NURS 6521 week
NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics
Advanced practice nurses will be working with a multitude of individuals and it is important for an advance practice nurse to know and understand pharmacokinetics and pharmacodynamics of the different medications that they will be prescribing throughout their career. According to Rosenthal and Burchum (2018), pharmacokinetics is the study of drug movement throughout the body and pharmacodynamics is the study of the biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced. Pharmacokinetics involves four basic processes which includes absorption, distribution, metabolism, and excretion (Rosenthal & Burchum, 2018).
A 68-year old female comes to the hospital because she is feeling flushed and just not feeling like herself. Upon examination the patient is hypertensive and slightly tachycardic. The patient does not have any complaints of pain. The patient has a health history of anxiety, depression, COPD, hypertension, and chronic kidney disease. The patient is being admitted for hypertensive crisis. The patient takes a serotonin reuptake inhibitor for her depression, an ace inhibitor for her hypertension.
One factor to consider while treating this patient is their chronic kidney disease. The chronic kidney disease could be one reason that the patient is having uncontrolled hypertension and will also need to be considered when treating this patient with new medications. A second factor could be the patient’s compliance with medication regimen at home. A third reason could be environmental exposure.
One of the first things that would need to be done would be to ask the patient about her compliance with her home medication regimen. It would be important to obtain a renal function panel to determine if the patient was in acute renal failure. After this information is obtained a better plan of care could be made for the patient’s long-term treatment.
If a patient is having acute kidney failure or injury the alterations of drug responses are attributed to pharmacokinetics and that at least 50% of all essential medications are influenced by kidney dysfunction (Keller & Hann, 2018). The four basic processes of pharmacokinetics play a major role in renally compromised patients. All four phases involve movement and if one phase is compromised it can cause a disruption in the effectiveness of the medication.
Environmental exposures can also be taken into consideration when considering the pharmacokinetics and pharmacodynamics of the effectiveness of a medication. In a recent study it was shown that environmental pollutants such as pesticides can alter drug-metabolizing enzymes, as well as pharmacokinetics of drug metabolism (Banerjee, 2020).
In conclusion, having the full details of this patient’s case would be beneficial in determining a full treatment plan. After the hypertensive crisis was under control then I would continue with the patient’s home dose and continue to monitor the patient. The patient may need to have an increase in their medication, or they may need to add in a secondary medication for hypertension.
References
Banerjee, et al. (01/17/2020). Effect of environmental exposure and pharmacogenomics of drug metabolism.
DOI: https://doi.org/10.2174/1389200221666200110153304
Keller, F., & Hann, A. (2018). Principles of drug response and alterations in kidney disease.
Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.
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.
Photo Credit: Getty Images/Ingram Publishing
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.
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 “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
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