NURS 6521 Pharmacokinetics and Pharmacodynamics

NURS 6521 Pharmacokinetics and Pharmacodynamics

Pharmacokinetics and Pharmacodynamics

To ensure the optimal administration of medication, it is imperative to conduct a comprehensive assessment of patients’ pharmacodynamic factors and pharmacokinetic processes before prescribing any drugs (Peeters et al., 2019). Whilst undertaking my nursing duties within a hospital setting, I encountered a 72-year-old female of Caucasian ethnicity who presented with mild symptoms of cardiac insufficiency. The laboratory results for the patient revealed elevated levels of creatinine at 1.56 mg/dl, which is indicative of renal dysfunction. The patient’s medical history indicated previous use of Digoxin.

The pharmacodynamic and pharmacokinetic processes of the patient are influenced by her advanced age. According to the American Geriatrics Society (2019), research indicates that aging impairs the regular operation of numerous bodily organs. The patient in the aforementioned case study exhibited heightened levels of creatinine, indicative of renal impairment. With age, the patient’s kidneys and liver were less able to get rid of the drug. This led to a decreased amount distribution and higher blood concentration of the drug. The process of aging is associated with a preeminent likelihood of patients exhibiting heightened sensitivity to medications such as digoxin.

The primary focus of the patient’s care plan will entail the modification of the patient’s digoxin dosage to achieve an optimal level that adheres to the safety parameters for geriatric patients. According to Abdel Jalil et al. (2021), Digoxin serum concentration should be between the ideal therapeutic range of 0.5 and 2 ng/dl. To mitigate the risk of digoxin toxicity in elderly patients with impaired renal function, it was imperative to conduct regular monitoring of their creatinine levels. The recorded creatinine level of the patient was elevated at 1.56 mg/dl. Therefore, it was imperative to perform titration of the digoxin dosage to achieve an optimal daily dose of 125mcg, while closely monitoring the levels of serum. The healthcare provider recommended that the patient contemplate lifestyle adjustments, such as engaging in physical activity, to enhance bodily functioning and facilitate a favorable treatment outcome.

References

Abdel Jalil, M., Abdullah, N., Alsous, M., & Abu-Hammour, K. (2021). Population Pharmacokinetic Studies of Digoxin in Adult Patients: A Systematic Review. European Journal of Drug Metabolism and Pharmacokinetics, 46(3), 325–342. https://doi.org/10.1007/s13318-021-00672-6

American Geriatrics Society. (2019). American geriatrics society 2019 updated AGS beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. https://doi.org/10.1111/jgs.15767

Peeters, L. E. J., Kester, M. P., Feyz, L., Van Den Bemt, P. M. L. A., Koch, B. C. P., Van Gelder, T., & Versmissen, J. (2019). Pharmacokinetic and pharmacodynamic considerations in the treatment of the elderly patient with hypertension. Expert Opinion on Drug Metabolism & Toxicology, 15(4), 287–297. https://doi.org/10.1080/17425255.2019.1588249

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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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