Pharmacology: Case Study Review with Focus on Pharmacokinetic and Pharmacodynamic Principles
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Feb 25, 2021
Pharmacology: Case Study Review with Focus on Pharmacokinetic and Pharmacodynamic Principles
The variation in patients both genotypically and phenotypically has resulted in an increased need for personalized medicine to improve patient outcomes. As such it is always necessary for healthcare practitioners to identify risk factors that may contribute to the worsening of an individual’s situation as well as existing personalized factors which occur as the care practitioners and the drug interact with the patient (Grande-Bretagne, 2014). Pharmacokinetics is well defined as the movement of the drug in a patient’s body or how the body affects the drug. On the other hand, pharmacokinetic reefers to how the drug affects the body or the therapeutic effects or toxicity provided by the drug (Peate, 2017; Bryant et al., 2019). In this discussion, I will give a case study of a 5-year-old African American male patient and also describe the pharmacokinetic and pharmacodynamic processes related to the case study. I will finally explain the most preferred personalized plan of care for the patient.
The Patient Case Scenario
A 5-year-old African American male was brought to the facility with a history of juvenile tuberculosis and complaining of recurrent fever cough, chest pains, and breathing difficulties. After full body examination, the patient was found to have a high pulse rate of 100/min, dull and irritable, and with high temperatures of 40 0c. Furthermore, the patient had increased breathing (RR 58/min) with wheezing, dehydrations, and crepitations. The general practitioner gave a provisional diagnosis but ordered further investigations. After the conduction of hematological and bacteriological investigations, the patient was found to have acute pneumonia and had to be introduced to antibiotics. The patient received amoxicillin orally which was done with lots of difficulties. It was also done after the conduction of bacteriological and hematological tests. This affected the resultant prognosis.
In this case scenario, the patient needed a drug that is fast-acting with more predictable action since the patient seemed to be severely ill. The preferred mode route of administration was the parenteral route which could quickly have the bioavailability levels as unitary. Existent dehydration eliminates the chances of drug delivery through i.v. which leaves the best option as i.m. The patient’s ethnicity had no impact on the patient’s drug response nor did the genetics. Despite there being incidences of drug-induced liver injury for patients on amoxicillin and clavulanic acid, there is no clear information on existing genetic factors that affect amoxicillin pharmacokinetics and response (Kim et al, 2015; Wu et al., 2011). The biggest obstacle was the patient behavior which determined the route of drug administration for better response. Similarly, the dosage could have been miscalculated due to the child being 5 years old and of average weight. With a low plasma protein binding capability (17%), and iv. mode of administration would be more effective in the management of patient symptoms and eventual treatment.
Personalized Care Plan
The physical state of the patient indicated that he was seriously ill and needed urgent treatment. The preferred mode of treatment should include a calculated dose of amoxicillin and clavulanic acid. As stated earlier, the preferred mode of administration should be i.v. and the dosage should start being administered as soon as the provisional diagnosis is made. The history of tuberculosis also prompts the combined use of amoxicillin and clavulanic acid. The drugs with low plasma protein binding capabilities are suitable in providing quick treatment with reduced toxicity since the two have a lower chance of toxicity even with slightly higher doses.
Case Study Review with Focus on Pharmacokinetic and Pharmacodynamic Principles
References
Bryant, B. J., Knights, K. M., Darroch, S., & Rowland, A. (2019).
Grande-Bretagne. (2014). Transforming primary care: Safe, proactive, personalized care for those who need it most. Lieu de publication non identifié, Angleterre: NHS England, Department of Health.
Kim, S.-H., Saide, K., Farrell, J., Faulkner, L., Tailor, A., Ogese, M., Daly, A. K., … Naisbitt, D. J. (September 01, 2015). Characterization of amoxicillin- and clavulanic acid- specific T cells in patients with amoxicillin-clavulanate-induced liver injury. Hepatology, 62, 3, 887-899
Peate, I. (2017). Fundamentals of care: A textbook for health and social care assistants.Pharmacology for health professionals.
Wu, A. H. B., & Yeo, K.-T. J. (2011). Pharmacogenomic testing in current clinical practice: Implementation in the clinical laboratory. New York: Humana Press.
Question
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples
Case Study Review with Focus on Pharmacokinetic and Pharmacodynamic Principles