How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow? Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat. This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors. 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. At least 2 citations APA format 7th edition FU One patient case from my experience that addresses the principles of pharmacokinetics and pharmacodynamics is where my patient was a 55 years old female, of African American decent, had a history of diabetes, hyperlipidemia, and hypertension. The patient was presented to our hospital with severe nausea, vomiting and abdominal pain. Assessment and lab work showed the patients blood glucose was 605mg/dL, HgA1C 8.5%, cholesterol 180 mg/dl, weight 290 lbs, height 68inches, BP 90/75, pulse 118, Respiration 23 bpm. Patient stated she had been very stressed lately and had mostly been dining out at fast-food restaurants and has not had the time to exercise. Patient had been prescribed insulin however, she stated she has not been checking her blood glucose level like she should have. This patient was presenting with symptoms of diabetic ketoacidosis (DKA). DKA is a medical emergency that occurs when the body is unable to produce adequate insulin to decrease blood glucose level and leads to the production of high levels of acids in the blood called ketones (Alshammari et. al., 2017). This was a medical emergency that required immediate intervention of fluid repletion and the administration of insulin. It also involved the frequent monitoring of patients vital signs, glucose levels, and electrolyte levels. Factors that might have influenced pharmacokinetics of insulin the patient was receiving are diet (eating fatty foods or foods high in carbohydrates increases glucose levels in the body), stress (cortisol increases insulin resistance), and lack of exercise. Eating a balanced diet decreases the likelihood that the patient will consume mostly foods high in fats and carbohydrates. When someone is stressed, the body produces stress hormones called cortisol which to a diabetic patient can significantly affect their health because it causes the body to release more glucose and to become resistant to the insulin the patient needs to reduce that blood glucose to a healthy level (Alshammari et. al., 2017). Exercise redistributes and lowers the blood glucose level. It could cause patients to go into hypoglycemia that is why it is important to check glucose levels before, during, and after exercise. The personalized care plan that I would develop for this patient would include; a Dietary and lifestyle change plan here the patient will be educated on how to count her carbohydrates and caloric intake. The Center for Disease Control has dietary guidelines for the different age groups. The site also provides My Food Diary (CDC, 2019) a flow sheet to help individuals keep a day-to-day record of how much food is consumed for breakfast, snacks, lunch, and dinner. I would also recommend she exercise regularly but that to check her blood glucose before, during and after exercise. The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes (Colberg, 2016). Also, I would suggest she check her blood glucose before each insulin administration, as this may affect the dosage to be administered. References Alshammari, A. A., Alahdal, L. M., Jawi, J. T., Alnofaie, H. A., Aldossari, N. A., AbdulazizAlassaf, H. M., Ramel, A. I., Almshikhess, S. H., Felemban, A. S., Alanazi, S. A., Joharji, R. N., Alzahrani, A. M. B., Almaghamsi, S. A. D., Alalawi, M. S. M., Alasmari, H. I., Abduljabbar, A. M., & alzahrani, A. fahad. (2017). First Line Management of Adult Diabetic Ketoacidosis Patients. Egyptian Journal of Hospital Medicine, 67(2), 571577. Centers fo Disease Control and Prevention [CDC], 2019. Eating Out. Retrieved from https://www.cdc.gov/diabetes/managing/eat-well.html Colberg, S.R., Sigal, R. J., Yardley, J. E., Riddle, M.C., Dunstan, D.W., Dempsey, P.C., & Tate, D.F. (2016). Physical activities/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care, 39(11), 2065-2079
