LM is an 89-year-old female resident<\/p>\n
Case Study:<\/p>\n
LM is an 89-year-old female resident of a long-term care facility who has been experiencing multiple falls, some resulting in injuries such as bruising and skin tears. Over the last 6 months, her ambulation status has declined from independent to wheelchair level. She complains of pain in her legs when walking more than short distances across the nursing unit.
\nPMH:
\n\u2022 HTN
\n\u2022 Alzheimer\u2019s disease
\n\u2022 Hypothyroidism
\n\u2022 Osteoarthritis
\n\u2022 Diabetes
\nMEDICATIONS:
\n\u2022 Amlodipine 10 mg QD
\n\u2022 Donepezil 10 mg QHS
\n\u2022 Levothyroxine 0.88 mg QAM
\n\u2022 Celecoxib 200 mg QD
\n\u2022 Furosemide 40 mg QAM
\n\u2022 Metformin 500mg, 1 BID
\n\u2022 Glyburide 5mg, 1 BID
\nALLERGIES: NKA
\nSOCIAL HISTORY:
\nWidowed with 2 adult children living in town, retired photographer and owner of an art supply store
\nVITALS: LABS:
\nWeight: 129 lbs TSH 2.45 Free T4 0.98
\nHeight: 64 inches Na 135, K+ 3.8, Cl 99, CO2 25,
\nBP: Supine = 177\/82 Glucose 101, SCr 0.9, BUN 42
\nHR: 78 bpm WBC 7.0, RBC 4.5, Hgb 11.9, Hct 34.1
\nPlt 255
\nCr: 1.6 UA: Clear
\neGFR: 45 ml\/min
\nPE:
\n\u2022 HEENT: Normocephalic, no evidence of trauma, PERRLA, EOMI, Dry mucous membranes
\n\u2022 CV: RRR
\n\u2022 Respiratory: Clear to auscultation bilaterally
\n\u2022 Abdomen: Soft, non-tender, no masses or guarding
\n\u2022 G\/U: Skin intact, assisted with toileting and personal hygiene by staff
\n\u2022 Extremities: Bilateral 2+ edema to lower extremities; skin dry, dark bruising and skin tear to right elbow and forearm
\n\u2022 Neuro: Alert and oriented to person only. MMSE 18\/30, stable over last 12 months.
\nPAIN ASSESSMENT:
\nFaces pain scale: No pain occurs at rest, upon walking, pain is moderate to severe<\/p>\n
Assignment
\n\u2022 Review the case study assigned by your Instructor for this Assignment.
\n\u2022 Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
\n\u2022 Explain on how the factor you selected might influence the patient\u2019s pharmacokinetic and pharmacodynamic processes.
\n\u2022 Explain how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient\u2019s recommended drug therapy.
\n\u2022 Explain how you might improve the patient\u2019s 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.
\nAPA format must be 2-3 pages and at least 3 references. Must be scholar references<\/p>\n
_____________________________________________
\nThe Impact of Age on Pharmacokinetics and Pharmacodynamics<\/p>\n
As people age, their bodies undergo a number of changes that can affect the way they metabolize drugs. These changes can lead to altered pharmacokinetics and pharmacodynamics, which can impact the effectiveness and safety of drug therapy.<\/p>\n
Factors Affecting Pharmacokinetics in the Elderly
\nThere are a number of factors that can affect the pharmacokinetics of drugs in the elderly, including:<\/p>\n
Reduced body weight and lean body mass: As people age, they tend to lose weight and muscle mass. This can lead to a decrease in the volume of distribution of drugs, which can increase the concentration of the drug in the blood.
\nChanges in liver and kidney function: The liver and kidneys are responsible for metabolizing and excreting drugs. With age, these organs can become less efficient, which can lead to a decrease in the clearance of drugs. This can increase the half-life of the drug in the body, which can lead to toxicity.
\nChanges in gastric emptying and intestinal absorption: The rate at which drugs are absorbed from the stomach and intestines can change with age. This can affect the peak concentration of the drug in the blood, as well as the overall bioavailability of the drug.
\nFactors Affecting Pharmacodynamics in the Elderly
\nThere are also a number of factors that can affect the pharmacodynamics of drugs in the elderly, including:<\/p>\n
Changes in receptor sensitivity: Receptor sensitivity can decrease with age. This can lead to a decrease in the response to drugs that act on these receptors.
\nChanges in drug-drug interactions: The risk of drug-drug interactions can increase with age. This is because the elderly are more likely to take multiple medications, which can increase the potential for interactions.
\nChanges in overall health status: The overall health status of the elderly can also affect the way they respond to drugs. For example, patients with chronic diseases such as heart disease, kidney disease, or liver disease may be more sensitive to the effects of drugs.
\nImpact of Age on Drug Therapy
\nThe changes in pharmacokinetics and pharmacodynamics that occur with age can impact the effectiveness and safety of drug therapy. For example, a drug that is effective in younger adults may not be effective in the elderly, or it may cause more side effects. It is important to consider the age of the patient when selecting and dosing medications.<\/p>\n
Conclusion
\nThe aging process can have a significant impact on the way drugs are metabolized and how they affect the body. It is important to be aware of these changes when prescribing medications to older adults. By carefully considering the patient’s age, health status, and other factors, healthcare providers can help to ensure that older adults receive safe and effective drug therapy.<\/p>\n
References
\nAmerican Geriatrics Society. (2019). Pharmacotherapy in older adults: AGS clinical practice guideline. Page Essay – Journal of the American Geriatrics Society, 67(1), 1-48.
\nBlaschke, T. F., & Hansten, P. D. (2012). Drug therapy in the elderly: Principles and practice. Philadelphia, PA: Lippincott Williams & Wilkins.
\nCossart, A.R., Cottrell, W.N., Campbell, S.B., Isbel, N.M. and Staatz, C.E., 2019. Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients. Translational andrology and urology, 8(Suppl 2), p.S198.
\nFoley, J.F., Goelz, S., Hoyt, T., Christensen, A. and Metzger, R.R., 2019. Evaluation of natalizumab pharmacokinetics and pharmacodynamics with standard and extended interval dosing. Multiple Sclerosis and Related Disorders, 31, pp.65-71.
\nRowland, M. (2015). Pharmacokinetics and pharmacodynamics in the elderly. Clinical Pharmacokinetics, 54(12), 1313-1331.<\/p>\n","protected":false},"excerpt":{"rendered":"
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