Pharmacokinetic and pharmacodynamic processes are critical to explore to enhance one’s understanding of the effects of drugs on the human body and apply such knowledge to particular patient needs. A case from my past clinical experience features an 81-year-old woman diagnosed with bipolar disorder. Furthermore, she had a history of diabetes and hypertension and demonstrated signs of confusion, poor appetite, and isolation. To address the problem, I examined the patient and a list of her prescribed medications. Among others, they included Lithium, Lantus insulin and hydrochlorothiazide, and metformin. In this regard, it was critical to explore the pharmacokinetic and pharmacodynamic processes involved. Research shows that certain medications can alter “drug-drug interactions” and the effectiveness of treatment in individuals with bipolar disorder (de Leon & Spina, 2018). Furthermore, the patient’s age may alter her body’s response to drugs due to the reduced glomerular filtration rate.
A personalized plan of care was developed based on clinical research and identified factors affecting the patient. According to Peeters et al. (2019), “recommendations on starting dosages followed by a stepwise increase of dosages will lead to improved blood pressure control and less adverse drug reactions in the elderly patient” (p. 287). It was established that the lithium dosage was too high for the patient due to her body’s slower response to drug absorption. As reported by Bocchetta et al. (2017), “median lithium serum concentration in this cohort of elderly patients with mainly bipolar disorders was lower than the therapeutic range indicated for younger adults” (p. 1). Therefore, it was recommended to conduct a lab test and administer a lower lithium dose based on the patient’s needs. As can be seen, focusing on pharmacokinetics and pharmacodynamics can improve patient outcomes.
References
Bocchetta, A., Cabras, F., Pinna, M., Poddighe, A., Sardu, C., Ardau, R., Chillotti, C., & Del Zompo, M. (2017). An observational study of 110 elderly lithium-treated patients followed up for 6 years with particular reference to renal function. International Journal of Bipolar Disorders, 5(1), 1-7. Web.
de Leon, J., & Spina, E. (2018). Possible pharmacodynamic and pharmacokinetic drug-drug interactions that are likely to be clinically relevant and/or frequent in bipolar disorder. Current Psychiatry Reports, 20(3), 1-24. Web.
Peeters, L. E. J., Kester, M. P., Feyz, L., Van Den Bemt, P. M. L. A., Koch, B. C. P., Van Gelder, T., & Versmissen, J. (2019). Pharmacokinetic and pharmacodynamic considerations in the treatment of the elderly patient with hypertension. Expert Opinion on Drug Metabolism & Toxicology, 15(4), 287-297. Web.