Instructions
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.
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 the 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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There is a need for advanced practice nurses (APN) to have good knowledge of pharmacokinetics and pharmacodynamics as this is helpful in diagnosis and treatment functions. Knowledge of pharmacokinetics helps to describe the rate at which drug concentration changes in the different parts of the body, which knowledge of pharmacodynamics helps to explain the relationship between drug concentration and response (Smith, 2020). This discussion explores the use of pharmacokinetics and pharmacodynamics.
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years.
The patient case involved a 72-year-old man who had been living in poor condition and was diagnosed with community-acquired pneumonia. The patient had a history of alcohol and drug abuse. In addition, he had kidney disease but was not on dialysis. He did not complain of any pain, but occasionally coughed and had a low-grade fever. Laboratory bloodwork for the patient revealed that he had elevated levels of blood urea nitrogen (BUN test), creatine, and white blood cells. Antibiotics were ordered for the patient’s treatment as an inpatient.
Describe factors that might have influenced the pharmacokinetic and pharmacodynamic processes of the patient you identified.
Cefotaxime (Claforan) was intravenously administered. As an elderly patient with kidney disease, there was a need to adjust the medication dosage to prevent drug-related toxicity. Besides that, this is an elderly patient with physiological aging changes that must be taken into account in the prescription. For that matter, the medication may have to be started in low doses to monitor the effects and identify any adverse effects (Smith, 2020). Besides that, beginning with low dosage would take into account the increasing toxicity as the dosage increases, as well as the impact of reduced drug elimination, longer half-life, and altered distribution volume owing to aging (Yoost & Crawford, 2020).
Explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.
For this patient, the plan of care would entail administering the prescribed medication at low doses, in the beginning, monitoring the patient for adverse effects, such as changes in renal function, and assessing the drug effectiveness. In addition, non-essential medication would be stopped to improve renal function. Also, the patient would be frequently informed about the therapeutic changes achieved and how to remain safe (Willihnganz, Gurevitz & Clayton, 2020).
References
Smith, B. T. (2020). Pharmacology for Nurses (2nd ed.). Jones & Bartlett Learning, LLC.
Willihnganz, M., Gurevitz, S. L., & Clayton, B. D. (2020). Study Guide for Clayton’s Basic Pharmacology for Nurses (18th ed.). Elsevier Inc.
Yoost, B, L., & Crawford, L. R. (2020). Fundamentals of Nursing: Active Learning for Collaborative Practice (2nd ed.). Elsevier Inc.