Finally Hydromorphone 1mg IV is administered After an hour the patient still

Finally hydromorphone 1mg iv is administered after an

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Finally, Hydromorphone 1mg, IV is administered. After an hour, the patient still reports pain 10/10. Pharmacokinetics and Pharmacodynamics
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Pharmacokinetics studies the absorption, distribution, metabolism, and excretion of drugs within the body system (Ball, Dains, Flynn, Solomon, & Stewart, 2019). The use of pharmacokinetics enables providers to determine the appropriate drug for a patient’s diagnosis. Pharmacodynamics refers to how the body is affected by the use of certain medications (Fox, Hawney, & Kaye, 2011). Due to the individualized nature of the human body, finding a drug that responds with minimal side effects are desired.Pharmacokinetics, as it relates to this patient’s pathophysiology, creates difficulty for the patient due to the diagnosis of kidney failure and cirrhosis. Cirrhosis of the liver prevents the body from absorbing, distributing, and metabolizing the drug. With significant disease process in effect, it is difficult for the body to absorb the drug at a rate that provides effective pain control. The first-pass metabolism with hydromorphone is decreased in liver cirrhosis and has a likelihood of high hepatic extraction (Wehrer, 2015). Whereas, fentanyl, is a protein-bound medication is reportedly unaffected by cirrhosis (Wehrer, 2015). Though the patient tolerated the fentanyl in our case, no specific relief is found due to the chronic nature of the pain. Decreased kidney function reduces the excretion of
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