug exposure. Due to the reduced metabolic capacity, it is necessary to change the amount of medication given to avoid adverse effects and ensure that the treatment remains effective. Diminished renal function is a characteristic feature of the aging process and directly affects the clearance of drugs.

Renal impairment can result in reduced drug excretion, which can increase the likelihood of drug buildup and raise the risk of toxicity (Maanen et al., 2019). Monitoring renal function and appropriately changing drug dosages are essential to a secure and efficient drug therapy regimen. Incorporating these age-related factors into the broader context of pharmacokinetics and pharmacodynamics processes guarantees a thorough comprehension of the difficulties and possibilities in handling cardiovascular illnesses in the senior demographic.

Impact on AB’s Drug Therapy

The recommended pharmacological therapy must be carefully considered in light of age-related changes and the complex nature of cardiovascular problems. Digoxin buildup is more likely due to age-related reductions in hepatic enzyme activity and decreased renal function, which could result in toxicity (Maher et al., 2020). Digoxin levels must be carefully monitored to reduce this risk, and thorough supervision is necessary for therapeutic efficacy without sacrificing safety.

According to Hui (2020), age-related alterations, such as reduced sensitivity and density of beta-receptors, may affect how well metoprolol regulates heart rate, requiring lower doses for the intended effect. Treatment strategy should be modified according to these age-related changes to preserve ideal heart rate regulation and general cardiovascular stability.

The age-related decline in hepatic enzyme activity and protein binding can exacerbate warfarin’s anticoagulant action, increasing the risk of bleeding (Maanen et al., 2019). Regularly monitoring international normalized ratio levels is essential to manage this potential problem. This meticulous approach ensures that warfarin dosages are adjusted promptly, striking a delicate balance between minimizing the risk of bleeding and preventing thrombosis. The decreased hepatic enzyme activity and age-related changes in renal function also elevate susceptibility to APAP-induced liver injury.

Adjusting APAP dosages or exploring alternative pain management techniques may be necessary to address this issue effectively. By adopting this proactive strategy, the risk of side effects is minimized while enhancing AB’s medication therapy safety profile. This tailored method considers the intricate interplay between age-related physiological changes and each drug’s unique pharmacological properties, fostering a comprehensive, patient-centered approach to cardiovascular therapy.

Improving AB’s Drug Therapy Plan

To improve AB’s drug therapy plan, a comprehensive approach is needed, considering age-related changes. Starting with a lower dose for all medications is a prudent strategy to minimize adverse effects and ensure therapeutic efficacy. As Maher et al. (2020) contend, vigilant monitoring of drug levels, particularly for medications like warfarin and digoxin, allows for precise titration to maintain therapeutic levels without compromising safety. Shorter-acting medications can be incorporated into the plan to minimize drug accumulation and respond to changing clinical conditions.

A systematic review of AB’s medication list is necessary to identify and discontinue unnecessary medications. Patient education about drugs, their significance, potential side effects, and adherence is crucial. It is essential to address additional risk factors like high blood pressure and long-term kidney disease to enhance overall health and optimize the response to medications. Other treatment options, such as changing one’s lifestyle, should also be considered. This approach establishes a patient-centered framework, aligning with the unique considerations posed by AB’s age-related changes, ensuring the safety and efficacy of drug therapy.

Conclusion

Understanding the complex ways aging affects PK and PD processes is essential to treating cardiovascular problems in older people. APNs can improve treatment outcomes and reduce risks for older patients, such as AB, by introducing tailored dosing, increasing patient education, and customizing medication therapy strategies to account for age-related changes. This research highlights the significance of individualized care in enhancing medication therapy for cardiovascular illnesses in the geriatric population through its multidimensional approach.

References

Hui, R. (2020). Hypertension drug therapy. Advances in Experimental Medicine and Biology, 149–268. https://doi.org/10.1007/978-981-15-2517-9_6

Maanen, A. C. D., Wilting, I., & Jansen, P. A. F. (2019). Prescribing medicines to older people—How to consider the impact of ageing on human organ and body functions. British Journal of Clinical Pharmacology, 86(10), 1921–1930. https://doi.org/10.1111/bcp.14094

Maher, D., Ailabouni, N., Mangoni, A. A., Wiese, M. D., & Reeve, E. (2020). Alterations in drug disposition in older adults: A focus on geriatric syndromes. Expert Opinion on Drug Metabolism & Toxicology, 17(1), 41–52. https://doi.org/10.1080/17425255.2021.1839413

Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2019). Products – Data Briefs – Number 328 – November 2018. Centers for Disease Control and Prevention CDC. https://www.cdc.gov/nchs/products/databriefs/db328.htm

Piña, I. L., Di Palo, K. E., Brown, M. T., Choudhry, N. K., Cvengros, J., Whalen, D., Whitsel, L. P., & Johnson, J. (2020). Medication adherence: Importance, issues and policy: A policy statement from the American Heart Association. Progress in Cardiovascular Diseases, 64. https://doi.org/10.1016/j.pcad.2020.08.003

Polaka, S., Tella, J. D., Tekade, M., Sharma, M. C., & Tekade, R. K. (2022, January 1). Chapter 10 – impact of ageing on the pharmacokinetics and pharmacodynamics of the drugs (R. K. Tekade, Ed.). ScienceDirect; Academic Press. https://www.sciencedirect.com/science/article/abs/pii/B9780323983679000081

Vinarov, Z., Abdallah, M., Agundez, J. A. G., Allegaert, K., Basit, A. W., Braeckmans, M., Ceulemans, J., Corsetti, M., Griffin, B. T., Grimm, M., Keszthelyi, D., Koziolek, M., Madla, C. M., Matthys, C., McCoubrey, L. E., Mitra, A., Reppas, C., Stappaerts, J., Steenackers, N., & Trevaskis, N. L. (2021). Impact of gastrointestinal tract variability on oral drug absorption and pharmacokinetics: An UNGAP review. European Journal of Pharmaceutical Sciences, 162, 105812. https://doi.org/10.1016/j.ejps.2021.105812

Xu, Y., Koh, X. H., Chua, Y. T. S., Tan, C. G. I., Aloweni, F. A. B., Yap, B. E. J., Tan, P. C., Chua, X., Lim, Y. K. S., Oh, H. C., Teo, S. H. S., & Lim, S. F. (2022). The impact of community nursing program on healthcare utilization: A program evaluation. Geriatric Nursing, 46, 69–79. https://doi.org/10.1016/j.gerinurse.2022.04.024