Week 3 Main Question PostPharmacokinetics and PharmacodynamicsMr. Angola is a 56-year-old African American man who was admitted to hospital with past medical history of hypertension (HTN), hyperlipidemia, heart failure (CHF), type 2 diabetes, hepatic congestion and history of untreated hepatitis C. The nurse informed the attending doctor about his worsening condition. The nurse reported that Mr. Angola was started on a new medication on this admission by a covering doctor. The nurse continued to state that Mr. Angola complaining of chest pain and his vitals were unstable (hypotensive) and had a dry irritating cough, poor appetite and dry mouth which seemed worse. After reviewing the medical record, the doctor discovers that the new medications on the list were Vasotec (Enalapril) and Hydrochlorothiazide. The doctor discovered that Mr. Angola had low creatinine levels (19ml/min). The covering doctor had prescribed Mr. Angola 5 mg of Vasotec by mouth daily, which is too high for a patient with a decreased creatinine clearance. The doctor discontinued thedrug.Factors Influencing Pharmacokinetics and PharmacodynamicsIn the above case study, age, ethnicity and pathophysiological changes due to the disease process are the factors influencing pharmacokinetic and pharmacodynamics of the drug Vasotec. Vasotec is an ACE inhibitor which research shows that it has minimal effect on individuals who are of African- American heritage (Arcangelo & Peterson, 2017). According to Arcangelo and Peterson (2017), African –Americans produce low-level renin, which inhibits the action of ACE inhibitors. Renin is an important factor in the renin- angiotensin- aldosterone system, which helps the ACE inhibitors elicit therapeutic effects. Caucasians respond well to ACE inhibitors
compared to African- Americans (Medscape, 2018). Due to this reason, the pharmacodynamics of Vasotec is affected thus a new drug has to be prescribed. The major organs like kidneys, CNS,the heart and the liver’s functions deteriorate as one age. “Age-related changes in pharmacokinetics and pharmacodynamics, together with comorbidity and polypharmacy, make elderly patients at special risk for adverse drug reactions, which in turn are the cause of relevant health burden and costs (Pedone, Corsonello & Incalzi, 2010). The hepatic function of drug clearance decreases with age and with Mr. Angola’s history of hepatic congestion, hepatitis C,
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Pharmacology, Discussion Post, Weekly Discussion, Blood urea nitrogen, Opioid receptor