Response #1 to Discussion Post (week 1) Adv Pharm.pdf - NURS 6521N-26 ADVANCED PHARMACOLOGY RESPONSE 1 to DISCUSSION POST(Week 1 Ruth Kingoo Deborah

Response #1 to Discussion Post (week 1) Adv Pharm.pdf -...

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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
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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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