Discussion: Pharmacokinetics and Pharmacodynamics: NURS 6521 Week 1

March 6, 2022

Discussion: Pharmacokinetics and Pharmacodynamics: NURS 6521 Week 1

NURS 6521 Week 1 Discussion:Pharmacokinetics and Pharmacodynamics

Module 1 Week 1

Pharmacokinetics and Pharmacodynamics

According to Rosenthal, L. D., & Burchum, J. R. (2021), pharmacokinetics studies drug movement throughout the body. In contrast, pharmacodynamics studies drugs’ biochemical and physiologic effects on the body and the molecular mechanisms by which those effects are produced. (Rosenthal, L. D., & Burchum, J. R., 2021).

The pharmacokinetics of medication is swayed by both patient-related conditions and the chemical properties of the drug. Any patient-related variables (such as renal function, genetic makeup, gender, and age) can be used to foresee pharmacokinetic parameters in populations. (Rosenthal, L. D., & Burchum, J. R., 2021).

Individual patient variables that may impair the patient’s pharmacokinetic and pharmacodynamic processes must be recognized. Genetics, gender, race, age, actions (food, nutrition, smoking, alcohol, and illegal substance abuse), and pathophysiological adjustments attributable to disease are several of the patient variables. (O’Malley, P., 2019).

Pharmacodynamics analysis is the physiological, physiologic, and molecular impact of medications on the body and involves receptor binding (including receptor sensitivity), post-receptor effects, and chemical interactions. (O’Malley, P., 2019).

The pharmacokinetics test is influenced by four factors: water solubility, fat solubility, dissociation degree, and molecular weight. Pharmacokinetics is the comprehensive study of drugs in the body’s absorption, delivery, metabolism, and excretion. (O’Malley, P., 2019).

Last 5 Years’ Experience

I received a 79-year-old female patient from postop after hip replacement from a fall at home with a past medical history of hypertension, atrial fibrillation, and diabetes. The patient was awake, alert, oriented to person, place, time, and situation. She knew where she was and why she had a procedure. After completing the health history, medication reconciliation, and health assessment, the patient took Metformin, Metoprolol, Eliquis, and lisinopril at home. The Surgeon placed the home medication order in the MAR. Also, the doctor scheduled Tramadol 50 mg every 6 hours for pain, oxycodone 5 mg, and 10 mg based on patient pain level. Elderly patients react differently to narcotics than younger adults. ( Chen, Y. & Zhou, Q. 2018).

The patient was alert throughout my shift. When I returned the following day, I received a report from the night shift nurse that the patient was confused and required a CNA or Telesitter for safety. Since I had the patient from the previous day and knew her baseline, she quickly became confused.

I reviewed her medication list, and I questioned the tramadol. The hospitalist was notified and requested to discontinue the tramadol. The doctor refused and stated that anesthesia medications could be a side effects. The patient got worse, and I escalated the concern to the joint coordinator and Surgeon. The Surgeon discontinued the tramadol. The patient started to return to normal, alert, and oriented.

Personalized plan

I monitored my patient diligently to make sure no other issues contributed to the confusion of my patient. I gave the lowest dose of oxycodone (5 mg ) based on my patient’s pain level, connected her to a continuous pulse ox machine for safety, and provided her oxygen 2L for comfort per the Surgeon’s order since she was taking narcotics. The patient also stayed for two days to ensure she was safe to return home. Patient safety has always been my priority. It is imperative to verify the medication and identify the patient before even considering administering any medication as a nurse.

Nonetheless, checking the medication, dosages, route, interaction, allergy, absorption, side effects are primordial. They provide medication administration education to provide and value patient safety and care. Monitoring is essential in medication therapy.

 

 

References

 

 

Chen, Y. & Zhou, Q. (2018). Effects of drug pharmacokinetic/pharmacodynamic properties,

characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients. Therapeutics & Clinical Risk Management10, 437–448. https://doi.org/10.2147/TCRM.S63756

O’Malley, P. (2019). Accounting for pharmacokinetic and pharmacodynamic variability: ten

factors to consider before prescribing. Clinical Nurse Specialist CNS21(6), 274–275. https://doi.org/10.1097/01.NUR.0000299615.62024.1a

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice

nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

 

Discussion: Pharmacokinetics and Pharmacodynamics

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 pharamcodynamic 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. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.

