According to Rosenthal & Burchum, 2022, the reaction of drugs in the body is described in two teams known as pharmacokinetics and pharmacodynamics. Pharmacokinetics is defined as the movement of the drug through the body, or how the body affects the drug. And pharmacodynamics is how the drug affects the body, or how the drug initiates a therapeutic or toxic effect in the body. There have been several times when I have given a drug and I experienced the desired outcome was not met. For this discussion, I have chosen to center my discussion on was a 75-year-old woman who was admitted to the hospital with pneumonia. She was started on a course of antibiotics, but she did not respond well to treatment. She continued to have fever, cough, and shortness of breath. The doctor ordered a blood test to check the patient’s drug levels. The results showed that the patient’s blood levels of the antibiotic were very low. This was because the patient’s liver was not able to metabolize the drug as well as a younger person’s liver, the doctor ordered a blood test to check the patient’s drug levels. The results showed that the patient’s blood levels of the antibiotic were very low. This was because the patient’s liver was not able to metabolize the drug as well as a younger person’s liver. I will explain basic pharmacokinetic processes, basic pharmacodynamics processes. Finally, I will explain personalized Plan of care.
Factors Influencing Pharmacokinetic and Pharmacodynamic Processes:
Age:
The age of the patient plays a significant role in pharmacokinetics and pharmacodynamics. As individuals age, physiological changes occur, such as a decrease in liver and kidney function. In this case, the patient’s liver function might have been compromised, leading to a decreased ability to metabolize the antibiotic. Older adults also tend to have a higher percentage of body fat and a lower percentage of lean body mass, which affects drug distribution and elimination.
Gender:
Gender differences can influence drug response due to variations in body composition and hormonal factors. Women generally have a lower body weight compared to men, which can affect drug distribution. Hormonal fluctuations during the menstrual cycle can also influence drug metabolism and clearance. However, specific gender-related factors were not explicitly mentioned in the case.
Diet:
The patient’s diet can impact drug absorption. For example, certain foods, like grapefruit juice, contain compounds that inhibit the activity of drug-metabolizing enzymes, leading to altered drug concentrations in the body. It is essential to assess the patient’s dietary habits and provide guidance on potential drug-food interactions.
Pathophysiological Changes:
The patient’s pneumonia might have influenced her liver and kidney function. Inflammation and infection can impair the liver’s ability to metabolize drugs, resulting in altered drug levels. Similarly, kidney dysfunction can affect drug elimination, leading to increased drug concentrations in the body. It is crucial to consider the patient’s underlying disease and its impact on drug metabolism and elimination (Balaram & Balachandran, 2022).
Personalized Plan of Care:
Therapeutic Drug Monitoring:
Regular monitoring of the patient’s drug levels was crucial to ensure therapeutic efficacy and minimize adverse effects. In this case, the low blood levels of the initial antibiotic prompted a change in medication. Monitoring the blood levels of the new antibiotic will help determine if the dose is appropriate for the patient.
Dose Adjustment:
Considering the patient’s age, gender, diet, and underlying disease, dosage adjustments may be necessary to optimize treatment outcomes. For example, a reduced dose might be warranted in older adults due to decreased drug metabolism and clearance. Individualized dosing regimens should be established to achieve optimal drug concentrations while minimizing the risk of toxicity (Isitan, & Hohler, 2017)
Patient Education:
Effective patient education is essential for medication adherence and safety. The patient should be educated about the importance of taking medications as prescribed, including the correct timing, dosage, and potential side effects. In this case, the patient should be informed about the need for regular blood tests and the rationale behind switching antibiotics.
Comprehensive Treatment of Underlying Health Conditions:
Collaborating with the patient’s physician, a comprehensive plan should be developed to address the patient’s pneumonia and any other underlying health conditions. This may involve additional therapies, such as respiratory treatments, chest physiotherapy, or supplemental oxygen, to improve the patient’s overall health and response to treatment.( Parnham & Kricker, 2022).
Multidisciplinary Approach:
To ensure the best outcomes for the patient, a multidisciplinary approach involving healthcare professionals from various specialties, such as physicians, pharmacists, and nurses, should be employed. Collaboration between these professionals facilitates comprehensive patient assessment, individualized treatment plans, and ongoing monitoring of the patient’s progress.
Conclusion:
In this discussion that feature a case of elderly with pneumonia who is taking antibiotics, several factors influenced the pharmacokinetic and pharmacodynamic processes, including age, gender, diet, and pathophysiological changes due to pneumonia. A personalized plan of care was developed, which included therapeutic drug monitoring, dose adjustments, patient education, and a comprehensive approach to treat the underlying health condition. By considering these influencing factors and tailoring the plan of care accordingly, healthcare professionals can optimize treatment outcomes and ensure the safety and well-being of elderly patients.
Reference:
Balaram, K., & Balachandran, S. (2022). Psychopharmacology in the Elderly: Why Does Age Matter?. Psychiatric Clinics.
Isitan, C, & Hohler, A. D. (2017). Cefepime induced neurotoxicity: A case series and
review of the literature. Eneurologicalsci8, 40-43. Retrieved from https://doiorg.ezp.waldenulibrary.org/10.1016/j.ensci.2017.08.001Links to an external site..
Le, J. (2019). Overview of pharmacokinetics. Merck Manual. Retrieved fromhttps://www.merckmanuals.com/professional/clinical-pharmacology/pharmacokinetics/overview-of-pharmacokinetic
Parnham, M. J., & Kricker, J. A. (2022). Factors determining plasticity of responses to drugs. International Journal of Molecular Sciences, 23(4), 2068.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.