Write a 2- to 3-page paper that addresses the following:
-Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
-Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
-Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
-Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Case Study 1
LM is an 86-year-old female admitted to the emergency department with delirium. Her spouse is with her and verifies that LM adheres to the medications she is currently prescribed. She does not self-monitor her BP or heart rate at home.
PMH:
A Fib diagnosed 1 month ago
HTN x 10 years
CKD x 5 years
Osteoarthritis x 7 years
GERD x 20 years
Medications:
Digoxin 0.25 mg QD
Metoprolol XL 25mg QD
Warfarin 3 mg QD
APAP 650 mg TID
Omeprazole 20mg QD
Multivitamin QD
Allergies: NKDA
Social History:
Married to husband for 57 years
No smoking, alcohol, limited daily exercise (short walks each morning)
Family History:
None reported
Vitals: Labs:
Wt 113 lbs Ht 5’4” Na+ 138 K+ 4.0
BP 101/58, HR 52 Cl- 99 CO2 27
BUN 33 Cr 1.2
Gluc 109 INR 3.8
Dig 2.4
PE:
Elderly female with altered level of consciousness, no signs of bruising, bleeding, or other injury.
Do not focus on coumadin although the INR is slightly elevated she has no signs of bleeding. i dont think its contributing to her symptoms
Her rate is low and blood pressure is on the low side. I think the prof wants to focus on factors for example age and metoprolol. like reduced hepatic and renal function with age: if function is decreased, impaired metabolism and elimination by these pathways may result in increased drug levels hence low bp and heart rate. Explain the pharmacokinetic and pharmocodynamics of metoprolol and older age( reduced hepatic and renal function)
The same with digoxin toxicity and age (hepatic and renal function) contributing to confusion. Explain the pharmacokinetic and pharmocodynamics of digoxin and older age( reduced hepatic and renal function)
older Age and Apap (acetaminophen) age induced hepatotoxicity. etc
older age is an easy factor focus on.
3 scholarly articles. apa format. Please do not plagiarize, I have to submit to safe assign. no medscape or kaiser
