Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6521

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Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6521

Pharmacotherapy for Cardiovascular Disorders

Patient AO has gained nine pounds of weight and is diagnosed with hyperlipidemia and hypertension. These patients require an effective plan of treatment to help them manage their health. Both hyperlipidemia and hypertension are connected, and one is a risk factor of the other. Using this case, it is evident that the treatment plan is

Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

not working out for patient AO. This is because the patient is still having weight gain and is diagnosed with two dangerous cardiovascular conditions. Approximately seventy million in the United States are diagnosed with hypertension. This translates to about one in every three people, and the statistics are not good (Arcangelo et al., 2017). This paper aims to analyze how old age affects the patient’s pharmacokinetics and pharmacodynamics processes. It also suggests how to improve patient AO treatment plan for cardiovascular condition.

Impact of Age on Pharmacodynamics and Pharmacokinetics

In this scenario, the patient has 3 major medical issues namely high cholesterol level, high blood pressure, and obesity. As people age and need treatment, there is a need to understand the pharmacodynamics and pharmacokinetics in old age. As one ages, the process of drug absorption, metabolisms, distribution, and excretion are drastically decreased (Thürmann, 2020). Due to the decrease in hepatic flow in older people, the rate of drug metabolism by the hepatic cells is lowered. Therefore, drugs having high extraction ratios will have an increase in bioavailability. Therefore, to avoid drug toxicity, initial dosages of medicines need to be given to older patients. It is critical to note that aging also affects renal functions by reducing its excretory function. Hence, these factors show how healthcare providers need to know the dosage prescription for older patients (Reeve et al., 2017).

Besides, older people are also marked with decreased gastric emptying, slow peristalsis, and colonic transit. These physiological changes in old age affect the rate of absorption (Arcangelo et al., 2017). It is essential to note that factors such as height, weight, behavioral characteristics, and weight are considered before selecting drugs and other treatment plans.

When the drug reaches its targeted site, the pharmacodynamics processes are triggered. When the drug comes to its targeted site, old age could alter the pharmacodynamics because of the changes in the binding site, differences in the post-receptor effects, and chemical interactions. The magnitude of drug response is dependent on other parameters. They include the receptors’ density, the affinity of the receptors to the drug, and the signal transduction pathways.

How to Improve the Patient’s Drug Therapy Plan

In determining the best treatment plan for the patient, detailed history taking should be conducted, more laboratory tests such as blood chemistry, EKG, liver, and renal function tests need to be undertaken (Kapoor, 2021). It is also noted that patient AO is on several blood pressure drugs. It is challenging to know the types of drugs that are effective. There is a need to determine the cause to select the right medicine to use in control hypertension. Secondly, drug interaction needs to be investigated since patient AO is put on many medications. It is essential to start the patient on low dosages then increase the amount steadily to avoid toxicity. Additionally, Patient AO’s loss of weight should be part of the plan of treatment.

In older adults, to help ensure the dosages are prescribed as per the age, it will be necessary to conduct renal function tests. This will help determine the drug dosage, optimize the patient’s hydration status, and be aware of the nephrotoxic drugs to be avoided (Peterson et al., 2018). Also, in the elderly, the use of SSRIs has been reported to have an increased risk of GI bleeding due to their antiplatelet properties. Because of this, the Sertraline for patient AO needs to be investigated for any potential risks before continuation (, & , 2019).

In conclusion, I will recommend the entire medication regimen be stopped. However, I would also suggest more investigations be conducted to find the source of hypertension, obesity, and hyperlipidemia to properly select the drugs in managing the conditions and promote quick healing.

Assignment: Pharmacotherapy for Cardiovascular Disorders NURS 6521

…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.

Photo Credit: Getty Images/Science Photo Library RF

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 for Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

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 of Assignment Pharmacotherapy for Cardiovascular Disorders NURS 6521

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 (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

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Grading Criteria

Pharmacotherapy for Cardiovascular Disorders

Patient AO has gained nine pounds of weight and is diagnosed with hyperlipidemia and hypertension. These patients require an effective plan of treatment to help them manage their health. Both hyperlipidemia and hypertension are connected, and one is a risk factor of the other. Using this case, it is evident that the treatment plan is not working out for patient AO. This is because the patient is still having weight gain and is diagnosed with two dangerous cardiovascular conditions. Approximately seventy million in the United States are diagnosed with hypertension. This translates to about one in every three people, and the statistics are not good (Arcangelo et al., 2017).

