Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide example Pharmacology Essay Paper
Introduction
Pharmacokinetics and pharmacodynamics are the terms used to describe how drugs react in the body. Pharmacokinetics is the drug’s movement in the body and how the body responds to the drug while pharmacodynamics refers to the medication affects the body or how the medication initiates a healing or toxic effect in the body (Keller & Hann, 2018).
The patient case I will describe is a 72-year-old Caucasian man diagnosed with congestive heart failure and in atrial fibrillation. The patient was taking 125 mcg of digoxin daily. However, the patient experienced digoxin toxicity as indicated by severe side effects such as hazy vision, lack of appetite, confusion, palpitations, irregular heartbeat, and breath shortness.
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The pharmacokinetics and pharmacodynamics evidence in digoxin toxicity for this patient are related to age. The decreased functional reserve and decreased homeostatic capacity have major pharmacokinetic implications. In older adults, the decreased functional reserve elevates their vulnerability to drug toxicity as evidence in this patient. Aging causes body changes which together with deteriorating renal function lengthens the plasma elimination of digoxin, increases the drug’s bioavailability and there is also poor renal excretion; these factors led to digoxin toxicity for the patient. Pharmacology Essay Paper
The main treatment goal for this patient is to correct cardiac toxicity (MacLeod-Glover et al., 2016). Since the patient manifested breath shortness, a CPR should be instituted immediately and provide the patient with supportive care. Supportive care includes cardiac monitoring, oxygen supplementation, and administering IV fluids if the patient is hypotensive. After the patient stabilizes, digoxin therapy should be discontinued immediately and an alternative medication prescribed such as Captopril. According to Messerli et al (2018), Captopril is well tolerated in older adults.
References
Keller, F., & Hann, A. (2018). Clinical Pharmacodynamics: Principles of Drug Response and Alterations in Kidney Disease. Clinical journal of the American Society of Nephrology: CJASN, 13(9), 1413–1420. https://doi.org/10.2215/CJN.10960917.
MacLeod-Glover, N., Mink, M., Yarema, M., & Chuang, R. (2016). Digoxin toxicity: Case for retiring its use in elderly patients? Canadian family physician Medecin de Famille Canadien, 62(3), 223–228.
Messerli, F. H., Bangalore, S., Bavishi, C., & Rimoldi, S. F. (2018). Angiotensin-converting enzyme inhibitors in hypertension: to use or not to use? Journal of the American College of Cardiology, 71(13), 1474-1482.