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NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay Paper

NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperNURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperAs 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 pharmacodynamic 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.For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperORDER A PLAGIARISM-FREE PAPER HERETo Prepare· Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics. (See pdf attachments and below links)PART 1300 – Section 1300.01 Definitions relating to controlled substances (usdoj.gov) Mid-Level Practitioners Authorization by State (usdoj.gov) Registration (usdoj.gov) List of Error-Prone Abbreviations | Institute For Safe Medication Practices (ismp.org)NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay Paper· Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.· 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. Discussion – Instructions1. Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. (Please use some case related to Behavioral Health)2. Describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified.3. Explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.4. Be specific and provide examples.5. Use at least 3 references. (One of them from the resources provided)6. Review the Grading Rubric **THIS DISCUSSION IS DIVIDE IN TWO PARTS–  1. MAIN DISCUSSION POST BYWEDNESDAY  9/1/2021 BEFORE 8:00 PM EST  2.  TWO REPLIES BY FRIDAY09/03/2021 BEFORE 8:00 PM EST  Discussion Week 1: Pharmacokinetics andPharmacodynamics  As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it isimportant to not only understand the impact of disorders on the body, but also the impact of drugtreatments on the body. The relationships between drugs and the body can be described bypharmacokinetics 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.NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay Paper When selecting drugs and determining dosages for patients, it is essential to consider individualpatient factors that might impact the patient’s pharmacokinetic and pharmacodynamic 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. For this Discussion, you reflect on a case from your past clinical experiences and consider how apatient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.  To Prepare · Review the Resources for this module and consider the principles of pharmacokinetics andpharmacodynamics. (See pdf attachments andbelow links) PART 1300– Section 1300.01 Definitions relating to controlled substances (usdoj.gov)  Mid–Level Practitioners Authorization by State (usdoj.gov)  Registration (usdoj.gov)  List of Error–Prone Abbreviations | Institute For Safe Medication Practices (ismp.org) NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay Paper· Reflect on your experiences, observations, and/or clinical practices from the last 5 years andthink about how pharmacokinetic and pharmacodynamic factors altered his or her anticipatedresponse to a drug. · Considerfactors that might have influenced the patient’s pharmacokinetic andpharmacodynamic 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 historyin your case study.  Discussion – Instructions 1. Post a description of the patient case from your experiences, observations, and/or clinicalpractice from the last 5 years.(Please use some case related toBehavioral Health) 2.NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperDescribe factors that might have influenced pharmacokinetic and pharmacodynamic processes ofthe patient you identified. 3. Explain details of the personalized plan of care that you would develop based on influencingfactors and patient history in your case. **THIS DISCUSSION IS DIVIDE IN TWO PARTS – 1. MAIN DISCUSSION POST BY WEDNESDAY 9/1/2021 BEFORE 8:00 PM EST2. TWO REPLIES BY FRIDAY 09/03/2021 BEFORE 8:00 PM EST Discussion Week 1: Pharmacokinetics andPharmacodynamics As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it isimportant to not only understand the impact of disorders on the body, but also the impact of drugtreatments on the body. The relationships between drugs and the body can be described bypharmacokinetics 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 individualpatient factors that might impact the patient’s pharmacokinetic and pharmacodynamic 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.For this Discussion, you reflect on a case from your past clinical experiences and consider how apatient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperTo Prepare Review the Resources for this module and consider the principles of pharmacokinetics andpharmacodynamics. (See pdf attachments and below links)PART 1300 – Section 1300.01 Definitions relating to controlled substances (usdoj.gov) Mid-Level Practitioners Authorization by State (usdoj.gov) Registration (usdoj.gov) List of Error-Prone Abbreviations | Institute For Safe Medication Practices (ismp.org)  Reflect on your experiences, observations, and/or clinical practices from the last 5 years andthink about how pharmacokinetic and pharmacodynamic factors altered his or her anticipatedresponse to a drug. Consider factors that might have influenced the patient’s pharmacokinetic andpharmacodynamic 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 historyin your case study. Discussion – Instructions1. Post a description of the patient case from your experiences, observations, and/or clinicalpractice from the last 5 years. (Please use some case related to Behavioral Health)2. Describe factors that might have influenced pharmacokinetic and pharmacodynamic processes ofthe patient you identified.3. Explain details of the personalized plan of care that you would develop based on influencingfactors and patient history in your case.Instructions:Read a selection of your colleague and respond by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure**minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end**NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperReply # 1Gifty Manu Top of FormI was working in the emergency department at Dallas VA medical center in Dallas, Texas, in 2017 when I took care of a 30 years old male that sustained injuring to the back of his hand and forearm from a piece of farm tool. The Emergency Department physician ordered Dilaudid 2mg IVP because the patient was in agonizing pain. I administered pain medication and reassessed the pain level in 10minutes later. The patient rated his pain at a 10/10. A second dose of 2mg IVP Dilaudid was ordered, administered, and reassessed. The patient still rated the pain at a 10/10. The physician ordered a third dose of Dilaudid 2mg IVP. He stated, “due to fear of respiratory distress, the third dose will be the final.”  