How Changes in the Processes Impact the Patient’s Recommended Drug Therapy

Changes in pharmacodynamics and pharmacokinetics negatively affect the recommended drug therapy because it alters preferred drug doses and interactions. Drug therapy is affected by changes in pharmacodynamics because some drugs cause adverse effects that can overwork some organs, such as the kidneys. Proton pump inhibitors such as omeprazole can result in acute kidney injury, leading to CKD if not treated early. Some medications used to manage heart conditions can also have side effects on the kidneys if not well controlled. Therefore, taking the drugs at low doses is advisable to prevent adverse effects on the body. Accumulation of waste products in the body due to reduced excretion of the drugs causes toxicity. It occurs due to changes in pharmacokinetics, such as reduced hepatic and renal clearance. This toxicity affects the liver and kidneys and can result in organ failure. If there are changes in the pharmacokinetics, the levels of the drugs taken should be investigated and corrected to prevent toxicity due to the accumulation of the drug in the body (Quiñones et al., 2021). The drug dose should be minimal to avoid drug-to-drug interactions and side effects. The underlying conditions in LM require various drugs to manage them; therefore, preventive measures such as reducing drug doses should be done to counter drug interactions. Anti-hypertensive medications such as digoxin, which causes elevated potassium levels, are already a threat to the kidneys that have already failed; therefore, their dose should be reduced to prevent interactions with other drugs like metoprolol and multivitamin. The mechanism of action of all these drugs is reduced, and their excretion is significantly reduced if they are administered simultaneously; therefore, taking the medications at different times to help them work effectively in the body is essential.

How I Will Improve the Patient’s Drug Therapy Plan

I will aim to improve the patient’s drug therapy plan depending on the changes in the pharmacokinetic and pharmacodynamic processes. The reason for improving drug therapy is to increase the drug’s effectiveness, prevent interactions with other medicines counter the effects those drug interactions will cause, and prevent the side effects of the drugs (Minichmayr et al., 2022) Since the patient’s kidneys have been damaged, I will put the patient on dialysis at least once a week to prevent the accumulation of waste products that will lead to toxicity. Some drugs, such as digoxin, have destructive side effects on the kidneys; therefore, I will replace it with diltiazem because its action mechanism is better than digoxin and has milder adverse effects. Diltiazem is a calcium channel blocker. Depolarization prevents the flow of calcium ions into the heart muscles, increasing muscle relaxation, decreasing blood pressure, and vasodilation of the arterial blood vessels. Its side effects include; sore throat, dry mouth, fever, fatigue, muscle pains, running nose, headache, dizziness, diarrhoea, constipation, vomiting, nasal congestion, and cough. The side effects of diltiazem are less severe than those of digoxin; therefore.

To sum it up, it is essential to check for the mechanism of action of each drug, its interactions with other drugs, and its side effects. When prescribing medications, it is important to consider the patient’s age, the underlying conditions, and the other medicines that the patient is using (Andrade et al.,2021). When taking the patient’s history, it’s essential to take notes from the person who accompanied them to the hospital to avoid missing important information that will help with investigations and diagnosis. In order to prevent comorbidities and side effects of the drugs, it is vital to alter the treatment plan when the pharmacodynamic and pharmacokinetic processes are affected by factors such as pre-existing medical conditions and the patient’s age.

References

Andrade, J. G., Wells, G. A., Deyell, M. W., Bennett, M., Essebag, V., Champagne, J., … & Verma, A. (2021). Cryoablation or drug therapy for initial treatment of atrial fibrillation. New England Journal of Medicine, 384(4), 305-315.

Anwar, M. K. M., Sarode, R. S., Sonune, A. G., Sayyad, S. T., & Kute, M. V. G. (2021) A Review On Controlled Release Drug Delivery System.