Care Plan: Pharmacokinetics and Pharmacodynamics

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Table of Contents

Introduction
Case Description
Influential Factors
Personalized Plan of Care
References

Introduction

The creation of any plan of care requires the investigation of different factors, as well as the relationships that may exist between a drug and a patient’s body. The evaluation of pharmacokinetics and pharmacodynamics is an important step because it helps to understand what the body can do to the drug, including such processes as absorption, metabolism, distribution, and excretion, and what the drug can do to the body, including adverse or side effects, new health problems, or body changes (Peterson, 2017).

Gender, age, and genetics are one of the main patient factors that may influence pharmacokinetics and pharmacodynamics. In this paper, a case of a particular patient will be used to clarify what patient factors and pharmacokinetic and pharmacodynamic principles should be taken into consideration in order to develop a personalized plan of care for the patient.

Case Description

WA is an 87-year-old African American female patient. To reduce the level of agitation and avoid complications, she was given Risperdal. In 30 minutes, the patient started feeling somnolence.

Influential Factors

Taking into consideration the information about the case and the health outcomes observed after taking medications, it is possible to identify several factors that may influence the processes of pharmacokinetics and pharmacodynamics. These factors are age (the patient is an elderly), genetics (the patient is African American), and gender (the patient is a female). Age-related changes in pharmacokinetics and pharmacodynamics may contribute to the development of new adverse medicine events, including drowsiness (Hilmer, McLachlan, & Le Couteur, 2007). Metabolism depends on such factors as patient’s behavior, gender, and concurrent diseases.

In this case, the patient is an elderly woman who takes Risperdal. Risperdal is a type of antipsychotics the side effects of which require a constant monitoring of the elderly for possible extrapyramidal symptoms, tardive dyskinesia, and different dystonic reactions (Stefanacci, 2017). The ethnicity of the patient promotes the creation of a special genetic makeup that governs hepatic enzymes and the ability to respond to agents (Peterson, 2017). African Americans are exposed to the production of a low level of rennin that affects the work of the ACE inhibitors in the body.

Personalized Plan of Care

Personalized medicine aims at incorporating personal genomic information, the results of a clinical assessment, and family history for medical management (Scott, 2012). It is necessary to make sure that the patient neither takes alcohol nor smokes because those who combine these harmful habits with antipsychotics put themselves at risk of having CNS depression, hypoglycemia, and other unpredictable metabolic changes (Kang & Peterson, 2017).

Another important issue in drug therapy is the choice of appropriate dosage. In adult therapy, the same dose can be used for almost all adults (Siu & Thigpen, 2017). In the case of an African American elderly patient, the dose of Risperdal can be reduced, given at night, or even replaced by other antipsychotics like Clozapine or Haldol. Regarding the fact that the patient used Risperdal to deal with her agitation, a new care plan should be based on the recognition of possible environmental triggers and the necessity to distract a patient and ensure support and communication. Constant observations and communication with the patient are required to deal with the problems of poor metabolism due to the patient’s ethnic group.

Finally, antipsychotics may influence memory, vision, and the urinary system’s work. A care plan should be based on the assessment of these quality indicators during the next one week if the patient continues taking antipsychotics.

References

Hilmer, S.N., McLachlan, A.J., & Le Couteur, D.G. (2007). Clinical pharmacology in the geriatric patient. Fundamental & Clinical Pharmacology, 21(3), 217-230.

Kang, T., & Peterson, A.M. (2017). Impact of drug interactions and adverse events on therapeutics. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4^th ed.) (pp. 33-51). Ambler, PA: Lippincott Williams & Wilkins.

Peterson, A.M. (2017). Pharmacokinetic basic of therapeutics and pharmacodynamics principles. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4^th ed.) (pp. 17-31). Ambler, PA: Lippincott Williams & Wilkins.

Scott, S.A. (2012). Personalizing medicine with clinical pharmacogeneitcs. Genetics in Medicine, 13(12), 987-995.

Siu, A., & Thigpen, J.C. (2017). Principles of pharmacotherapy in pediatrics. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4^th ed.) (pp. 53-63). Ambler, PA: Lippincott Williams & Wilkins.

Stefanacci, R.G. (2017). Principles of pharmacotherapy in older adults. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4^th ed.) (pp. 73-89). Ambler, PA: Lippincott Williams & Wilkins.

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Care Plan: Pharmacokinetics and Pharmacodynamics

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