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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.

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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

Discussion Post. Respond to this discussion . 2 citations APA 7th edition

Advanced nurse practitioners need to be knowledgeable about pharmacokinetics and pharmacodynamics when assisting in the diagnosis and treatment of disorders. Pharmacodynamics explains the relationship between drug concentration and drug response and pharmacokinetics describes the relationship between the rates of change of drug concentrations in various parts of the body (Corrie & Hardman, 2020). The purpose of this discussion is to review a patient’s case that was observed and examine how pharmacokinetic and pharmacodynamic factors alter the patient’s response to a drug administered and what the patient’s personalized plan of care entails.  Patient Case.  The patient a 70-year-old was admitted for community-acquired pneumonia (CAP). The patient had a history of alcohol abuse and chronic kidney disease, but no dialysis had been started yet. The patient had a low-grade fever (temperature was 99.5), occasional coughing, and no complaints of pain. Blood work was ordered which revealed elevated white blood cells, creatine, and BUN levels. After blood cultures were drawn, antibiotics were ordered and started.  Factors Affecting the Patient’s Pharmacokinetic and Pharmacodynamic Processes  Levofloxacin (a fluoroquinolone antibiotic) was ordered to be given intravenously. For elderly patients, with renal impairment, dosage adjustments should be necessary to prevent drug-related toxicity because levofloxacin is primarily renally eliminated as an unchanged moiety (Cojutti et al., 2017). When prescribing new medications particularly for the elderly, extra consideration should be taken and monitoring done for expected and adverse effects (Cojutti et al., 2017). The physiological changes of aging have a substantial impact on prescribing practices for the elderly, thus beginning a new medication at low doses and gradually increasing it, takes into account the potential of an increased effect or toxicity of the drug, and the impact of decreased elimination, altered volume of distribution and longer half-life (McKearney & Coleman, 2020).  Plan of Care  The plan of care for the patient would include laboratory monitoring to monitor for deteriorating renal function, regular medication review to assess the effectiveness of the drug, and any adverse effects.  Nonessential polypharmacy would be avoided, and holistic therapeutic care provided to the patient (McKearney & Coleman, 2020). Ensuring that the patient is safe and frequently educated on any therapy changes will be attained.  

References  Cojutti, P. G., Ramos-Martin, V., Schiavon, I., Rossi, P., Baraldo, M., Hope, W., & Pea, F. (2017). Population Pharmacokinetics and Pharmacodynamics of Levofloxacin in Acutely Hospitalized Older Patients with Various Degrees of Renal Function. Antimicrobial agents and chemotherapy, 61(3), e02134-16. https://doi.org/10.1128/AAC.02134-16.

  Corrie, K., & Hardman, J. G. (2020). Mechanisms of drug interactions: pharmacodynamics and pharmacokinetics. Anaesthesia & Intensive Care Medicine, 21(5), 219–222.  McKearney, K., & Coleman, J. J. (2020). 

Prescribing medicines for elderly patients. Medicine, 48(7), 463–467. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mpmed.2020.04.004    

 

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