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Pharmacokinetics and Pharmacodynamics Essay Discussion

Pharmacokinetics and Pharmacodynamics Essay Discussion

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Pharmacokinetics and Pharmacodynamics Essay Discussion

Pharmacokinetics and Pharmacodynamics Essay Discussion Week 1
discussion

Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the
diagnosis and treatment of disorders, it is important to not only understand
the impact of disorders on the body, but also the impact of drug treatments on
the body. The relationships between drugs and the body can be described by
pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body
does to the drug through absorption, distribution, metabolism, and excretion,
whereas pharmacodynamics describes what the drug does to the body. When
selecting drugs and determining dosages for patients, it is essential to
consider individual patient factors that might impact the patient’s
pharmacokinetic and pharamcodynamic processes. These patient factors include
genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking,
alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
In this Discussion, you reflect on a case from your past clinical experiences
and consider how a particular patient’s pharmacokinetic and pharmacodynamic
processes altered his or her response to a drug. Pharmacokinetics and Pharmacodynamics Essay Discussion.

To prepare:

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Review this week’s media presentation with Dr. Terry
Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott
article in the Learning Resources. Consider the principles of pharmacokinetics
and pharmacodynamics.

Reflect on your experiences, observations, and/or clinical
practices from the last five years. Select a case from the last five years that
involves a patient whose individual differences in pharmacokinetic and
pharmacodynamic factors altered his or her anticipated response to a drug. When
referring to your patient, make sure to use a pseudonym or other false form of
identification. This is to ensure the privacy and protection of the patient. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Consider factors that might have influenced the patient’s
pharmacokinetic and pharmacodynamic processes such as genetics (including
pharmacogenetics), gender, ethnicity, age, behavior, and/or possible
pathophysiological changes due to disease.

Think about a personalized plan of care based on these
influencing factors and patient history in your case study.

With these thoughts in mind:

By Day 3

Post a description of the case you selected. Then, describe
factors that might have influenced pharmacokinetic and pharmacodynamic
processes of the patient from the case you selected. Finally, explain details
of the personalized plan of care that you would develop based on influencing
factors and patient history in your case. Pharmacokinetics and Pharmacodynamics Essay Discussion.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days by suggesting
additional patient factors that might have interfered with the pharmacokinetic
and pharmadynamic processes of the patients in their case studies. In addition,
suggest how the personal care plan might change if the age of the patient were
different and if the patient had a comorbid condition such as renal failure,
heart failure, or liver failure.

Week 2
discussion

Discussion: Ethical and Legal Implications of Prescribing
Drugs

What type of drug should you prescribe based on your
patient’s diagnosis? How much of the drug should the patient receive? How often
should the drug be administered? When should the drug not be prescribed? Are
there individual patient factors that could create complications when taking
the drug? Should you be prescribing drugs to this patient?

These are some of the questions you might consider when
selecting a treatment plan for a patient. As an advanced practice nurse
prescribing drugs, you are held accountable for people’s lives on a daily
basis. Patients and their families will often place trust in you because of
your position. With this trust comes power and responsibility, as well as an
ethical and legal obligation to “do no harm.” It is important that you are
aware of current professional, legal, and ethical standards for advanced
practice nurses with prescriptive authority. In this Discussion, you explore
ethical and legal implications of scenarios and consider how to appropriately respond.

Scenario 1:

As a nurse practitioner, you prescribe medications for your
patients. You make an error when prescribing medication to a 5-year-old
patient. Rather than dosing him appropriately, you prescribe a dose suitable
for an adult. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Scenario 2:

A friend calls and asks you to prescribe a medication for
her. You have this autonomy, but you don’t have your friend’s medical history.
You write the prescription anyway.

Scenario 3:

You see another nurse practitioner writing a prescription
for her husband who is not a patient of the nurse practitioner. The
prescription is for a narcotic. You can’t decide whether or not to report the
incident.

Scenario 4:

During your lunch break at the hospital, you read a journal
article on pharmacoeconomics. You think of a couple of patients who have
recently mentioned their financial difficulties. You wonder if some of the
expensive drugs you have prescribed are sufficiently managing the patients’
health conditions and improving their quality of life.

To prepare:

Review Chapter 1 of the Arcangelo and Peterson text, as well
as articles from the American Nurses Association, Anderson and Townsend, the
Drug Enforcement Administration, and Philipsend and Soeken.

Select one of the four scenarios listed above.

Consider the ethical and legal implications of the scenario
for all stakeholders involved such as the prescriber, pharmacist, patient, and
the patient’s family.

Think about two strategies that you, as an advanced practice
nurse, would use to guide your ethically and legally responsible
decision-making in this scenario. Pharmacokinetics and Pharmacodynamics Essay Discussion.

