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42067 Please use the references in the learning resources. Thank you.
Discussion: 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 pharamcodynamic 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. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.
To prepare:
Review this week’s media presentation with Dr. Terry Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Weitzel et al (2014) article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last five years. Select a case from the last five years that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.
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.
Required Readings
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 2, “Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles” (pp. 17-31)
This chapter examines concepts related to pharmacokinetics and pharmacodynamics. It also explores patient factors that health care providers consider when prescribing drug therapy to patients.
Chapter 3, “Impact of Drug Interactions and Adverse Events on Therapeutics” (pp. 33-51)
This chapter explains drug-drug, drug-food, drug-herb, and drug-disease interactions. It also reviews patient factors that influence drug interactions and then covers adverse drug reactions.
Chapter 4, “Principles of Pharmacotherapy in Pediatrics” (pp. 53-63)
This chapter explores concepts relating to drug selection, administration, and interaction for pediatric patients. It also compares age-related pharmacokinetic differences in children and adults.
Chapter 6, “Principles of Pharmacotherapy in Elderly Patients” (pp. 73-89)
This chapter describes issues and factors that affect drug therapy for elderly patients. It then explores concepts relating to drug selection, administration, and management for elderly patients.
American Geriatric Society 2015 Beers Criteria Update Expert Panel. (2015). American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. Retrieved February 25, 2019, from https://www.sigot.org/allegato_docs/1057_Beers-Criteria.pdf
This article is an update to the Beers Criteria which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug–drug interactions documented to be associated with harms in older adults.
Weitzel, K. W., Elsey, A. E., Langaee, T. Y., Benjamin, B., Nessl, D. R., Obeng, A. W.,…Johnson, J. A. (2014). Clinical pharmacogenetics implementation: Approaches, successes, and challenges. American Journal of Medical Genetics, 0(1): 56–67. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076109/
Drugs.com. (2012). Retrieved August 22, 2012, from http://www.drugs.com/
This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.
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