Advanced Pharmacology
The scenario is of a patient aged 64 years and is suffering from a rare skin disease. The experience within the last five years with various patients has been interesting. The reason is that patients have different levels of responding to drugs. The interesting experiences comprise of both pharmacokinetics and pharmacodynamics processes. Other patients with similar diseases have different reactions. The differences between the two sets of patients are the age. The younger patients have a high rate of absorption compared to the old patient.
The factors that influence pharmacokinetic are due to the significant changes that occur among the elderly. Aging results in the reduced renal elimination of drug substances in the body (Heise, Pieber, Danne, Erichsen & Haahr, 2017). Creatinine decreases significantly among people who are above 40 years. The change is due to the reduced performance of the organs at old age. On the other hand, pharmacodynamics processes are affected significantly with age (Cebers et al., 2017). The changes are due to the reduced performance of Central Nervous System (CNS) which reduced the sensitivity of the body to opioids and anesthetics (Stott & Hope, 2017). Additionally, Jones et al. (2015) the drug-receptor interaction also change among the elderly. Therefore, in the case of the 64-year-old patient, the pharmacokinetic and pharmacodynamic processes are affected significantly.
The personalized plan for the elderly patient will comprise of changing the mode of administering the drugs (Vellonen et al., 2018). Administering drugs through the stomach can inhibit fast absorption. For example, fast absorption can be enhanced by injecting the drugs directly to the veins. The personalized plan can also include changing the medication to include personalized drugs that are customized for the elderly.
References
Cebers, G., Alexander, R. C., Haeberlein, S. B., Han, D., Goldwater, R., Ereshefsky, L., … & Maltby, J. (2017). AZD3293: Pharmacokinetic and pharmacodynamic effects in healthy subjects and patients with Alzheimerβs disease. Journal of Alzheimer’s Disease, 55(3), 1039-1053.
Heise, T., Pieber, T. R., Danne, T., Erichsen, L., & Haahr, H. (2017). A pooled analysis of clinical pharmacology trials investigating the pharmacokinetic and pharmacodynamic characteristics of fast-acting insulin as part in adults with type 1 diabetes. Clinical Pharmacokinetics, 56(5), 551-559.
Jones, H. M., Chen, Y., Gibson, C., Heimbach, T., Parrott, N., Peters, S. A., … & Hall, S. D. (2015). Physiologically based pharmacokinetic modeling in drug discovery and development: a pharmaceutical industry perspective. Clinical Pharmacology & Therapeutics, 97(3), 247-262.
Stott, K. E., & Hope, W. W. (2017). Therapeutic drug monitoring for invasive mold infections and disease: pharmacokinetic and pharmacodynamic considerations. Journal of Antimicrobial Chemotherapy, 72(suppl_1), i12-i18.
Vellonen, K. S., Hellinen, L., Mannermaa, E., Ruponen, M., Urtti, A., & Kidron, H. (2018). Expression, activity and pharmacokinetic impact of ocular transporters. Advanced Drug Delivery Reviews, 126, 3-22.