The Advanced Knowledge Of Pharmacy Therapeutics
The advanced knowledge of pharmacy therapeutics is crucial for all advanced practice nurses. According to Lopes-Júnior (2021), advanced practice nurses need to understand the individual variation in drug responses is very critical. Understanding the individual variations allows nurses to reduce potential harm to their patients. You should have added some of the harm patients experience if they are affected by various drugs. It is essential to consider the age, genetics, environment, gender, and pathophysiology factors (Lopes-Júnior, 2021)The Advanced Knowledge Of Pharmacy Therapeutics . In terms of age, some old patients have problems with drugs, which are not absorbed easily. It is also essential to consider the history of the patients and understand the kind of medicine they have been taking before. Analyzing all these factors will help determine the correct drugs to give the patient, improving patient outcomes.
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As indicated, pharmacokinetics studies explain how drugs are absorbed, distributed, metabolized, and excreted. According to Palmer et al. (2022), pharmacokinetics studies use various healthy volunteers and patients to conduct these investigations. Obtaining the pharmacokinetic information of any new drug development is essential to ensure that all medicines are used appropriately. A nurse should understand all the factors of pharmacodynamics to understand how various drugs will behave in the body. It is important to note that drug developers use insights gained from the PK and PD analysis to design better clinical studies (Palmer et al., 2022)The Advanced Knowledge Of Pharmacy Therapeutics . The more studies are conducted, the higher the chances of improving efficiency and ensuring that each patient is given the proper medication.
From the case, the patient is a smoker and has been smoking for 30 years. According to Keepers et al. (2020), smoking is one of the major causes of significant drug interactions in human beings. The polyaromatic hydrocarbons in cigarette smoke are known to induce cytochrome P4501A2 (CYP1A2), which highly affects drug disposition in the body. According to Keepers et al. (2020), smokers often need a % higher daily dosage than non-smokers because smoking leads to the induction of the CYP1A2 enzymes. I also agree with you that sex differences are a significant factor in pharmacokinetics. According to Pollock et al. (2018), there are differences in olanzapine due to gender differences. In this case, a patient is a man. Various studies explain that men usually clear the olanzapine at a 38% faster rate than women (Pollock et al., 2018). You should have explained further about this concerning the case. Besides, since estrogen is a significant inhibitor of CYPA2, women clear the olanzapine at a slower rate than men. In this case, the patient is a man, which explains why the olanzapine was cleared faster (Pollock et al., 2018)The Advanced Knowledge Of Pharmacy Therapeutics . It is good that you have also included that sex differences in the blood flow and liver size were also some of the factors that might have influenced the pharmacokinetics and pharmacodynamics processes in the patient. However, you should have included more details in relation to the patient’s symptoms.
Drug sensitivity indeed varies with age. Infants and older adults are more sensitive to drugs. Following this, it is very important to know the age of the patients so that the right drugs that will have minimal reactions are administered. Young patients have high drug sensitivity results because their organs are yet to mature. On the other hand, older adults experience high sensitivity results because the organs have declined in their functionalities (Palmer et al., 2022). It would help if you related the age factor to the case. In this case, the patient is old; hence his organs might fail to function correctly. Following this, the decline in functionality alters drug absorption, metabolism, distribution, and excretion. It is good that you have defined the various terms clearly. According to Glassman and Muzykantov (2019), absorption is the movement of drugs from the administration site to the circulation system. Distribution is the movement of the administered drugs from the systematic circulation to the site where drug action must occur. Metabolism is changing drugs from a lipid-soluble form to a more water-soluble form for easier excretion (Glassman & Muzykantov, 2019). Conversely, excretion is the process where the drugs are removed from the body (Glassman & Muzykantov, 2019)The Advanced Knowledge Of Pharmacy Therapeutics .
I like the personalized care plan you gave your patient, considering his age, gender, and symptoms. The patient is old, and I agree with you that he will need very close monitoring so that the drugs given will not affect him negatively. Considering that the patient has a history of diabetes, it is crucial to give mood stabilizers since olanzapine can severely exacerbate diabetic control (OBER et al., 2019). Since the patient has a poor medication compliance history, it is good to ensure they get a long-acting antipsychotic medication. The patient should be monitored closely to ensure they take the medication on time and avoid smoking, as it will interfere with the olanzapine metabolism (OBER et al., 2019)The Advanced Knowledge Of Pharmacy Therapeutics . You should also have included the right food for the patients so there are no drug-food interactions.
References
Glassman, P. M., & Muzykantov, V. R. (2019). Pharmacokinetic and Pharmacodynamic Properties of Drug Delivery Systems. The Journal of Pharmacology and Experimental Therapeutics, 370(3), 570-580. https://doi.org/10.1124/jpet.119.257113
Keepers, G. A., Fochtmann, L. J., Anzia, J. M., Benjamin, S., Lyness, J. M., Mojtabai, R., Servis, M., Walaszek, A., Buckley, P., Lenzenweger, M. F., Young, A. S., Degenhardt, A., & Hong, S. (2020). The American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia. American Journal of Psychiatry, 177(9), 868-872. https://doi.org/10.1176/appi.ajp.2020.177901
Lopes-Júnior, L. C. (2021). Advanced Practice Nursing and the Expansion of the Role of Nurses in Primary Health Care in the Americas. SAGE Open Nursing, 7, 237796082110194. https://doi.org/10.1177/23779608211019491
OBER, S. K., HUDAK, R., & RUSTERHOLTZ, A. (2019)The Advanced Knowledge Of Pharmacy Therapeutics . Hyperglycemia and Olanzapine. American Journal of Psychiatry, 156(6), 970–970. https://doi.org/10.1176/ajp.156.6.970
Palmer, M. E., Andrews, L. J., Abbey, T. C., Dahlquist, A. E., & Wenzler, E. (2022). The Importance of Pharmacokinetics and Pharmacodynamics in Antimicrobial Drug Development and their Influence on the Success of Agents Developed to Combat Resistant Gram-Negative Pathogens: A review. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.888079
Pollock, B. G., Wylie, M., Stack, J. A., Sorisio, D. A., Thompson, D. S., Kirshner, M. A., Folan, M. M., & Condifer, K. A. (2018). Inhibition of Caffeine Metabolism by Estrogen Replacement Therapy in Postmenopausal Women. The Journal of Clinical Pharmacology, 39(9), 936–940. https://doi.org/10.1177/00912709922008560 The Advanced Knowledge Of Pharmacy Therapeutics
