NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS ESSAY

NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS ESSAY

NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS ESSAY

Discussion: Pharmacokinetics and Pharmacodynamics
My most vivid patient encounter included an 84-year-old man who had spent some time living in a long-term care institution. The patient was diagnosed with severe congestive heart failure, arthritis, hypertension, and hyperlipidemia. The patient also had a 25-year history of smoking and drinking, two past heart attacks, and other medical conditions. After being hospitalized, the patient received a prescription for metoprolol 25 mg, atorvastatin 40 mg, aspirin 325 mg, furosemide 40 mg daily, and acetaminophen 650 mg twice daily before being released after four days. But after eight days, the patient came back complaining of excruciating muscular pain, exhaustion, and anuria. Dehydration and rhabdomyolysis led to the patient’s readmission.
Individual bodily systems and functions alter as we get older, on average. The modifications impact the pharmacokinetics and pharmacodynamics of the drugs. For instance, one crucial factor to take into account is aging-related changes in metabolism. Older patients have a smaller liver and less blood flow to the liver. Drugs mostly metabolized by phase-1 hepatic pathways have decreased clearance due to alterations in metabolism (Li et al., 2019). Therefore, the pill was examined to see what caused the significant adverse effects given the patient’s condition and the recommended prescriptions. The medicine has a peak plasma concentration of one to two hours and a bioavailability of 14%, which is poor owing to substantial first-pass metabolism.
Atorvastatin is typically readily absorbed after oral administration (Takagi et al., 2020). The medicine is processed hepatically by cytochrome P450 3A4 (CYP3a4) and excreted via bile, with a distribution volume of 380 liters (Elnaem et al., 2020). The older patient may have had elevated plasma levels of atorvastatin, which may raise the risk of myopathies brought on by statins. Myopathies include muscular pain, soreness, and weakness; rhabdomyolysis, a side effect of atorvastatin brought on by reduced renal function, is a frequent myopathy. Combining atorvastatin with another prescription medicine may have raised the drug’s plasma levels, posing an elevated risk for myopathies and rhabdomyolysis. This indicates that the medicine was most likely to blame for the patient’s unpleasant side effects.

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The strategy for treating the older patient would be to discover a secure approach to reduce their cholesterol levels and then stop taking atorvastatin. To effectively reduce their cholesterol levels without taking statins, the therapy will include dietary adjustments and modest exercise (Takagi et al., 2020). A patient-specific diet that emphasizes reducing fat intake, boosting fiber intake, and consuming fresh fruits and vegetables will be given to the resident facility. cholesterol and saturated fats are often the dietary factors associated with heart disease (Elnaem et al., 2020). Fibrates will then be recommended to lower the body’s cholesterol production. Additionally, the patient will be urged and advised to cut down on alcohol use. After three months, the patient’s cholesterol levels will be reassessed to see how well the individualized treatment plan is doing.
References
Elnaem, M. H., Rosley, N. F. F., Alhifany, A. A., Elrggal, M. E., & Cheema, E. (2020). Impact of Pharmacist-Led Interventions on Medication Adherence and Clinical Outcomes in Patients with Hypertension and Hyperlipidemia: A Scoping Review of Published Literature. Journal of Multidisciplinary Healthcare, Volume 13, 635–645. https://doi.org/10.2147/jmdh.s257273
Li, Liu, Song, An, Zeng, Li, Jiang, Xie, & Wu. (2019). Characteristics of Gut Microbiota in Patients with Hypertension and/or Hyperlipidemia: A Cross-Sectional Study on Rural Residents in Xinxiang County, Henan Province. Microorganisms, 7(10), 399. https://doi.org/10.3390/microorganisms7100399
Takagi, T., Naito, Y., Kashiwagi, S., Uchiyama, K., Mizushima, K., Kamada, K., Ishikawa, T., Inoue, R., Okuda, K., Tsujimoto, Y., Ohnogi, H., & Itoh, Y. (2020). Changes in the Gut Microbiota are Associated with Hypertension, Hyperlipidemia, and Type 2 Diabetes Mellitus in Japanese Subjects. Nutrients, 12(10), 2996. https://doi.org/10.3390/nu12102996

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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 pharmacodynamic 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.For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To prepare:

Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.

Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.

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.

BY DAY 3 OF WEEK 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

BY DAY 6 OF WEEK 1

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

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NURS_6521_Week1_Discussion_Rubric

NURS_6521_Week1_Discussion_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeMain Posting

50 to >44.5 pts
Excellent

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. …Supported by at least three current, credible sources….Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

44.5 to >39.5 pts

Good

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. …At least 75% of post has exceptional depth and breadth. …Supported by at least three credible sources….Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

39.5 to >34.5 pts
Fair

Responds to some of the discussion question(s). …One or two criteria are not addressed or are superficially addressed. …Is somewhat lacking reflection and critical analysis and synthesis. …Somewhat represents knowledge gained from the course readings for the module. …Post is cited with two credible sources….Written somewhat concisely; may contain more than two spelling or grammatical errors. …Contains some APA formatting errors.

34.5 to >0 pts
Poor

Does not respond to the discussion question(s) adequately….Lacks depth or superficially addresses criteria. …Lacks reflection and critical analysis and synthesis. …Does not represent knowledge gained from the course readings for the module. …Contains only one or no credible sources….Not written clearly or concisely. …Contains more than two spelling or grammatical errors. …Does not adhere to current APA manual writing rules and style.

50 pts

This criterion is linked to a Learning OutcomeMain Post: Timeliness

10 pts
Excellent

Posts main post by day 3

0pts

Poor

Does not post by day 3

10 pts

This criterion is linked to a Learning OutcomeFirst Response

18 to >16.02 pts

Excellent

Response exhibits synthesis, critical thinking, and application to practice settings. …Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. …Demonstrates synthesis and understanding of learning objectives….Communication is professional and respectful to colleagues. ….Responses to faculty questions are fully answered, if posed. …Response is effectively written in standard, edited English.

16.02 to >14.22 pts
Good

Response exhibits synthesis, critical thinking, and application to practice settings. …Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. …Demonstrates synthesis and understanding of learning objectives….Communication is professional and respectful to colleagues. ….Responses to faculty questions are fully answered, if posed. …Response is effectively written in standard, edited English.

14.22 to >12.42 pts
Fair

Response is on topic and may have some depth….Responses posted in the discussion may lack effective professional communication. …Responses to faculty questions are somewhat answered, if posed. …Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

12.42 to >0 pts

Poor

Response may not be on topic and lacks depth….Responses posted in the discussion lack effective professional communication. …Responses to faculty questions are missing. …No credible sources are cited.

18 pts

This criterion is linked to a Learning OutcomeSecond Response

17 to >15.13 pts

Excellent

Response exhibits synthesis, critical thinking, and application to practice settings….Responds fully to questions posed by faculty. …Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. …Demonstrates synthesis and understanding of learning objectives….Communication is professional and respectful to colleagues. ….Responses to faculty questions are fully answered, if posed. …Response is effectively written in standard, edited English.

15.13 to >13.43 pts

Good

Response exhibits critical thinking and application to practice settings….Communication is professional and respectful to colleagues. …Responses to faculty questions are answered, if posed. …Provides clear, concise opinions and ideas that are supported by two or more credible sources. …Response is effectively written in standard, edited English.

13.43 to >11.73 pts

Fair

Response is on topic and may have some depth….Responses posted in the discussion may lack effective professional communication. …Responses to faculty questions are somewhat answered, if posed. …. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

11.73 to >0 pts
Poor

Response may not be on topic and lacks depth….Responses posted in the discussion lack effective professional communication. …Responses to faculty questions are missing. …No credible sources are cited.

17 pts

This criterion is linked to a Learning OutcomeParticipation

5 pts

Excellent

Meets requirements for participation by posting on three different days.

0 pts

Poor

Does not meet requirements for participation by posting on 3 different days

5 pts

Total Points: 100