Impact of Age on Pharmacodynamics and Pharmacokinetics

In this scenario, the patient is suffering from three problems; high cholesterol level, high blood pressure, and obesity. As people age and need treatment, there is a need to understand the pharmacodynamics and pharmacokinetics in old age (Sera & Uritsky). As one ages, the process of drug absorption, metabolisms, distribution, and excretion are drastically decreased. Due to the decrease in hepatic flow in older people, the rate of drug metabolism by the hepatic cells is lowered. Therefore, drugs having high extraction ratios will have an increase in bioavailability. Therefore, to avoid drug toxicity, initial dosages of medicines need to be given to older patients. It is critical to note that aging also affects renal functions by reducing its excretory function. Hence, these factors show how healthcare providers need to know the dosage prescription for older patients.

Besides, older people are also marked with decreased gastric emptying, slow peristalsis, and colonic transit. These physiological changes in old age affect the rate of absorption (Arcangelo et al., 2017). It is essential to note that factors such as height, weight, behavioral characteristics, and weight are considered before selecting drugs and other treatment plans.

When the drug reaches its targeted site, the pharmacodynamics processes are triggered (Jaobson, 2013). When the drug comes to its targeted site, old age could alter the pharmacodynamics because of the changes in the binding site, differences in the post-receptor effects, and chemical interactions (Durakovic & Vitezic, n.d). The magnitude of drug response is dependent on other parameters. They include the receptors’ density, the affinity of the receptors to the drug, and the signal transduction pathways.

How to Improve the Patient’s Drug Therapy Plan

In determining the best treatment plan for the patient, detailed history taking should be conducted, more laboratory tests such as blood chemistry, EKG, liver, and renal function tests need to be undertaken. It is also noted that patient AO is on several blood pressure drugs (Topinková et al., 2012). It is challenging to know the types of drugs that are effective. There is a need to determine the cause to select the right medicine to use in control hypertension. Secondly, drug interaction needs to be investigated since patient AO is put on many medications. It is essential to start the patient on low dosages then increase the amount steadily to avoid toxicity. Additionally, Patient AO’s loss of weight should be part of the plan of treatment.

In older adults, to help ensure the dosages are prescribed as per the age, it will be necessary to conduct renal function tests. This will help determine the drug dosage, optimize the patient’s hydration status, and be aware of the nephrotoxic drugs to be avoided (Jacobson, 2013). Also, in the elderly, the use of SSRIs has been reported to have an increased risk of GI bleeding due to their antiplatelet properties (Carlo & Alpert, 2015). Because of this, the Sertraline for patient AO needs to be investigated for any potential risks before continuation.

In conclusion, I will recommend the entire medication regimen be stopped. However, I would also suggest more investigations be conducted to find the source of hypertension, obesity, and hyperlipidemia to properly select the drugs in managing the conditions and promote quick healing.

References

Arcangelo, V.P., Peterson, A.M., Wilbur, V., & Reinhold, J.A. (2017). Pharmacotherapeutics for Advanced Practice. A Practical Approach. (4th Ed.). Philadelphia, PA: Wolters Kluwer

Carlo, A. D., & Alpert, J. E. (2015). Geriatric Psychopharmacology: Pharmacokinetic and Pharmacodynamic Considerations. Psychiatric Annals, 45(7), 336. Doi: 10.3928/00485713-20150626-04

Durakovic, Z., & Vitezic, D. (n.d). Pharmacodynamics and pharmacokinetics in the elderly. Periodicum Biologorum, 115(4), 517-520.