With these thoughts in mind:

By Day 3

Post an explanation of the ethical and legal implications of
the scenario you selected on all stakeholders involved such as the prescriber,
pharmacist, patient, and the patient’s family. Describe two strategies that
you, as an advanced practice nurse, would use to guide your decision making in
this scenario.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different scenario than you did, in one or more of the following ways:

Suggest additional ethical and legal implications for all
stakeholders in your colleagues’ scenarios.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Week 3
discussion

Discussion: Pharmacotherapy for Cardiovascular Disorders

As the leading cause of death in the United States for both
men and women, cardiovascular disorders account for 7 million hospitalizations
per year (NCSL, 2012). This is the result of the extensive treatment and care
that is often required for patients with these disorders. While the incidences
of hospitalizations and death are still high, the mortality rate of
cardiovascular disorders has been declining since the 1960s (CDC, 2011).
Improved treatment options have contributed to this decline, as well as more
knowledge on patient risk factors. As an advanced practice nurse, it is your
responsibility to recommend appropriate treatment options for patients with
cardiovascular disorders. To ensure the safety and effectiveness of drug
therapy, advanced practice nurses must consider aspects that might influence
pharmacokinetic and pharmacodynamic processes such as medical history, other
drugs currently prescribed, and individual patient factors. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Consider the following case studies:

Case Study 1:

Patient AO has a history of obesity and has recently gained
9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia.
Drugs currently prescribed include the following:

Atenolol 12.5 mg daily

Doxazosin 8 mg daily

Hydralazine 10 mg qid

Sertraline 25 mg daily

Simvastatin 80 mg daily

Case Study 2:

Patient HM has a history of atrial fibrillation and a
transient ischemic attack (TIA). The patient has been diagnosed with type 2
diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs
currently prescribed include the following:

Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun

Aspirin 81 mg daily

Metformin 1000 mg po bid

Glyburide 10 mg bid

Atenolol 100 mg po daily

Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Case Study 3:

Patient CB has a history of strokes. The patient has been
diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs
currently prescribed include the following:

Glipizide 10 mg po daily

HCTZ 25 mg daily

Atenolol 25 mg po daily

Hydralazine 25 mg qid

Simvastatin 80 mg daily

Verapamil 180 mg CD daily

To prepare:

Review this week’s media presentation on hypertension and
hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson
text.

Select one of the three case studies, as well as one the
following factors: genetics, gender, ethnicity, age, or behavior factors.

Reflect on how the factor you selected might influence the
patient’s pharmacokinetic and pharmacodynamic processes.

Consider how changes in the pharmacokinetic and
pharmacodynamic processes might impact the patient’s recommended drug therapy.

Think about how you might improve the patient’s drug therapy
plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on
whether you would modify the current drug treatment or provide an alternative treatment
option for the patient.

With these thoughts in mind:

By Day 3

Post an explanation of how the factor you selected might
influence the pharmacokinetic and pharmacodynamic processes in the patient from
the case study you selected. Then, describe how changes in the processes might
impact the patient’s recommended drug therapy. Finally, explain how you might
improve the patient’s drug therapy plan. Pharmacokinetics and Pharmacodynamics Essay Discussion.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different case study than you did, in one or more of the following ways:

Provide alternative recommendations for drug treatments.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Week 4
discussion

Discussion: Pharmacotherapy for Respiratory Disorders

To the untrained ear, most coughs sound the same. However,
as you might recall from past clinical experiences, a simple cough can lead to
a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive
pulmonary disease (COPD). Although it can sometimes be challenging to diagnose
a patient based on common respiratory symptoms such as congestion, coughing,
and wheezing, it is important to be able to distinguish minor differences as
even mild symptoms might require intervention with drug treatments. When
recommending potential treatment options, advanced practice nurses must
consider how individual patient factors might impact the effects of prescribed
drugs.

To prepare:

Review Chapter 26 and Chapter 27 of the Arcangelo and
Peterson text.

Select and research one of the following respiratory
disorders: the common cold, pneumonia, or a chronic obstructive pulmonary
disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs
that would be prescribed to patients to treat symptoms associated with this
disorder.

Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact effects of
prescribed drugs, as well as any measures you might take to help reduce
negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms. Then, explain how the factor you selected might impact
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different respiratory disorder than you did. If the disorder you selected is
primarily associated with the upper respiratory system, respond to colleagues
who selected disorders primarily associated with the lower respiratory system.
Provide alternative recommendations for drug treatments. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Week 5
discussion

Discussion: Pharmacotherapy for Cardiovascular Disorders

Neurological disorders, such as headaches, seizure
disorders, sleep disorders, depression, and dementia can present several
complications for patients of all ages. These disorders affect patients
physically and emotionally, impacting judgment, school and/or job performance,
and relationships with family and friends. Since these disorders may have
drastic effects on patients’ lives, it is important for advanced practice
nurses to effectively manage patient care. With patient factors and medical
history in mind, it is the advanced practice nurse’s responsibility to manage
the diagnosis, treatment, and education of patients with neurological
disorders.

