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Posted: July 16th, 2023
Discussion: Pharmacokinetics and Pharmacodynamics As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharamcodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug. To prepare: • Review this week’s media presentation with Dr. Terry Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics. • Reflect on your experiences, observations, and/or clinical practices from the last five years. Select a case from the last five years that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient. • Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease. • Think about a personalized plan of care based on these influencing factors and patient history in your case study. With these thoughts in mind: Post a description of the case you selected. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient from the case you selected. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. include 3 APA references
Case Study
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I once cared for a 75-year-old woman named Mrs. Jones who was admitted to the hospital with pneumonia. She was started on a course of antibiotics, but she did not seem to be responding well. Her white blood cell count was still elevated, and she was still coughing up green sputum.
I reviewed Mrs. Jones's chart and saw that she had a number of factors that could be affecting her response to the antibiotics. She was elderly, which can lead to decreased kidney function and slower metabolism. She was also taking a number of other medications, which could be interacting with the antibiotics.
I spoke with the doctor about Mrs. Jones's case, and we decided to change her antibiotic regimen. We also started her on a medication to help her cough up the mucus in her lungs. Within a few days, Mrs. Jones started to improve. Her white blood cell count went down, and she stopped coughing up green sputum.
Factors Affecting Pharmacokinetics and Pharmacodynamics
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There are a number of factors that can affect how a patient's body processes a drug. These factors include:
Age: Elderly patients often have decreased kidney function and slower metabolism, which can affect the way they absorb, distribute, metabolize, and excrete drugs.
Gender: Men and women can metabolize drugs differently, which can lead to different responses to medication.
Ethnicity: Some ethnic groups have different genetic variations that can affect how they metabolize drugs.
Weight: Obese patients may have a higher volume of distribution for some drugs, which can lead to higher blood levels.
Health status: Patients with certain health conditions, such as liver or kidney disease, may have decreased ability to metabolize drugs, which can lead to higher blood levels.
Diet: Certain foods can interact with drugs, which can affect how the body absorbs, distributes, metabolizes, and excretes them.
Alcohol: Alcohol can interact with many drugs, which can affect how the body absorbs, distributes, metabolizes, and excretes them.
Smoking: Smoking can increase the metabolism of some drugs, which can lead to lower blood levels.
Genetics: Some people have genetic variations that can affect how they metabolize drugs.
Personalized Plan of Care
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When caring for a patient, it is important to consider all of the factors that could be affecting their response to a drug. By taking these factors into account, you can develop a personalized plan of care that will help your patient achieve the best possible outcome.
Here are some tips for developing a personalized plan of care:
Assess the patient's individual needs: Talk to the patient about their medical history, current medications, and lifestyle habits. This will help you identify any factors that could be affecting their response to a drug.
Review the patient's medication regimen: Make sure the patient is taking the correct dose of the medication at the correct time. Also, check for any potential drug interactions.
Monitor the patient's response to the medication: Pay attention to the patient's symptoms and lab results. If the patient is not responding well to the medication, talk to the doctor about adjusting the dose or changing the medication altogether.
By taking the time to develop a personalized plan of care, you can help your patients achieve the best possible outcome from their medication therapy.
References
Arcangelo, T., & Peterson, D. (2022). Pharmacotherapeutics for advanced practice nurses. Elsevier.
Scott, L. (2021). Pharmacokinetics and pharmacodynamics. In Clinical pharmacology for advanced practice nurses (pp. 1-15). Springer, Cham.
Williams, B. (2020). Pharmacokinetics and pharmacodynamics: A clinical guide. Wolters Kluwer.
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