The Drug Administration Assignment Discussion

Pharm WK 2 Assignment
Drug administration is crucial for nurse practitioners as they engage in their daily activities. That is because these nurses have to comprehend the pharmacokinetics and pharmacodynamics concepts to be in a position to understand ways drugs alter a patient’s body using the physiological perspective. That way, assessing patients and providing the most effective medication that may not trigger adverse effects becomes easy. The paper assesses a 74-year-old African American male, BN. The main areas to evaluate include explaining how the selected factor may influence pharmacodynamic and pharmacokinetic processes for the patient. The paper will also examine ways the process change may influence the patient’s recommended drug therapy. Lastly, there will be an explanation of ways to enhance the patient’s drug therapy plan and reasons for such recommendations. The Drug Administration Assignment Discussion

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How The Selected Factor May Influence Pharmacodynamic and Pharmacokinetic Processes for the Patient
Age is the factor selected that may impact BN’s pharmacodynamic and pharmacokinetic processes. According to Chapron et al. (2021), as individuals age, it becomes hard for their bodies to digest and dissolve drugs leading to increasing length of drug clearance rates and half-lives. Such results lead to medication accumulation within the patient’s body, increasing the chances of developing adverse consequences. For instance, it is possible for BN to experience issues with Lisinopril solubility since the drug’s bioavailability and uptake might impact it. Other drug medication issues impacted by BN’s age include how drugs interact within his body due to body makeup alterations, organ function, and metabolic activity.
As Partridge et al. (2020) postulate, there is a link between how patients respond to various medications and age. For example, when individuals age, they tend to experience kidney failure, which may result in the patient’s inability to function properly, thus failing to excrete drugs from the body system. Such an instance may lead the patient to drug poisoning. Consequently, aged individuals have instances of minimized intestinal blood circulation, which may reduce or delay medication absorption amount. As Partridge et al. (2020) accentuate, the elderly develop more fats as they grow compared to their young age, where these fats settle at areas within the abdomen. Such factor has been found to impact lipophilic medications diffusion, such as metoprolol greatly.
Ways The Processes Change May Influence the Patient’s Recommended Drug Therapy The Drug Administration Assignment Discussion
As individual ages, their pharmacodynamics and pharmacokinetic processes become affected due to the changes in their metabolism, organic function, and body composition (Damiani et al., 2020). The main cause is linked with PH rise that is associated with aging, leading to stomach clearing slowdown. In the case of BN, there is a possibility that the diminishing intestinal surface might influence the pharmacokinetic properties of his administered medications. An example is Lisinopril, whose absorption takes place when taken orally or when passed through the patient’s digestive system. In that case, the reduced stomach clearing may increase the amount of medicine absorbed within the digestive system. The only issue arises when there is a bioavailability reduction.
The lower intestines’ surface area can potentially reduce the available space for uptake. That is because when individuals ages, their bodies naturally have less body water which may impact the diffusion and uptake of various hydrophilic medications like digoxin (Damiani et al., 2020). However, BN can experience diffusion increase when taking lipophilic medications such as metoprolol, essential for his hypertension treatment. When such diffusion rises, it is mainly triggered by the natural patient’s fat content surge, common with aging individuals. Hence, the pharmacokinetic mechanisms of Lisinopril, digoxin, and diltiazem may be disrupted for BN. In such a case, BN’s current medication would need to be adjusted for those whose metabolism happens in the liver to prevent drug poisoning due to hazardous concentration buildup.
Ways to Enhance Patient’s Drug Therapy Plan and Reasons for Such Recommendations The Drug Administration Assignment Discussion
There are various approaches that the nurse needs to be incorporated into the patient’s medication regimen. As Satoskar and Bhandarkar (2020) posit, nurses and other healthcare professionals must be very careful when administering drugs and thus must carry out various tests to ascertain other underlying issues with the patient. In that regard, in the BN’s case, there is a need to evaluate his kidney and liver functions. Regularly assessing the patient’s kidney and liver function is essential to assess if a lower dose for Lisinopril will be necessary and help BN achieve optimal hypertension control. There will also be a need to evaluate all medications’ side effects to ensure that the patient is only given the appropriate medication that will help control his blood pressure and minimize potential adverse effects (Satoskar & Bhandarkar, 2020). In that case, the healthcare professional attending BN has to provide him with essential patient education to increase his knowledge of better ways to control his condition. In such a case, the healthcare professional can use the teach-back or show-me strategies to collaborate effectively with the patient during BN’s treatment plan.
Conclusion
Age is the main factor influencing the case study patient’s pharmacodynamic and pharmacokinetic processes. Hence, before a healthcare provider attends to patients and administers the required pharmacological treatment, it is important to assess these medications’ interaction with the patient’s body to prevent instances of drug poisoning, which can lead to more adverse effects or even death to a patient.

References
Chapron, B. D., Chapron, A., & Leeder, J. S. (2021). Recent advances in the ontogeny of drug disposition. British Journal of Clinical Pharmacology, 88(10), 4267–4284. https://doi.org/10.1111/bcp.14821
Damiani, I., Corsini, A., & Bellosta, S. (2020). Potential statin drug interactions in elderly patients: a review. Expert Opinion on Drug Metabolism & Toxicology. https://doi.org/10.1080/17425255.2020.1822324
Partridge, L., Fuentealba, M., & Kennedy, B. K. (2020). The quest to slow ageing through drug discovery. Nature Reviews Drug Discovery, 19(8), 513–532. https://doi.org/10.1038/s41573-020-0067-7
Satoskar, R., & Bhandarkar, S. (2020)The Drug Administration Assignment Discussion. Pharmacology and Pharmacotherapeutics. Elsevier India.

To Prepare

• Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
• Review the case study assigned by your Instructor for this Assignment.
• Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

Write a 2- to 3-page paper that addresses the following: The Drug Administration Assignment Discussion

• Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
• Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
• Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Case Study 

BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital.

Upon presentation to the hospital:

PMH:

• HTN x 7 years
• Type II DM
• CAD s/p angioplasty 2 years ago
• MI 3 years ago
• EF = 60%
• PVD s/p left femoral to posterior bypass
• Hx of A Fib x 4 years

Medications:

• Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD
• Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD
• Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache
• Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD
• Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID
• HCTZ 12.5 mg QD Humalog 8u with meals The Drug Administration Assignment Discussion

PE:

• BP 110/50 Pulse 38 bpm Resp 14/min
• Rest of physical exam unremarkable

Labs:

• K+ 6.9 WBC 5,800/mm3
• Na+ 135 Hct 35%
• Cr 1.9 Dig 2.78
• BUN 35 INR 2.3
• Gluc 102

• 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 33, “Review of Hemodynamics” (pp. 285–289)
  • Chapter 37, “Diuretics” (pp. 290–296)
  • Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
  • Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
  • Chapter 40, “Vasodilators” (pp. 313–317)
  • Chapter 41, “Drugs for Hypertension” (pp. 316–324)
  • Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
  • Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
  • Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
  • Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
  • Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)The Drug Administration Assignment Discussion
    

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RUBRIC

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeExplain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.

25 pts

This criterion is linked to a Learning OutcomeDescribe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.

30 pts

This criterion is linked to a Learning OutcomeExplain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.

30 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.

5 pts

Total Points: 100