ORDER NOW FOR AN ORIGINAL PAPER

To prepare FOR Discussion: Pharmacokinetics and Pharmacodynamics:

Review this week’s media presentation with Dr. Terry Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics.

Reflect on your experiences, observations, and/or clinical practices from the last five years. Select a case from the last five years that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

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.

With these thoughts in mind:

By Day 3 of Discussion: Pharmacokinetics and Pharmacodynamics

Post a description of the case you selected. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient from the case you selected. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.

By Day 6 of Discussion: Pharmacokinetics and Pharmacodynamics

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmadynamic processes of the patients in their case studies. In addition, suggest how the personal care plan might change if the age of the patient were different and if the patient had a comorbid condition such as renal failure, heart failure, or liver failure.

Readings

  • Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
    • Chapter 2, “Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles” (pp. 15–29)This chapter examines concepts related to pharmacokinetics and pharmacodynamics. It also explores patient factors that health care providers consider when prescribing drug therapy to patients.
    • Chapter 3, “Impact of Drug Interactions and Adverse Events on Therapeutics” (pp. 30–48)This chapter explains drug-drug, drug-food, drug-herb, and drug-disease interactions. It also reviews patient factors that influence drug interactions and then covers adverse drug reactions.
    • Chapter 4, “Principles of Pharmacotherapy in Pediatrics” (pp. 49–59)This chapter explores concepts relating to drug selection, administration, and interaction for pediatric patients. It also compares age-related pharmacokinetic differences in children and adults.
    • Chapter 6, “Principles of Pharmacotherapy in Elderly Patients” (pp. 66–78)This chapter describes issues and factors that affect drug therapy for elderly patients. It then explores concepts relating to drug selection, administration, and management for elderly patients.
  • Hilmer, S. N., McLachlan, A. J., & Le Couteur, D. G. (2007). Clinical pharmacology in the geriatric patient. Fundamental & Clinical Pharmacology21(3), 217–230.
    Retrieved from the Walden Library databases.This article explores issues that health care providers consider when prescribing drug treatment to geriatric patients. It also examines the role of polypharmacy in adverse drug reactions and the importance of managing patient response to drug treatment.
  • Scott, S. A. (2011). Personalizing medicine with clinical pharmacogenetics. Genetics in Medicine,13(12), 987–995. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290900/This article examines pharmacogenetic testing in relation to personalized drug therapy plans and explores evidence-based guidelines and recommendations on pharmacogenetic testing.
  • Drugs.com. (2012). Retrieved August 22, 2012, from http://www.drugs.com/This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Media

  • Laureate Education, Inc. (Executive Producer). (2012). Introduction to advanced pharmacology. Baltimore, MD: Author.

NURS 6521 Week 1: Basic Pharmacotherapeutic Concepts

In 2011, more than 3.7 billion drug prescriptions were filled at pharmacies in the United States (The Kaiser Family Foundation, 2011). With billions of drugs prescribed each year for the treatment and management of various disorders, it is essential for advanced practice nurses to familiarize themselves with common drug treatments and effects of these treatments on patients. When prescribing drugs, ensuring patient safety is the major concern. In many clinical settings, nurses work more closely with patients than any other health care provider, making it their responsibility to assist physicians with this task. As an advanced practice nurse maintaining patient safety, you must consider the many patient factors that impact pharmacotherapeutics.

This week you explore factors that influence pharmacokinetic and pharmacodynamic processes in patients. You also examine patient factors that advanced practice nurses must consider when developing drug therapy plans.

Learning Objectives

By the end of this week, students will:
  • Analyze factors that influence pharmacokinetic and pharmacodynamics processes in patients
  • Assess patient factors and history to develop personalized plans of care
  • Understand and apply key terms, concepts, and principles related to pharmacotherapeutics
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat geriatric patients

NURS 6521 Week 1 Quiz Answers (Walden)