I gave the third dose and reassessed the patient’s pain. He stated 8/10. At this point, I began to question why the pain medication was not resolving the patient’s pain.Upon further questioning of the patient, I learned that the patient was a recovering opioid abuser. Based on the information above, I knew the patient had developed an increased tolerance to opioids and did not respond as well to the pain medication. Tolerance to opioids is a phenomenon that grows with repeated opioid use resulting in a decrease in analgesic effects or side effects of opiates, thus requiring an increase in opioid dose to achieve adequate pain relief (Wenzel, Schwenk, Baratta, & Viscusi, 2016). The information received was relayed to the physician, and I received an order of ketorolac. I administered the medication to the patient and reassessed his pain level 20 minutes later. He now rated his pain as a 4/10.Pain is a complex phenomenon; the use of a combination of analgesics of different classes that act on distant target sites in the pathways may provide better pain relief while reducing opioid requirement and the risk of adverse effects (Chou et al., 2016). Reflecting the nature of his injury pain rating of 4/10 was acceptable to the patient and workforce. The plan of care for the above patient would include non-pharmacological modalities, pharmacologic agent include opioids, Tylenol, non-steroid anti-inflammatory drugs (NSAID) anticonvulsants, N- methyl D-aspartate receptor antagonist, serotonin, antidepressants,  alpha2 agonist and skeletal muscle relaxants, norepinephrine reuptake inhibitor, tricyclic, multimodal analgesia agents, and  perioperative interventions (Cooney & Broglio, 2017).NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperReference:Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., …& Wu, C. L. (2016). Management of Postoperative Pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ committee on regional anesthesia, executive committee, and administrative council. The journal of pain, 17(2), 131-157. Retrieved August 30, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S1526590015009955Cooney, M. F., & Broglio, K. (2017). Acute pain management in opioid-tolerant individuals. The Journal for Nurse Practitioners, 13(6), 394-399. Retreived August 30, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S1555415517303070Wenzel, J. T., Schwenk, E. S., Baratta, J. L., & Viscusi, E. R. (2016). Managing opioid-tolerantpatients in the perioperative surgical home. Anesthesiology clinics, 34(2), 287-301. Retrieved from August 30, 2021, from https://www.anesthesiology.theclinics.com/article/S1932-2275(16)00006-9/fulltextBottom of Form Instructions:  Read a selection of your colleague and respond by suggesting additional patientfactors that might have interfered with the pharmacokinetic and pharmacodynamicprocesses of the patients they described. In addition, suggest how the personalizedplan of care might change if the age of the patient were different and/or if the patienthad a comorbid condition, such as renal failure, heart failure, or liver failure **minimum of three(3)scholarly references arerequired for each reply citedwithin the body of the reply & at the end**Instructions:Read a selection of your colleague and respond by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure**minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end** Reply # 2Angela David Top of FormI work in a busy cardiovascular intensive care unit (CVICU), and of the many cases that I could reflect upon, one in particular stands out.  I once cared for a75-year-old woman who required an emergency repair of a type A aortic dissection.  Her case was complex and required extensive time on cardiopulmonary bypass and total circulatory arrest.  She bled postoperatively, was subsequently hypotensive,  and required transfusion of multiple products.  Prior to surgery, she had a history of renal insufficiency.  Post operatively, she went into acute renal failure, required continuous renal replacement therapy(CRRT) and remained intubated for five days.  Due to the fact that she remained intubated and unstable, she was sedated on a combination of IV propofol and morphine bolus doses for pain management.  When the patient became hemodynamically stable and attempts were made to reduce sedation in order to assess her neurological status, the patient was somnolent, and remained so after sedation was completely discontinued. NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperThere are a number of pharmacokinetic changes that occur with aging, such as reduction in hepatic metabolism and reduction in renal excretion, which are both important considerations in this case(Linnebur and Ruscin, 2021).  One pharmacodynamic change in the elderly, particularly related to opioid analgesics, is increased drug sensitivity(Bath, et al, 2011).  Considering these factors, along with the fact that this patient was in acute renal failure, morphine, which is metabolized by the liver and primarily excreted by the kidneys, was not the best choice for this patient and likely led to increased sedation and depressed respiratory drive. Upon reflection, fentanyl, a shorter acting opioid, might have been a safer choice for this patient.  References Linnebur, S., and Ruscin, J., (2021). Pharmacokinetics in Older Adults, Merck Manual.  