Pharmacokinetics and Pharmacodynamics
The therapeutic effectiveness of drugs is influenced by factors that affect pharmacokinetics and pharmacodynamics properties, including age, gender, diet, drug interactions, body weight, and genetics. In my past practice, I observed how patient factors influence the pharmacokinetics and pharmacodynamics of drugs while working with the geriatric population. In particular, I was involved in a case of a 79-year-old female patient with depression with anxiety, hypertension, and osteoarthritis. Older patients experience changes in homeostatic mechanisms and response to stimulation because of the biological changes in the body, influencing pharmacokinetics and pharmacodynamics (Glassman & Muzykantov, 2019). These changes increase the susceptibility to the side effects of some drugs, reduce drug effectiveness, and cause issues with the rates of absorption and elimination of some drugs. In my patient case scenario, the patient had been using warfarin to enhance blood flow. Additionally, the patient was on alprazolam to relieve symptoms of anxiety. As a result of these medications, the patient experienced falls due to impaired coordination from alprazolam and bleeding as a side effect of warfarin instead of showing improvements.
Given these reactions, the personalized care plan would involve replacing warfarin with rivaroxaban, supported by evidence for its effectiveness and safety with the adult population (Hou et al., 2020). The recommended dose for reducing the risk of stroke and other cardiovascular events is 2.5 mg twice daily. However, I will start with a lower dose of 2.5 mg daily and observe the patient’s drug tolerability. A lower dose is recommended in the geriatric population to reduce the risk of bleeding and other adverse events (Maanen et al., 2019). Similarly, I would replace alprazolam to eliminate the risk of adverse events. Apart from undesirable side effects in older adults, alprazolam also poses the risk of drug dependence and should not be used for long (Gerlach et al., 2018). The patient had been using the drug for only two weeks. As an alternative, I would prescribe sertraline, which has a proven safety profile and effectiveness with older adults.
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References
Gerlach, L. B., Wiechers, I. R., & Maust, D. T. (2018). Prescription Benzodiazepine Use Among Older Adults: A Critical Review. Harvard review of psychiatry, 26(5), 264–273. https://doi.org/10.1097/HRP.0000000000000190.
Glassman, P. M., & Muzykantov, V. R. (2019). Pharmacokinetic and Pharmacodynamic Properties of Drug Delivery Systems. The Journal of pharmacology and experimental therapeutics, 370(3), 570–580. https://doi.org/10.1124/jpet.119.257113.
Hou, H., Li, A., Zhang, L., Qin, X., Jiang, Y., & Zhao, H. (2020). Analysis of Effectiveness, Safety, and Bleeding Related to Rivaroxaban in Elderly Patients. Clinical and Applied Thromosis, Vol 26. https://doi.org/10.1177/1076029620925923.
Maanen, A. C.-v., Wilting, I., & Jansen, P. (2019). Prescribing medicines to older people—How to consider the impact of ageing on human organ and body functions. British Journal of Clinical Pharmacology, https://doi.org/10.1111/bcp.14094.
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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| Excellent | Good | Fair | Poor | ||
| Main Posting | 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
35 (35%) – 39 (39%)
Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
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| Main Post: Timeliness | 10 (10%) – 10 (10%)
Posts main post by day 3 |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not post by day 3 |
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| First Response | 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
15 (15%) – 16 (16%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
13 (13%) – 14 (14%)
Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
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| Second Response | 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
12 (12%) – 13 (13%)
Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. . Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
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| Participation | 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days |
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| Total Points: 100 | |||||
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