Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease.

Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:   * Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun * Aspirin 81 mg daily * Metformin 1000 mg po bid * Glyburide 10 mg bid * Atenolol 100 mg po daily * Motrin 200 mg 1-3 tablets every 6 hours as needed for pain * 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