NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics Essay
NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics Essay
NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics Essay
Discussion: Pharmacokinetics and Pharmacodynamics
During the course of my regular clinical practice, I ran across a 14-year-old male patient who had been complaining of a sore throat for the previous three days. The patient had no prior history of ear infections, pneumonia, influenza, or repeated colds. He claimed he is allergy-free. Physical examination indicated that the patient’s posterior pharynx was red and that the patient’s tonsils had swelled. The strep test yielded positive findings. So, for ten days, he received the antibiotic amoxicillin 500 mg twice daily. After taking the first tablet, the patient started experiencing allergic symptoms, such as tongue and lip swelling, wheezing, and breathing difficulties. He did, however, obtain treatment for his allergic reaction after dialing for assistance. The pharmacokinetic and pharmacodynamic mechanisms that may have altered the patient’s response to amoxicillin are thoroughly discussed in this discussion.
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The patient’s HLA-B gene susceptibility may have had a role in the development of their penicillin allergy. A relationship between penicillin allergy and genetic risk factors, such as the HLA-B*55:01 allele, has been shown by genome-wide research (Krebs et al., 2020).Amoxicillin is a member of the penicillin group of substances, which are widely recognized as sensitive agents capable of inducing an allergic reaction of the anaphylactic type in susceptible individuals (Shenoy et al., 2019). The immune system of body developed a hypersensitivity to the medicine after the first dose (Lima et al., 2020). The patient’s immune system generated antibodies against amoxicillin after taking the medication a second time because it thought it was a dangerous material like a virus or bacterium. Chemicals generated during this exercise are to blame for symptoms including wheezing, swelling tongue and lips, and breathing problems.
Controlling allergic symptoms and desensitization to amoxicillin are the two main aspects of the patient’s therapy strategy. In the beginning, the patient will be told to stop taking the drug, and antihistamines such as diphenhydramine will be given to decrease the allergic response (Staicu et al., 2020). The inflammation will be brought under control by corticosteroids. Anaphylaxis treatment will need an immediate epinephrine injection, blood pressure monitoring, and patient breathing support. Azithromycin 500mg once a day for five days should be administered to patients with penicillin allergy. The patient will substitute this medication for amoxicillin.
References
Krebs, K., Bovijn, J., Zheng, N., Lepamets, M., Censin, J. C., Jürgenson, T., … & Fadista, J. (2020). Genome-wide study identifies an association between HLA-B∗ 55: 01 and self-reported penicillin allergy. The American Journal of Human Genetics, 107(4), 612-621. https://doi.org/10.1016/j.ajhg.2020.08.008
Lima, L. M., da Silva, B. N. M., Barbosa, G., & Barreiro, E. J. (2020). β-lactam antibiotics: An overview from a medicinal chemistry perspective. European Journal of Medicinal Chemistry, 208, 112829. https://doi.org/10.1016/j.ejmech.2020.112829
Shenoy, E. S., Macy, E., Rowe, T., & Blumenthal, K. G. (2019). Evaluation and management of penicillin allergy: a review. Jama, 321(2), 188-199. doi:10.1001/jama.2018.19283
Staicu, M. L., Vyles, D., Shenoy, E. S., Stone, C. A., Banks, T., Alvarez, K. S., & Blumenthal, K. G. (2020). Penicillin allergy Delabeling: a multidisciplinary opportunity. The Journal of Allergy and Clinical Immunology: In Practice, 8(9), 2858-2868. https://doi.org/10.1016/j.jaip.2020.04.059
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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.
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.
