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Pharmacokinetics and PharmacodynamicsAll healthcare providers, involved with developing drug therapy plans, must assess and analyze the many patient factors that impact pharmacotherapeutics. Safe practitioners understand the pharmacokinetics as wells as the pharmacodynamics as they provide a foundationfor effective and focused individualized plans. Without this understanding, drug therapy plans can be detrimental on many levels but especially for the patient (Laureate Education, Inc. (Executive Producer), 2012). The purpose of this discussion is to provide a patient case scenario,a description of factors that might have influenced pharmacokinetic and pharmacodynamic processes, and an explanation of a personalized plan of care for the patient scenario.Patient Case ScenarioSubjective findings for Ms. M. included 55 years of age upon admission to the wound care center for a painful, chronic lower extremity ulcer that started two months ago. Her past medical history included end-stage renal disease caused by over-use of NSAIDs (ibuprofen), requires hemodialysis 3x/week. She also had a history of diabetes mellitus, obesity, hypertension, fibromyalgia, and headaches. She had a negative family history. Her social history was negative for smoking, negative for alcohol use. She relied on disability programs for income and insurance. She lived independently, was single, education level was high school graduate. Objective findings included tearful but pleasant obese female with severe pain of 10/10 surrounding her chronic ulcer. Physical exam demonstrated ulcer to left leg, vascular studies ABI 08 bilaterally. Assessment on admission was a chronic ulcer, calciphylaxis, venous insufficiency ulcer, arterial ulcer. The plan involved biopsy of the wound, complete metabolic profile, culture and sensitivity of wound, metabolic profile, complete blood counts, education regarding wound types and knowledge deficit, and health promotion to address obesity.
Patient Factors Influencing Pharmacokinetic and Pharmacodynamic ProcessesPharmacokinetics refers to the bodies response to a drug. It includes absorption, distribution, and elimination and impacts the drug's action and blood levels (Arcangelo, Peterson,Wilbur, & Reinhold, (Eds.), 2017). Ms. M.'s factors related to ibuprofen use led to a pharmacokinetic basis for her end-stage renal disease years earlier. The long-term impact can be seen in the development of calciphylaxis and a chronic painful wound. According to Lexicomp (2013), NSAID use can compromise renal function. Depending on dosage, NSAIDs can reduce renal blood flow and cause decompensation. Long-term, chronic use can lead to renal papillary necrosis. Patients with impaired renal function are at higher risk for renal toxicity and should have renal function closely monitored. Ms. M. stated she, sadly, was unaware of how ibuprofen