Assignment: 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.

Assignment: 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.

Assignment: 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.

Pharmacokinetics and Pharmacodynamics

            The reaction of drugs in different people varies significantly. Pharmacokinetics and pharmacodynamics are two terms used to describe a drug’s response in the body. Pharmacokinetics is how the drug moves throughout the body. On the other hand, pharmacodynamics refers to the effects of the drug on the body. Sometimes the desired outcomes are not achieved upon administering a medication to a patient with a particular condition. This discussion will focus on an 87-year -old African-American female presented in the clinical practice with a history of bipolar disorder and other medical conditions. It will include pharmacokinetics and pharmacodynamics processes. Finally, a personalized plan of care will be included.

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            The client is an 87-year -old African-American female who was struggling with bipolar disorder. Additionally, she had a history of hypertension, dyslipidemia, diabetes, and gout. She was transferred from another clinic due to lithium toxicity and health deterioration. The client was alert when she was admitted to the psychiatric unit. An altered level of consciousness was the primary clinical presentation of this client. She was administered several medications while at home, including Lithium 300 mg twice a day, hydrochlorothiazide 25mg daily, Metformin 75 Mg daily, 10 units of Lantus insulin every night, and Crestor 20mg daily. Pharmacokinetic and Pharmacodynamics processes were reflected in the way drugs were working in the body.

            Pharmacokinetic involves various processes, including absorption, distribution, and excretion of a particular drug (Currie, 2018). Several factors influence the response of a patient’s body to drug administration. First, the patient’s age impacts the rate of glomerular filtration falls. Aging slows down the functioning of various body systems and organs. Therefore, the patient’s age (87 years) is the primary cause of lithium toxicity and health deterioration.

For this reason, her metabolism should be monitored regularly. On the other hand, the Pharmacodynamics process begins when the drug reaches the target tissue (Holford, 2018). The drug can have effects on the patient postsynaptic or presynaptic or might entail enzyme inhibition. Various processes, including drug-receptor binding, cellular response, and signal transduction, influence the movement of these. The patient’s family stated that she was continuing with her medications, including lithium 300 mg twice a day. The client did not present severe lithium toxicity symptoms such as vomiting, nausea, confusion, and coma. However, her lithium level was 2.9mmol/L, which was relatively high. The Elderly’s average lithium level ranges from 0.5 to 0.8mmol/L (De Fazio et al., 2017). Thus, a lower therapeutic is recommended for elderly patients to maintain the required serum level.                 

The personalized plan of care will focus on addressing all medical issues presented by this client. First, her medical care management will be transferred to the main hospital since my unit does not treat medical illnesses but rather focuses on the evaluation and management of various psychiatric conditions. In particular, nursing care will be involved to manage lithium toxicity in this patient. The dosage of lithium for this patient will be lowered. Additionally, the patient and her family will be educated on managing her condition after being discharged. The symptoms and signs that require reporting will be emphasized to prevent the client from further complications or even death. Furthermore, monitoring lithium levels weekly until the patient’s serum level stabilizes will be involved in this care plan. Upon stabilization, follow-up will be scheduled monthly, which will be rescheduled to two months later depending on the client’s progress. This follow-up will continue for the next six months following the discharge. This care plan’s overall goal is to manage lithium toxicity by increasing the level of fluids in the body to restore various processes, including normalizing urine output and improving glomerular filtration rate. These processes will enhance the clearance of lithium from the body without the need for dialysis.

References

Currie, G. M. (2018). Pharmacology, part 2: introduction to pharmacokinetics. Journal of nuclear medicine technology, 46(3), 221-230.

De Fazio, P., Gaetano, R., Caroleo, M., Pavia, M., De Sarro, G., Fagiolini, A., & Segura-Garcia, C. (2017). Lithium in late-life mania: a systematic review. Neuropsychiatric disease and treatment, 13, 755.

Holford, N. (2018). Pharmacodynamic principles and the time course of delayed and cumulative drug effects. Translational and clinical pharmacology, 26(2), 56.

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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.
Discussion:
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.

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