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.
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.
Full Answer Section
n addition, she was taking a number of other medications, which could be interacting with the antibiotics. I spoke with the patient's doctor and we decided to change her antibiotic regimen. We also started her on a proton pump inhibitor to protect her stomach from the side effects of the antibiotics.
The patient's condition improved after the medication changes. This case illustrates the importance of considering a patient's individual factors when prescribing medications. By taking these factors into account, we can improve the chances of a positive outcome.
Here are the factors that might have influenced the patient's pharmacokinetic and pharmacodynamic processes:
- Age: Elderly people tend to have slower metabolisms than younger people. This means that it takes longer for their bodies to break down drugs, which can lead to higher drug levels and increased risk of side effects.
- Gender: Women tend to have lower body weights than men, which means that they have less water in their bodies to dilute drugs. This can also lead to higher drug levels and increased risk of side effects.
- Ethnicity: Some ethnic groups, such as African Americans, may be more sensitive to certain drugs than other groups. This is due to genetic differences in how the body metabolizes drugs.
- Disease: People with certain diseases, such as liver disease, may have difficulty metabolizing drugs. This can lead to higher drug levels and increased risk of side effects.
- Behavior: Smoking and alcohol use can affect how the body absorbs, distributes, metabolizes, and excretes drugs. This can lead to higher drug levels and increased risk of side effects.
Here is a personalized plan of care that I would develop based on the influencing factors and patient history in this case:
- I would start the patient on a lower dose of the antibiotic than I would for a younger person.
- I would monitor the patient's drug levels closely to make sure that they are not too high.
- I would talk to the patient about their other medications to make sure that there are no interactions.
- I would encourage the patient to stop smoking and drinking alcohol.
By taking these factors into account, I can improve the chances of a positive outcome for this patient.
Sample Answer
Here is a case from my past clinical experiences where a patient's pharmacokinetic and pharmacodynamic processes altered his or her response to a drug:
I was working as an advanced practice nurse in a hospital setting when I was called to the bedside of a 75-year-old woman who was admitted with pneumonia. She was started on a course of antibiotics, but her condition did not improve. In fact, she seemed to be getting worse.
I reviewed her chart and saw that she had a number of factors that could be affecting her response to the antibiotics. She was elderly, which can affect how the body absorbs, distributes, metabolizes, and excretes drugs. She also had a history of liver disease, which can also affect drug metabolism.