NUR 6521 Expert review of Respiratory Medicine

APA style. Please follow all APA rules. No running head. Please use only peer-reviewed journals or articles as references. Use doi as indicated. No references older than five years. No books to be used as references. Thanks.

The patient is an 83-year-old White American man presenting to the clinic with increasing shortness of breath, wheezing and persistent cough and tightness of chest with a history of energy loss and unexplained loss of weight. The patient is diagnosed with Chronic obstructive pulmonary disease (COPD) and admitted to the emergency ward for treatment. COPD is a chronic disease characterized by the inflammation of the lungs due to obstructed airflow which makes it difficult to breath (Eapen et al., 2017).

Pharmacodynamics of bronchodilators involved in the treatment of COPD entails targeting the G-protein coupled receptor known as beta-2 receptor present in the airways of the lungs (Matera et al., 2018). The medication causes the relaxation of the smooth muscle of the airways as the beta-2 receptor is activated. NUR 6521 Expert review of Respiratory Medicine. Pharmacodynamics is influenced by the sensitivity and binding of the receptor, chemical interactions as well as post receptor effects. On the other hand, the pharmacokinetic factors that will influence the distribution, absorption, excretion and metabolism process will be fat solubility, water solubility, molecular weight and the degree of dissociation. More specifically, bronchodilators metabolism takes place in the gastrointestinal tract with about 20% excreted through feces and 80-10% through urine (Wang et al., 2019). The relationship between the response and dosage a drug is determined by the pharmacokinetic and pharmacodynamic factors.

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The personalized plan of care of the client will involve prevention and management of symptoms with the aim of improving his quality of life and wellbeing. It will involve the prescription of short-Acting Bronchodilators which will help loosen the muscles of the airways to improve breathing (Kopsaftis et al., 2018). This will also help in relieving sudden symptoms as they start to work in minutes and retain their effects for at least four hours. The inhaler given will be albuterol 2.5mg three to four times a day.

References

Eapen, M. S., Myers, S., Walters, E. H., & Sohal, S. S. (2017). Airway inflammation in chronic obstructive pulmonary disease (COPD): a true paradox. Expert review of respiratory medicine, 11(10), 827-839.

Kopsaftis, Z., Sulaiman, N., Carson, K., Mountain, O., Phillips, P., & Smith, B. (2018). Short-acting bronchodilators for in-hospital management of acute exacerbation of COPD: Systematic Review.

Matera, M. G., Rinaldi, B., Page, C., Rogliani, P., & Cazzola, M. (2018). Pharmacokinetic considerations concerning the use of bronchodilators in the treatment of chronic obstructive pulmonary disease. Expert Opinion on Drug Metabolism & Toxicology, 14(10), 1101-1111.

Wang, Y., Zhang, Q., Xie, L., Dembek, C., Kamble, P. S., & Ganapathy, V. (2019). Overuse of Short-Acting Bronchodilators and the Risk of Exacerbation Among Patients with Chronic Obstructive Pulmonary Disease (COPD) Treated with Nebulized Short-Acting Bronchodilators. In D101. CLINICAL AND TRANSLATIONAL STUDIES IN ASTHMA AND COPD (pp. A7100-A7100). American Thoracic Society. NUR 6521 Expert review of Respiratory Medicine.

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.

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. NUR 6521 Expert review of Respiratory Medicine.