Promoting Positive Outcomes of Drug Therapy Discussion

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Promoting Positive Outcomes of Drug Therapy 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. NEED at least 3 REFERENCES

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DISCUSSION POST INSTRUCTIONS

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. Promoting Positive Outcomes of Drug Therapy Discussion

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.

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. Promoting Positive Outcomes of Drug Therapy Discussion 

RESOURCES:

  • Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
    • Chapter 1, “Prescriptive Authority” (pp. 1–3)
    • Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
    • Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
    • Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
    • Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
    • Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
  • American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics SocietyDownload Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767 Promoting Positive Outcomes of Drug Therapy Discussion

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

  • Drug Enforcement Administration. (2021). CFR – Code of Federal Regulations Title 21Links to an external site.. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300 Promoting Positive Outcomes of Drug Therapy Discussion

This website outlines the code of federal regulations for prescription drugs.

  • Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by stateLinks to an external site.. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

  • Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designationsLinks to an external site.. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

  • Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner studentsLinks to an external site.. Journal of the American Association of Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator. Promoting Positive Outcomes of Drug Therapy Discussion

Discussion Post

Nurses come across various patients with different clinical needs, thus the need to understand medication pharmacodynamics and pharmacokinetics during prescription. Rosenthal and Burchum(2021) postulate that clinical pharmacokinetics is essential since it enhances patient drug therapy efficacy and decreases toxicity. Pharmacodynamics refers to physiologic and biochemical drug effects on an individual’s body and the effects caused by this relationship. The discussion post will focus on patient care experience, pharmacokinetic and pharmacodynamic factors influencing the patient, and the personalized plan care for the patient

Patient Case Experience

The patient case experience is with a 70-year-old Caucasian female who presented to our clinic. The patient’s chief complaint was, “I am not feeling okay.” After examining her, it was evident that the patient was hypertensive and experienced sinus tachycardia but did not experience pain. However, her history proved that she had previously had medical issues, including chronic obstructive pulmonary disease, chronic kidney disease, hypertension, and depression. At admission, due to her hypertensive condition, the patient took ace inhibitor and serotonin reuptake inhibitor for hypertension and depression consecutively.Promoting Positive Outcomes of Drug Therapy Discussion

Pharmacokinetic and Pharmacodynamic Factors Influencing the Patient

The patient’s chronic kidney is necessary to determine the patient’s pharmacokinetic and pharmacodynamic effects on the patient. According to Pugh et al. (2019), chronic kidney disease is a common cause of uncontrolled hypertension, with their interaction having an adverse effect which may lead to adverse cardiovascular conditions. Hence, it will be necessary to consider these situations when administering new medications to the patient. Also, it is necessary to assess the patient’s compliance with medication.

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Personalized Plan Care for the Patient

The best-personalized care for the patient will be through admitting her to monitor how she takes medication and how they interact (Reddy et al., 2020). Close patient monitoring will help the nurses realize when the medication regimen fails and intervene to prevent adverse effects. Promoting Positive Outcomes of Drug Therapy Discussion

Conclusion

Nurses must have all the patients’ information when dealing with pharmacokinetics and pharmacodynamics in clinical settings to have an effective treatment plan. That is because some diseases medication may affect the patient’s compliance. Hence by admitting the patient, it will be easier to monitor the patient closely to prevent adverse effects until she can stabilize. Promoting Positive Outcomes of Drug Therapy Discussion