Pharmacology Essay Paper
PLEASE HAVE THE SAME WRITER THAT WROTE ORDER NUMBER 223338 DO THIS WORK. Responde to Katrina post: responde separately with 2 refrences within 5 years.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. Katrina’s post In my previous job, I cared for mostly geriatric patients. I had an elderly patient that had a history of falls, CKD, HTN, and other cardiac issues. Over the past 2-3 months prior to her episode, the patient began to complain of progressive dyspnea and lower extremity edema. The patient had a PCP appointment and returned with a new order for Lasix. At the beginning of shift one day the patient was stable, no complaints, upon assessment lower extremity edema was noted as well as a significant amount of weight gain was reported within the last 2 days. Pharmacology Essay Paper .A couple of hours later the patient began to complain of increased shortness of breath. The patient was sent out to the hospital for further evaluation. Upon return to the facility, the patient was noted to have had an exacerbation of heart failure and was prescribed Carvedilol, Spironolactone, and Lasix. Pharmacodynamics Pharmacodynamics takes into account the interactions between the drug and the body. Lasix or furosemide is a loop diuretic that works to increase the excretion of sodium and water by the kidneys by inhibiting their reabsorption from the proximal and distal tubules, as well as the loop of Henle (De Bruyne, 2003). Furosemide promotes diuresis by blocking reabsorption of sodium and chloride in the tubules. The diuretic effect results in the elimination of water and various electrolytes. Lasix is indicated to manage hypertension and edema associated with congestive heart failure, cirrhosis, and renal disease (Ellison, 2019).
Pharmacokinetics Pharmacokinetics is how a body processes a drug from absorption, distribution, metabolize and excretion. The metabolism of furosemide occurs mainly in the kidneys. Lasix is quickly absorbed through the GI tract though food can have a negative effect on absorption. Diuresis begins in 30 to 60 minutes and peaks 1 to 2 hours after oral administration (Ellison, 2019). The mean bioavailability of furosemide from tablets and oral solution is 64% and 60% (fda.gov, n.d.). Care Plan Since furosemide has such a high incidence of water and electrolyte depletion, elderly patients need close observation because they are more susceptible to diuretic-induced diuresis. Also, elderly patients are more likely to have decreased renal function, care should be taken in dose selection and closely monitor renal function (fda.gov, n.d.). Excessive diuresis leads to hypovolemia, hypokalemia, hyponatremia, and ultimately circulatory collapse. References De Bruyne, L. (2003). Pharmacology Essay Paper .Mechanisms and management of diuretic resistance in congestive heart failure. Postgraduate Medical Journal, 79:268-271. Retrieved from https://pmj.bmj.com/content/79/931/268.info Ellison, D. (2019). Clinical pharmacology in diuretic use. Clinical Journal of the American Society of Nephrology (CJASN), 14 (8) 1248-1257. doi: https://doi.org/10.2215/CJN.09630818 Fda.gov. (n.d.). Lasix. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/016273s066lbl.pdf Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Please responde to separately with 2 refrences within 5 years. 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. Jamie’sPost: The experience I am going to discuss was an over sedated post spinal obstetrics patient. The patient received a spinal for labor pains and patient became over sedated and developed respiratory depression. Patient history was that the patient was a first time mother and had never taken any narcotic or analgesic stronger than tylenol or ibuprofen. According to Wong,\” Most clinicians and patients agree that treating pain is beneficial\” (Wong & Dyer, 2019). Due to the need for the patient to have pain treatment the spinal was given to the patient for comfort. The patient became sleepy and the nurses attributed it to the decrease in pain and ability to relax. Following a break the patient was reassessed by the nurse and patient was found to be barely responsive with a respiratory rate of 6 and heart rate of 42. Pharmacokinetics show that the patient had quick absorption of the medication due to her quick sleepy state. Pharmacodynamics shows that the drug causes the patient to have a decreased LOC, respiratory rate and heart rate. The patients plan of care should consist of a longer observation period and more alternatives to pain control before quick insertion of a spinal. Wong, Cynthia A. MD; Dyer, Robert A. FCA (SA), PhD. Enough but not too much: monitoring for neuraxial morphine-associated respiratory depression in obstetric patients. Anesthesia & Analgesia: August 2019. Volume 129. Issue 2, p330-332. Pharmacology Essay Paper .doi:10.1213/ANE.0000000000004248
A strong understanding of how medications affect the body is important. Pharmacokinetics discusses how the medicines are metabolized by the liver, and pharmacodynamics describes the drug’s impact on the body. This post will explore a particular case, including causes that may have altered the patient’s reaction to drug therapy, as well as a review of a customized treatment plan for the above-mentioned patient. Owing to their reduced physiological capacity, the vulnerable aged within the elderly population is particularly susceptible to the toxic effects of medications, particularly antimicrobials (van den Anker et al ,2018). This decreased reserve is linked to a significantly lower function of one or more organs due to severe age, increased occurrence of concurrent chronic diseases, and recurrent polypharmacy with a rise in adverse effect- and drug-related stressors on physiological systems. Extensive data suggests delayed and insufficient dosage of antimicrobials correlates with elevated adverse effects, including resistance growth and mortality.
If the individual in the scenario has a co-morbid condition such as renal failure, pharmacological management includes an assessment of renal function, clinical judgment, and therapeutic monitoring to ensure sufficient concentrations of drugs that maximize pharmacodynamic response while minimizing toxicity (Mebazaa et al,2015).My plan of care for the patient would include verbal de-escalation as the first line of treatment and a low dose of Lasix. A safe rule for a prescriber is to go low and slow when prescribing drugs and monitor responses to therapy accordingly (Bassetti, Carnelutti and Peghin,2017).
Changes in blood pressure, particularly during initial therapy, must be closely monitored when using LASIX with other antihypertensive medications. If LASIX is added to the treatment, the dose of other medications should be decreased by at least 50 percent to avoid unnecessary fall in blood pressure. As the blood pressure falls under LASIX’s potentiating influence, further dose reduction or stopping of other antihypertensive medication could be needed.
In pediatric individuals, the normal initial dosage of oral LASIX is 2 mg/kg of body weight, administered as a single dose. If the diuretic reaction after the initial dose is unsatisfactory, the dose may still be increased by 1 or 2 mg/kg no earlier than 6 hours after the previous dose. Not indicated doses more than 6 mg/kg body weight. The dosage should be modified to the minimum effective amount for maintenance therapy in pediatric patients (Coté and Wilson, 2016). Pharmacology Essay Paper .
Bassetti, M., Carnelutti, A., & Peghin, M. (2017). Patient specific risk stratification for antimicrobial resistance and possible treatment strategies in gram-negative bacterial infections. Expert Review of Anti-infective Therapy, 15(1), 55-65.
Coté, C. J., & Wilson, S. (2016). Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures: update 2016. Pediatric dentistry, 38(4), 13E-39E.
Mebazaa, A., Yilmaz, M. B., Levy, P., Ponikowski, P., Peacock, W. F., Laribi, S., … & McDonagh, T. (2015). Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine–short version. European heart journal, 36(30), 1958-1966.
van den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental changes in pharmacokinetics and pharmacodynamics. The Journal of Clinical Pharmacology, 58, S10-S25. Pharmacology Essay Paper.