To prepare:

Review this week’s media presentation on pharmacology for
the nervous system.

Select one of the following neurological disorders:
headaches, seizure disorders, sleep disorders, depression, or dementia.
Consider the types of drugs that would be prescribed to patients to treat
symptoms associated with this disorder.

Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the neurological disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms. Then, explain how the factor you selected might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different neurological disorder than you did. Provide recommendations for
alternative drug treatments and patient education strategies for treatment and
management. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Week 6
discussion

Discussion: Pharmacotherapy for Endocrine and
Musculoskeletal Disorders

Patients with endocrine and musculoskeletal disorders often
require long-term treatment and care resulting in the need for extensive
patient education. By appropriately educating patients, advanced practice
nurses can assist patients with the management of their disorders. In clinical
settings, patients with endocrine and musculoskeletal disorders typically seek
treatment for symptoms that pose problems to their everyday lives as ordinary
tasks may become difficult to complete. For instance, patients might have
difficulty walking short distances, preparing meals, or even running errands.
To reduce these symptoms and additional health risks, it is essential to
develop drug therapy plans with individual patient factors in mind.

To prepare:

Select one of the following endocrine or musculoskeletal
disorders: thyroid disease, osteoarthritis, rheumatic arthritis, gout, multiple
sclerosis, or fibromyalgia. Consider the types of drugs that would be
prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the endocrine or musculoskeletal
disorder you selected including types of drugs that would be prescribed to
patients to treat associated symptoms. Then, explain how the factor you
selected might impact the effects of prescribed drugs, as well as any measures
you might take to help reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different endocrine or musculoskeletal disorder than you did. Provide
recommendations for alternative drug treatments and patient education
strategies for treatment and management.

Week 7
discussion

Discussion: Pharmacotherapy for Gastrointestinal and
Hepatobiliary Disorders

Gastrointestinal (GI) and hepatobiliary disorders affect the
structure and function of the GI tract. Many of these disorders often have
similar symptoms such as abdominal pain, cramping, constipation, nausea,
bloating, and fatigue. Since multiple disorders can be tied to the same
symptoms, it is important for advanced practice nurses to carefully evaluate
patients and prescribe treatment that targets the cause rather than the
symptom. Once the underlying cause is identified, an appropriate drug therapy
plan can be recommended based on medical history and individual patient
factors. In this Discussion, you examine a case study of a patient who presents
with symptoms of a possible GI/hepatobiliary disorder, and you design an
appropriate drug therapy plan. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Consider the following case study:

Patient HL comes into the clinic with the following
symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug
abuse and possible Hepatitis C. HL is currently taking the following
prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

Review this week’s media presentation on pharmacology for
the gastrointestinal system.

Review the provided case study. Reflect on the patient’s
symptoms, medical history, and drugs currently prescribed.

Think about a possible diagnosis for the patient. Consider
whether the patient has a disorder related to the gastrointestinal and
hepatobiliary system or whether the symptoms are the result of a disorder from
another system or other factors such as pregnancy, drugs, or a psychological
disorder.

Consider an appropriate drug therapy plan based on the
patient’s history, diagnosis, and drugs currently prescribed.

With these thoughts in mind:

By Day 3

Post an explanation of your diagnosis for the patient
including your rationale for the diagnosis. Then, describe an appropriate drug
therapy plan based on the patient’s history, diagnosis, and drugs currently
prescribed.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who diagnosed the
patient differently than you did, in one or more of the following ways:

Provide alternative recommendations for drug treatments.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Week 8
discussion

Discussion: Drug Treatments for HIV/AIDS

While HIV/AIDS is still currently incurable, the prognosis for
patients with this infectious disease has improved due to advancements in drug
treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in
1992 and was told she would survive, at most, 10 more years. Despite
unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis,
she has witnessed tremendous improvements in HIV/AIDS treatments which have
helped patients live longer with fewer side effects. While she acknowledges
that these drug treatments have kept her alive, she fears that improvements in
drug therapy have led to more people becoming complacent about the disease
(Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in
the United States is higher than it has ever been (CDC, 2012). This poses the
question: Is there a relationship between drug advancements, societal
complacency, and infection? Pharmacokinetics and Pharmacodynamics Essay Discussion.

To prepare:

Review Chapter 49 of the Arcangelo and Peterson text, as
well as the Krummenacher et al. and Scourfield articles in the Learning
Resources.

Reflect on whether or not the prevalence of HIV cases might
be attributed to increased complacency due to more advanced drug treatment
options for HIV/AIDS.

Consider how health care professionals can help to change
perceptions and make people more aware of the realities of the disease.

Think about strategies to educate HIV positive patients on
medication adherence, as well as safe practices to reduce the risk of infecting
others.

