NURS 6521N-26: ADVANCED PHARMACOLOGY RESPONSE # 1 to DISCUSSION POST (Week 1): Ruth Kingoo Deborah Lucero, RN, BS, CVRN-BC, FACCN Basic Pharmacotherapeutic Concepts Dear Ruth, Wonderful discussion post regarding diabetic ketoacidosis (DKA). As I read your post it reminded me of a patient that was a frequent flyer in the ICU with DKA and a non-healing foot ulcer. My patient, CJ, was also a mid to late 70 year old female patient, but was African- American with additional history of congestive heart failure (CHF) and end stage renal disease (ESRD). Like your patient, CJ had a similar history of hypercholesterolemia, diabetes mellitus type 1, hypertension, and a chronic non-healing right foot ulcer. Not only would I be concerned with her primary admission diagnosis of DKA, but I would also be concerned with her non-healing foot ulcer, especially with her history of high cholesterol, DM type I, hypertension, and DKA status. I have been a cardiac ICU nurse for 15 years, achieved my Board Certification as Cardiovascular Registered Nurse (CVRN-BC) and a fellow with the American College of Cardiovascular Medicine in Nursing (FACCN); your patient’s history with a non-healing right foot ulcer, I would also be concerned that the patient may have peripheral artery disease (PAD) as a possible contributor to why her foot ulcer is not healing. Factors Influencing Pharmacokinetics & Pharmacodynamics Pharmacokinetics can be thought of as what the body does to the drug, while pharmacodynamics is essentially what the drug does to the body (Peterson, 2013). Both
pharmacokinetics and pharmacodynamics are influenced by different variables. Such variables include pathophysiology, genetics, age, sex, ethnicity, diet, and nutrition (Peterson, 2013). These factors influence how a drug is absorbed, distributed, metabolized, and eliminated for the body (Peterson, 2013). In the case of CJ, a 76-year-old African-American female, there are several factors than can influence the pharmacokinetics and pharmacodynamics of her medications. In particular, her age, co-morbidities, and ethnicity. For example, “drug-disease interactions can
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- Summer '15