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Posted: April 4th, 2019
NURS 6521 Week 1 Discussion: Exploring Pharmacokinetics and Pharmacodynamics
NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics
Advanced practice nurses are entrusted with the care of diverse individuals, making it imperative for them to possess a comprehensive understanding of pharmacokinetics and pharmacodynamics. Rosenthal and Burchum (2018) define pharmacokinetics as the investigation of drug movement within the body, while pharmacodynamics pertains to the study of drugs’ biochemical and physiological impacts on the body, along with the molecular mechanisms responsible for those effects. The fundamental aspects of pharmacokinetics include absorption, distribution, metabolism, and excretion (Rosenthal & Burchum, 2018).
Consider a case involving a 68-year-old female admitted to the hospital due to feeling flushed and unwell. The patient presents with hypertension and slight tachycardia, with a medical history comprising anxiety, depression, COPD, hypertension, and chronic kidney disease. The primary reason for admission is hypertensive crisis. Notably, the patient takes a serotonin reuptake inhibitor for depression and an ACE inhibitor for hypertension.
Several crucial factors come into play when treating this patient. Firstly, her chronic kidney disease must be considered, as it could contribute to her uncontrolled hypertension and influence her response to new medications. Secondly, her adherence to the prescribed medication regimen at home warrants evaluation. Lastly, environmental exposures might also be contributing to her condition.
The initial step would involve assessing the patient’s compliance with her home medication regimen. Simultaneously, obtaining a renal function panel to identify acute renal failure would be paramount. Armed with this data, a more informed and effective long-term treatment plan could be devised.
In cases of acute kidney failure or injury, alterations in drug responses are largely attributed to pharmacokinetics. Notably, around 50% of essential medications are affected by kidney dysfunction (Keller & Hann, 2018). All four stages of pharmacokinetics play a pivotal role in patients with compromised renal function. The disruption of any phase can hinder the medication’s efficacy.
Moreover, environmental exposures must be considered in the context of pharmacokinetics and pharmacodynamics. Recent research highlights the influence of environmental pollutants, such as pesticides, on drug-metabolizing enzymes and the pharmacokinetics of drug metabolism (Banerjee, 2020).
In conclusion, comprehending the entirety of the patient’s case is essential for formulating a comprehensive treatment plan. After stabilizing the hypertensive crisis, it would be prudent to maintain the patient’s home dose and closely monitor her condition. Adjustments to the medication dose or the addition of a supplementary hypertensive agent might be necessary (NURS 6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics).
References:
Banerjee, et al. (01/17/2020). Effect of environmental exposure and pharmacogenomics of drug metabolism. DOI: https://doi.org/10.2174/1389200221666200110153304
Bates, D. W., et al. (2019). Drug-induced diseases. (9th ed.). Philadelphia, PA: Wolters Kluwer.
Katzung, G. W., et al. (2020). Basic and clinical pharmacology (14th ed.). New York, NY: McGraw-Hill Education.
Keller, F., & Hann, A. (2018). Principles of drug response and alterations in kidney disease. CJASN September 2018, 13 (9) 1413-1420; DOI: https://doi.org/10.2215/CJN.10960917
Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.
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