With these thoughts in mind:

By Day 3

Post an explanation of whether or not you think the
prevalence of HIV cases might be attributed to increased complacency due to
more advanced drug treatment options.Then, explain how health care
professionals can help to change perceptions and increase awareness of the
realities of the disease. Finally, describe strategies to educate HIV positive
patients on medication adherence, as well as safe practices to reduce the risk
of infecting others.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who provided a
different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Week 9
discussion

Discussion: Pharmacotherapy for Hematologic Disorders

In the 1970s, the average lifespan for patients diagnosed
with sickle cell disease was 14 years. Today, the average lifespan has increased
to 50 years and beyond (TriHealth, 2012). The patient prognosis for many other
hematologic disorders such as hemophilia and cancer continue to improve as
well. This can be attributed to advancements in medical care—specifically drug
therapy and treatment. When managing drug therapies for patients, it is
essential to continuously examine current treatments and evaluate the impact of
patient factors on drug effectiveness. To prepare for your role as an advanced
practice nurse, you must become familiar with common drug treatments for
various hematologic disorders seen in clinical settings. Pharmacokinetics and Pharmacodynamics Essay Discussion.

To prepare:

Select one of the following hematologic disorders: anemia,
hemophilia, cancer, sickle cell anemia, thalassemia, thrombolytic disorders, or
white blood cell disorders. Consider the types of drugs that would be
prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the hematologic disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms Pharmacokinetics and Pharmacodynamics Essay Discussion. Then, explain how the factor you selected might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different hematologic disorder than you did. Provide recommendations for
alternative drug treatments and patient education strategies for treatment and
management.

Week 10
discussion

Discussion: Hormone Replacement Therapy

In recent years, hormone replacement therapy has become a
controversial issue. When prescribing therapies, advanced practice nurses must
weigh the strengths and limitations of the prescribed supplemental hormones. If
advanced practice nurses determine that the limitations outweigh the strengths,
then they might suggest alternative treatment options such as herbs or other
natural remedies, changes in diet, and increase in exercise.

Consider the following scenario:

As an advanced practice nurse at a community health clinic,
you often treat female (and sometimes male patients) with hormone deficiencies.
One of your patients requests that you prescribe supplemental hormones. This
poses the questions: How will you determine what kind of treatment to suggest?
What patient factors should you consider? Are supplemental hormones the best
option for the patient, or would they benefit from alternative treatments?

To prepare:

Review Chapter 56 of the Arcangelo and Peterson text, as
well as the Holloway and Makinen and Huhtaniemi articles in the Learning
Resources. Pharmacokinetics and Pharmacodynamics Essay Discussion.

Review the provided scenario and reflect on whether or not
you would support hormone replacement therapy.

Locate and review additional articles about research on
hormone replacement therapy for women and/or men. Consider the strengths and
limitations of hormone replacement therapy.

Based on your research of the strengths and limitations,
again reflect on whether or not you would support hormone replacement therapy.

Consider whether you would prescribe supplemental hormones
or recommend alternative treatments to patients with hormone deficiencies.

With these thoughts in mind:

By Day 3

Post a description of the strengths and limitations of
hormone replacement therapy. Based on these strengths and limitations, explain
why you would or why you would not support hormone replacement therapy. Explain
whether you would prescribe supplemental hormones or recommend alternative
treatments to patients with hormone deficiencies and why.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who provided a
different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Week 11
discussion

Discussion: Off-Label Drug Use in Pediatrics

The unapproved use of approved drugs, also called off-label
use, with children is quite common. This is because pediatric dosage guidelines
are typically unavailable since very few drugs have been specifically
researched and tested with children.

When treating children, prescribers often adjust dosages
approved for adults to accommodate a child’s weight. However, children are not
just “smaller” adults. Adults and children process and respond to drugs
differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence.
This poses potential safety concerns when prescribing drugs to pediatric
patients. As an advanced practice nurse, you have to be aware of safety
implications of the off-label use of drugs with this patient group. Pharmacokinetics and Pharmacodynamics Essay Discussion.

To prepare:

Review the Bazzano et al. and Mayhew articles in the
Learning Resources. Reflect on situations in which children should be
prescribed drugs for off-label use.

Think about strategies to make the off-label use and dosage
of drugs safer for children from infancy to adolescence. Consider specific
off-label drugs that you think require extra care and attention when used in
pediatrics.

With these thoughts in mind:

By Day 3

Post an explanation of circumstances under which children
should be prescribed drugs for off-label use. Then, describe strategies to make
the off-label use and dosage of drugs safer for children from infancy to
adolescence. Include descriptions and names of off-label drugs that require extra
care and attention when used in pediatrics.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who provided a
different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research. Pharmacokinetics and Pharmacodynamics Essay Discussion.

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