https://www.merckmanuals.com/professional/geriatrics/drug-therapy-in-older-adults/pharmacokinetics-in-older-adultsBath,S., Blythe, F.,  Couteur, D., Gibson, S., Hilmer, S., McLachlan, A., and Naganathan, V., (2011). Clinical pharmacology of analgesic medicines in older people: impact of frailty and cognitive impairment, Br J Clin Pharmacol 71(3):351-364. Doi: 10.1111/j.1365-2125.2010.03847.xNURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperInstructions:  Read a selection of your colleague and respond by suggesting additional patientfactors that might have interfered with the pharmacokinetic and pharmacodynamicprocesses of the patients they described. In addition, suggest how the personalizedplan of care might change if the age of the patient were different and/or if the patienthad a comorbid condition, such as renal failure, heart failure, or liver failure **minimum of three(3)scholarly references arerequired for each reply citedwithin the body of the reply & at the end**  Reply # 2 Angela David    I work in a busy cardiovascular intensive care unit (CVICU), and of the many cases that I could reflect upon,one in particular stands out.  I once cared for a75–year–old woman who required an emergency repair of a typeA aortic dissection.  Her case was complex and requiredextensive time on cardiopulmonary bypass and totalcirculatory arrest.  She bled postoperatively, was subsequently hypotensive, and required transfusion ofmultiple products.  Prior to surgery, she had a history of renal insufficiency.  Post operatively,she went intoacute renal failure, required continuous renal replacement therapy(CRRT) and remained intubated for fivedays.  Due to the fact that she remained intubated and unstable, she was sedated on a combination of IVpropofol and morphine bolus doses for pain management.  When the patient became hemodynamically stableand attempts were made to reduce sedation in order to assess her neurological status, the patient was somnolent,and remained so after sedation was completely discontinued.    There are a number of pharmacokinetic changes that occur with aging, such as reduction in hepaticmetabolism and reduction in renal excretion, which are both important considerations in this case(Linnebur andRuscin, 2021).  One pharmacodynamic change in the elderly, particularly related to opioid analgesics, isincreased drug sensitivity(Bath, et al, 2011).  Considering these factors, along with the fact that this patient wasin acute renal failure, morphine, which is metabolized by the liver and primarily excreted by the kidneys, wasnot the best choice for this patient and likely led to increased sedation and depressed respiratory drive. Uponreflection, fentanyl, a shorter acting opioid, might have been a safer choice for this patient.     References   Linnebur, S., and Ruscin, J., (2021). Pharmacokinetics in Older Adults, MerckManual. https://www.merckmanuals.com/professional/geriatrics/drug–therapy–in–older–adults/pharmacokinetics–in–older–adults Bath,S., Blythe, F., Couteur, D., Gibson, S., Hilmer, S., McLachlan, A., and Naganathan, V., (2011). Clinical pharmacology ofanalgesic medicines in older people: impact of frailty and cognitive impairment, Br J Clin Pharmacol 71(3):351–364. Doi:10.1111/j.1365-NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay Paper2125.2010.03847.x  Instructions:Read a selection of your colleague and respond by suggesting additional patientfactors that might have interfered with the pharmacokinetic and pharmacodynamicprocesses of the patients they described. In addition, suggest how the personalizedplan of care might change if the age of the patient were different and/or if the patienthad a comorbid condition, such as renal failure, heart failure, or liver failure**minimum of three (3) scholarly references are required for each reply citedwithin the body of the reply & at the end** Reply # 2Angela DavidI work in a busy cardiovascular intensive care unit (CVICU), and of the many cases that I could reflect upon,one in particular stands out. I once cared for a75-year-old woman who required an emergency repair of a typeA aortic dissection. Her case was complex and required extensive time on cardiopulmonary bypass and totalcirculatory arrest. She bled postoperatively, was subsequently hypotensive, and required transfusion ofmultiple products. Prior to surgery, she had a history of renal insufficiency. Post operatively, she went intoacute renal failure, required continuous renal replacement therapy(CRRT) and remained intubated for fivedays. Due to the fact that she remained intubated and unstable, she was sedated on a combination of IVpropofol and morphine bolus doses for pain management. When the patient became hemodynamically stableand attempts were made to reduce sedation in order to assess her neurological status, the patient was somnolent,and remained so after sedation was completely discontinued.NURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay PaperThere are a number of pharmacokinetic changes that occur with aging, such as reduction in hepaticmetabolism and reduction in renal excretion, which are both important considerations in this case(Linnebur andRuscin, 2021). One pharmacodynamic change in the elderly, particularly related to opioid analgesics, isincreased drug sensitivity(Bath, et al, 2011). Considering these factors, along with the fact that this patient wasin acute renal failure, morphine, which is metabolized by the liver and primarily excreted by the kidneys, wasnot the best choice for this patient and likely led to increased sedation and depressed respiratory drive. Uponreflection, fentanyl, a shorter acting opioid, might have been a safer choice for this patient.  References Linnebur, S., and Ruscin, J., (2021). Pharmacokinetics in Older Adults, MerckManual. https://www.merckmanuals.com/professional/geriatrics/drug-therapy-in-older-adults/pharmacokinetics-in-older-adultsBath,S., Blythe, F., Couteur, D., Gibson, S., Hilmer, S., McLachlan, A., and Naganathan, V., (2011). Clinical pharmacology ofanalgesic medicines in older people: impact of frailty and cognitive impairment, Br J Clin Pharmacol 71(3):351-364. Doi:10.1111/j.1365-2125.2010.03847.xNURS 6521 Week 1: Pharmacokinetics and Pharmacodynamics Essay Paper

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