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
1.Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
2.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.
3.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.
4.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.

Pharmacokinetic and Pharmacodynamics

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Pharmacokinetic and Pharmacodynamics

Introduction

Drugs can have multiple effects on the human body. The reaction of a drug in a body can be described in two terms: pharmacokinetics and Pharmacodynamics. The critical goal of clinical pharmacokinetics is to enhance the efficacy and decrease the toxicity of the patient’s drug therapy. The relationship between the concentration of drugs at the site of action and effects is referred to as Pharmacodynamics. These two processes on a patient have, in certain instances, altered the responses of her/him to drugs.

Case

There have been numerous times when I have given a drug to the patient and failed to meet the desired outcome.  One of the cases is an 83-year -old African-American female with a history of a bipolar disorder, and other medical issues. The patient had also had been exposed to neuroactive drugs as she was growing, which ultimately affected her central nervous systems, hence all responses to certain medications. As a result, the drugs she had been using often altered her moods, emotions, and behaviors by changing her brain chemistry and perceptions.   I was keen on ensuring that her therapy sessions, took into consideration this history, and ensured to incorporate medication that considered her psychiatric condition. In the course of her treatment, all the drugs had to be thoroughly analyzed and factor her sensitivity.

Both the pharmacokinetic and Pharmacodynamics affected his responses to the medication. The pharmacokinetic factors noted include his chemical absorption and distribution, his metabolism, and excretion, which significantly interfered with his response rate of the drugs administered to him (PHRMA foundation, 2020).  The pharmacodynamics factors also controlled her control of the cellular response to the chemicals in the drugs, which altered her response rate, more so considering his elderly age (Holford, 2020). As a result, the patient needs to have a personalized plan of care. There have been sizeable individual variability in the rate of aging that exists in humans. This hence leads to an increase in intersubjective variability in responding to the drugs as compared to the younger adults. This is a factor that has, therefore, influenced the pharmacokinetics and Pharmacodynamics process of the patient.

Treatment plan

There is a need to ensure that drugs that have multiple side effects to the patient are avoided. Precisely, naproxen and aspirin ought to be avoided and should not be co-administered. It is also clear that biological age is more relevant than the chronologic age. However, it is not always to obtain information that shows the biological age of an organ system (Holford, 2020). This is feasible for the key pharmacokinetic factors such as urine clearance and hepatic metabolism since they often determine the clinical pharmacokinetic studies. These indices can, therefore, be used in the drug dosage titration, which ultimately helps in attaining optimal activity and ensuring that there are minimal side effects in the elderly individuals, more so the current patient who experienced a narrow therapeutic index (Weerink, et al., 2017). There is also a need to avoid some antidepressants such as Lithium, which could make the patient’s condition worsen. Such drugs may also worsen or stimulate the episodes of the mania of the patient who has bipolar disorder.

Since the patient is elderly, there will be a need for Psychotropic medications, which helps him manage her behavior and psychiatric symptoms.  However, I always take into consideration her vulnerability due to her old age, where most of these medications have side effects and differentially affect older adults. In the treatment plan, there will also be a need be familiar with the group of drugs that best suit the patient, the side effects of these drugs,  and the impact they have on the patient’s pharmacodynamics and pharmacokinetics.

Conclusion

A patient’s pharmacokinetic and Pharmacodynamics processes may alter his or her response to a drug. In this case, the patient is an 83-year-old woman who has pre-existing conditions such as Bipolar and was also exposed to neuroactive medications as she was growing. Therefore, there is a need to ensure that her medication does not result in multiple side effects or more harm when administered. The history of the patient and other factors that could affect her health, also ought to be considered when administering the medication.

References

Holford, N. H. (2020). Pharmacokinetics & Pharmacodynamics: Rational Dosing & the Time Course of Drug Action. Retrieved from https://accessmedicine.mhmedical.com/content.aspx?bookid=2249&sectionid=175215748

PHRMA foundation. (2020). PHARMACODYNAMICS OF AGING. Retrieved from http://www.phrmafoundation.org/case-study-answers-and-discussion-pharmacodynamics-of-aging/

Weerink, M. A., Struys, M. M., Hannivoort, L. N., Barends, C. R., Absalom, A. R., & Colin, P. (2017). Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine. Clinical pharmacokinetics. 56(8), 893-913.