  1. A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to
  2. A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
  3. A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)
  4. Which of the following affects drug distribution throughout the body?
  5. In response to a patient’s nausea, the nurse has mixed a dose of an antiemetic with 50 mL of sterile normal saline and will administer the dose by IV piggyback. What is the rationale for the use of IV piggyback?
  6. A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?
  7. During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
  8. Tylenol 325 mg/tablet, patient needs 650 mg; how many tables should patient take?
  9. The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?
  10. An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
  11. A home health nurse notes that there have been changes to a patient’s oral drug regimen. The nurse will closely monitor the new drug regimen to
  12. A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of
  13. A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
  14. A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?
  15. Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is
  16. A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patient’s stay in the hospital?
  17. The culture and sensitivity testing of a patient’s wound exudate indicates that a specific antibiotic is necessary for treatment. The United States Pharmacopeia–National Formulary indicates that the drug in question is 96% protein bound. What are the implications of this fact?
  18. A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?
  19. On the 1 a.m. rounds, the nurse finds a patient awake and frustrated that she cannot go to sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later, the nurse finds the patient out of bed, full of energy and cleaning her room. The nurse evaluates the patient’s response to the hypnotic as
  20. A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient’s compromised renal function will likely
  21. For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications?
  22. A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?
  23. In which of the following patients would a nurse expect to experience alterations in drug metabolism?
  24. Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should
  25. A nurse who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the nurse should encourage them to
  26. A 70-year-old woman with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse’s admission assessment, the nurse realizes that the patient has been taking ginkgo biloba supplements in addition to her prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this patient’s care?
  27. A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 p.m. The nurse finds the patient drowsy and confused at 10 a.m. the next day. The nurse is aware that this behavior is most likely due to
  28. A nurse is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The nurse will base the patient’s plan of care on the understanding that there is
  29. An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client’s lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient’s pulmonary edema?
  30. A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
  31. An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that
  32. An 80-year-old patient has been taking lorazepam since his wife died a year ago. He has been staying with his son, but will now move to an assisted living facility. Before admission to the assisted living facility, the patient’s physician has determined that the drug is no longer needed. The nurse at the facility will plan to
  33. A nurse is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient’s drug regimen?
  34. A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs?
  35. A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication?
  36. A 77-year-old woman who is 5 feet 3 inches tall and weighs 89 lbs has been admitted to the hospital with a diagnosis of failure to thrive. What action should the nurse prioritize when addressing the woman’s apparent lack of nutrition?
  37. A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient’s daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that
  38. A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

Content

Rubric Details

Select Grid View or List View to change the rubric’s layout.

Content
Name: NURS_6521_Week1_Discussion_Rubric

Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement
Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 44 (44%) – 44 (44%)

Thoroughly responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

supported by at least 3 current, credible sources

Points Range: 40 (40%) – 43 (43%)

Responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

75% of post has exceptional depth and breadth

supported by at least 3 credible references

Points Range: 35 (35%) – 39 (39%)

Responds to most of the discussion question(s)

is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of post has exceptional depth and breadth

supported by at least 3 credible references

Points Range: 31 (31%) – 34 (34%)

Responds to some of the discussion question(s)

one to 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 fewer than 2 credible references

Points Range: 0 (0%) – 30 (30%)

Does not respond to the discussion question(s)

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 1 or no credible references

Main Posting:
Writing

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely

Contains no grammatical or spelling errors

Fully adheres to current APA manual writing rules and style

Points Range: 5.5 (5.5%) – 5.5 (5.5%)

Written clearly and concisely

May contain one or no grammatical or spelling error

Adheres to current APA manual writing rules and style

Points Range: 5 (5%) – 5 (5%)

Written concisely

May contain one to two grammatical or spelling error

Adheres to current APA manual writing rules and style

Points Range: 4.5 (4.5%) – 4.5 (4.5%)

Written somewhat concisely

May contain more than two spelling or grammatical errors

Contains some APA formatting errors

Points Range: 0 (0%) – 4 (4%)

Not written clearly or concisely

Contains more than two spelling or grammatical errors

Does not adhere to current APA manual writing rules and style

Main Posting:
Timely and full participation

Points Range: 10 (10%) – 10 (10%)

Meets requirements for timely and full participation

posts main discussion by due date

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
NA

Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings

responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

Points Range: 8.5 (8.5%) – 8.5 (8.5%)
Response exhibits critical thinking and application to practice settings

Points Range: 7.5 (7.5%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting

Points Range: 6.5 (6.5%) – 7 (7%)
Response is on topic, may have some depth

Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth

First Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully 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

Points Range: 5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues

Response 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

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

Points Range: 4.5 (4.5%) – 4

PLACE THIS ORDER OR A SIMILAR ORDER WITH ALL NURSING ESSAYS TODAY AND GET AN AMAZING DISCOUNT  ordernowcc-blue
Posted in nursing by Clarissa