NURS 6521 Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in a patient

Sample Answer for NURS 6521 Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in a patient Included After Question

*** Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

Atenolol 12.5 mg daily
Doxazosin 8 mg daily
Hydralazine 10 mg qid
Sertraline 25 mg daily
Simvastatin 80 mg daily

******Write a 3-page paper that addresses the following:

(Including the Introduction and conclusion)

Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case you were assigned.
Describe how changes in the pharmacokinetic and pharmacodynamic 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 by changing medications or provide an alternative treatment option for the patient.

A Sample Answer For the Assignment: NURS 6521 Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in a patient

Title: NURS 6521 Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in a patient

Ageing is the progressive accumulation of more or less random changes. This limits the average life expectancy to about 85 years [1], maximum life span to around 122 years [2], and lowers the ability to cope with external stresses. Moreover, the interindividual variability in the physiological responses increases with age. Ageing is not a single entity but a collective term representing the sum of cumulative local effects at the molecular, cellular and tissue level. Ageing is the effect of these underlying changes and not the cause. Although an all-encompassing definition of ageing is not possible, several characteristics are recognized. The most consistent is the time-related loss of functional units. These units are the smallest structures still capable of performing the specific physiological

activities characteristic of the organ of which they are a part (e.g. nephrons, alveoli or neurones). A further characteristic is the disruption of some of the regulatory processes that provide functional integration between cells and organs. Consequently, there is a failure to maintain homeostasis under conditions of physiological stress. This loss of functional reserve is associated with a decrease in viability and an increase in vulnerability. Ageing is not solely a progression of functional decline but produces anatomical and physiological changes which might lead to decompensation of the relevant system when they progress beyond a threshold. Some important age-related physiological changes are discussed. This is followed by a detailed description of the age-related changes in pharmacokinetics (drug absorption, distribution, metabolism, and excretion) and pharmacodynamics (the effect of a drug on its target site).

A Sample Answer 2 For the Assignment: NURS 6521 Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in a patient

Title: NURS 6521 Explain how the age factor might influence the pharmacokinetic and pharmacodynamic processes in a patient

The patient under review is a 78-year-old African American male. The patient has a history of CHF, CKD, HTN, obesity, dementia, and falls. The patient reports intermittent alcohol use and denies tobacco use. The patient arrives at the facility and is diagnosed with cellulitis. The patient reports a history of renal complications secondary to IV antibiotics.

This patient has multiple variables such as obesity, age, comorbidities, and cognitive concerns that may impact pharmacokinetics and pharmacodynamics. Research suggests that infection promotes inflammation and has procoagulant properties that can negatively impact cardiovascular disease processes (Ng et al., 2022). This patient, having an infectious process, is at an increased risk for heart failure exacerbation. The presence of CKD poses a concern in this case due to antibiotic treatments used to manage infection being nephrotoxic, increasing the patient’s risk of developing ESRD (Ishigami et al., 2020). It is critical to be mindful of these concepts when prescribing medications and managing care to prevent further harm to the patient.

While managing this patient’s care, it is vital to consider obesity as a pharmacokinetic principle when dosing medications. For example, vancomycin may appear low initially (especially within the first ten days of treatment) in the serum while accumulating in adipose tissue, causing overdose over time (Assadoon et al., 2022). Treating an obese patient with vancomycin should prompt clinicians to frequently monitor levels, especially in early treatment, to prevent damage to the kidneys while managing infection. It is prudent to implement frequent follow-up appointments following discharge for this patient. Lastly, the clinician should consider the patient’s cognitive status and ability to provide self-care. If the patient cannot appropriately manage his care, the treatment team should involve family or community resources to help improve the patient’s outcome.

References

Assadoon, M. S., Pearson, J. C., Kubiak, D. W., Kovacevic, M. P., & Dionne, B. W. (2022). Evaluation of Vancomycin Accumulation in Patients With Obesity. Open Forum Infectious Diseases, 9(10), 1–5. https://doi.org/10.1093/ofid/ofac491

Links to an external site.

Ishigami, J., Cowan, L. T., Demmer, R. T., Grams, M. E., Lutsey, P. L., Coresh, J., & Matsushita, K. (2020). Hospitalization With Major Infection and Incidence of End-Stage Renal Disease: The Atherosclerosis Risk in Communities (ARIC) Study. Mayo Clinic Proceedings, 95(9), 1928–1939. https://doi.org/10.1016/j.mayocp.2020.02.026

Links to an external site.

Tien M. H. Ng, Esther E. Oh, Yuna H. Bae-Shaaw, Emi Minejima, & Geoffrey Joyce. (2022). Acute Bacterial Infections and Longitudinal Risk of Readmissions and Mortality in Patients Hospitalized with Heart Failure. Journal of Clinical Medicine, 11(740), 740. https://doi.org/10.3390/jcm11030740

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Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.