Posted: May 15th, 2023

Factors That May Influence Pharmacokinetic and Pharmacodynamic Processes

Week 2: Cardiovascular System

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

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This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.
Learning Objectives

Students will:

Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes
Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies
Evaluate drug therapy plans for cardiovascular disorders

Learning Resources

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Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Assignment: Pharmacotherapy for Cardiovascular Disorders

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...heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

Photo Credit: Getty Images/Science Photo Library RF

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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.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm
To Prepare

Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select 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.

By Day 7 of Week 2

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Write a 2- to 3-page paper that addresses the following:

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

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Factors That May Influence Pharmacokinetic and Pharmacodynamic Processes

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There are a number of factors that may influence pharmacokinetic and pharmacodynamic processes. These factors can include:

Age: Older adults may have decreased liver and kidney function, which can affect the way their bodies metabolize and excrete drugs. This can lead to higher drug levels in the blood, which can increase the risk of side effects.
Gender: Women may metabolize some drugs differently than men. For example, women tend to have lower levels of an enzyme called CYP3A4, which metabolizes many drugs. This can lead to higher drug levels in women, which can increase the risk of side effects.
Ethnicity: Some ethnic groups may metabolize drugs differently than others. For example, African Americans tend to have lower levels of CYP2D6, which metabolizes many drugs. This can lead to higher drug levels in African Americans, which can increase the risk of side effects.
Genetics: Some people may have genetic variants that affect the way their bodies metabolize and excrete drugs. This can lead to different drug levels in people with different genetic variants, which can increase the risk of side effects.
Weight: People who are overweight or obese may have higher drug levels in the blood than people who are at a healthy weight. This is because fat tissue can store drugs, which can slow down the rate at which the drugs are metabolized and excreted.
Health conditions: People with certain health conditions, such as liver or kidney disease, may have decreased drug clearance. This can lead to higher drug levels in the blood, which can increase the risk of side effects.
Medications: People who are taking multiple medications may be at increased risk for drug interactions. Drug interactions can occur when two or more drugs interact with each other, which can change the way the drugs work. This can lead to side effects, decreased effectiveness, or even toxicity.
Impact of Changes in Pharmacokinetic and Pharmacodynamic Processes on Drug Therapy

Changes in pharmacokinetic and pharmacodynamic processes can have a significant impact on drug therapy. For example, if a patient's drug clearance is decreased, the patient may need to take a lower dose of the drug to avoid side effects. Conversely, if a patient's drug clearance is increased, the patient may need to take a higher dose of the drug to achieve the desired therapeutic effect.

In addition to affecting the dose of a drug, changes in pharmacokinetic and pharmacodynamic processes can also affect the way a drug works. For example, if a patient's drug levels are too high, the drug may be more likely to cause side effects. Conversely, if a patient's drug levels are too low, the drug may not be effective at treating the patient's condition.

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Improving Drug Therapy Plans

There are a number of things that can be done to improve drug therapy plans for patients who have changes in pharmacokinetic and pharmacodynamic processes. These include:

Monitoring drug levels: In some cases, it may be necessary to monitor drug levels in patients who have changes in pharmacokinetic and pharmacodynamic processes. This can help to ensure that the patient's drug levels are within the therapeutic range and that the patient is not experiencing side effects.
Adjusting drug doses: In some cases, it may be necessary to adjust the dose of a drug in patients who have changes in pharmacokinetic and pharmacodynamic processes. This can help to ensure that the patient is receiving the correct amount of the drug to treat their condition without experiencing side effects.
Switching to a different drug: In some cases, it may be necessary to switch to a different drug in patients who have changes in pharmacokinetic and pharmacodynamic processes. This can help to ensure that the patient is receiving a drug that can be metabolized and excreted by their body in a way that is safe and effective.
Conclusion

Changes in pharmacokinetic and pharmacodynamic processes can have a significant impact on drug therapy. It is important for healthcare providers to be aware of these changes and to take steps to ensure that patients are receiving the correct dose of the correct drug to treat their condition without experiencing side effects.

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