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.

To prepare:

•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.

Post on or before Day 3 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.
RESOURCES:

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 Pharmacology, 21(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 https://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 https://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.

Note: The approximate length of this media piece is 8 minutes.

In this media presentation, Dr. Terry Buttaro, Associate Professor of Practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.