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Past clinical experiences where a patient’s pharmacokinetic and pharmacodynamic processes

Posted: May 5th, 2020

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.
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.

_________________________
Past clinical experiences where a patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.

I was working as a nurse in a hospital when I was assigned to care for a 75-year-old man who had been admitted with pneumonia. The patient was taking a number of medications, including antibiotics, pain medication, and a blood thinner.

One day, the patient’s blood thinner levels were found to be dangerously high. The doctor ordered a reduction in the patient’s dose, but the levels continued to rise.

I reviewed the patient’s chart and found that he had a number of factors that could have been contributing to the high blood thinner levels. These factors included:

Age: Older adults tend to metabolize drugs more slowly than younger adults.
Weight: The patient was overweight, which can also slow down drug metabolism.
Liver disease: The patient had liver disease, which can also affect drug metabolism.
Medication interactions: The patient was taking a number of other medications, some of which could have been interacting with the blood thinner.

Based on this information, I developed a personalized plan of care for the patient. This plan included:

Reducing the patient’s dose of the blood thinner even further.
Monitoring the patient’s blood thinner levels closely.
Educating the patient about the importance of taking his medications as prescribed and avoiding any changes to his diet or lifestyle without first talking to his doctor.

With this plan in place, the patient’s blood thinner levels were able to be brought under control.

This case highlights the importance of considering a patient’s individual pharmacokinetic and pharmacodynamic processes when prescribing medications. By taking these factors into account, we can help to ensure that patients receive the correct doses of medications and that they are at a lower risk of experiencing adverse drug reactions.

Here are some additional factors that can influence pharmacokinetic and pharmacodynamic processes:

Gender: Men and women metabolize drugs differently. For example, women tend to have a higher percentage of body fat than men, which can affect the distribution of drugs in the body.
Ethnicity: Some ethnic groups, such as African Americans, tend to be more sensitive to certain drugs than others.
Genetics: People with certain genetic mutations may be more or less likely to metabolize drugs effectively.
Disease: Diseases such as liver or kidney disease can affect the way the body processes drugs.
Medication interactions: Some drugs can interact with each other, which can affect their absorption, distribution, metabolism, or excretion.

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