Jacobson, S. (2013). Effects of pharmacokinetic and pharmacodynamic changes in the elderly. Psychiatric Times, (1),

Sera, L., & Uritsky, T. (2016). Pharmacokinetic and pharmacodynamic changes in older adults and implications for palliative care. Progress in Palliative Care, 24(5), 255-261. doi:10.1080/09699260.2016.1192319

Topinková, E., Baeyens, J.P., Michel, J.P. et al. (2012). Evidence-Based Strategies for the Optimization of Pharmacotherapy in Older People. Drugs Aging 29, 477–494. https://doi.org/10.2165/11632400-000000000-00000

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Week 2 Assignment Rubric

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Week 2 Assignment

What’s Coming Up in Week 3?

 

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will examine strategies for the treatment and management of respiratory disorders, including asthma. You will analyze asthma and stepwise management and consider the impact of this approach for patient health.

Next Week

To go to the next week:

Week 3

 

Week 3: Respiratory System

Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

Learning Objectives

Students will:

Evaluate drug therapy plans for asthma
Assess the impact of asthma treatments on patients
Analyze the stepwise approach to asthma treatment and management

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Chapter 62, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 557–579)
Chapter 63, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 580–588)

Document: APA Presentation Template

 

Optional Resources (click to expand/reduce)

 

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

 

This web resource presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.

Week 2: Cardiovascular System

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

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 33, “Review of Hemodynamics” (pp. 285–289)
  • Chapter 37, “Diuretics” (pp. 290–296)
  • Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
  • Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
  • Chapter 40, “Vasodilators” (pp. 313–317)
  • Chapter 41, “Drugs for Hypertension” (pp. 316–324)
  • Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
  • Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
  • Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
  • Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
  • Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)
Required Media (click to expand/reduce)

Cardiovascular Disorders

Meet Dr. Norbert Myslinski as he discusses ACE inhibitors, angiotensin inhibitors, beta-blockers, calcium channel blockers, and diuretics as different categories of hypertension drugs. What potential drugs might be best recommended for patients suffering from hypertension? (8m)

 

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6521_Week2_Assignment_Rubric
Grid View
List View
Excellent Good Fair Poor
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
23 (23%) – 25 (25%)
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
20 (20%) – 22 (22%)
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
0 (0%) – 17 (17%)
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
27 (27%) – 30 (30%)
The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.

Accurate, complete, and aligned examples are provided to support the response.
24 (24%) – 26 (26%)
The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.

Accurate examples may be provided to support the response.
21 (21%) – 23 (23%)
The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.

Inaccurate or vague examples are provided to support the response.
0 (0%) – 20 (20%)
The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.

Inaccurate and vague examples may be provided to support the response, or is missing.
Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
27 (27%) – 30 (30%)
The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.

The response includes an accurate and detailed explanation to support the recommended improvements.
24 (24%) – 26 (26%)
The response accurately explains how to improve the patient’s drug therapy plan.

The response may include an accurate explanation to support the recommended improvements.
21 (21%) – 23 (23%)
The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.

The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.
0 (0%) – 20 (20%)
The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.

The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 (5%) – 5 (5%)
Uses correct APA format with no errors
4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100
Name: NURS_6521_Week2_Assignment_Rubric

NURS_6521_Week2_Assignment_Rubric

Excellent Good Fair Poor
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Points Range: 23 (23%) – 25 (25%)
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 20 (20%) – 22 (22%)
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 0 (0%) – 17 (17%)
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Points Range: 27 (27%) – 30 (30%)
The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.

Accurate, complete, and aligned examples are provided to support the response.

Points Range: 24 (24%) – 26 (26%)
The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.

Accurate examples may be provided to support the response.

Points Range: 21 (21%) – 23 (23%)
The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.

Inaccurate or vague examples are provided to support the response.

Points Range: 0 (0%) – 20 (20%)
The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.

Inaccurate and vague examples may be provided to support the response, or is missing.

Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
Points Range: 27 (27%) – 30 (30%)
The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.

The response includes an accurate and detailed explanation to support the recommended improvements.

Points Range: 24 (24%) – 26 (26%)
The response accurately explains how to improve the patient’s drug therapy plan.

The response may include an accurate explanation to support the recommended improvements.

Points Range: 21 (21%) – 23 (23%)
The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.

The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.

Points Range: 0 (0%) – 20 (20%)
The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.

The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100
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