Post- Tami- Pharmacology Assignments | Online Homework Help

Respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described.

Don't use plagiarized sources. Get Your Assignment on
Post- Tami- Pharmacology Assignments | Online Homework Help
Just from $13/Page
Order Now

In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Main Post

Clinical Scenario

The patient is a tall, lanky 67-year-old male with end-stage renal failure and cirrhosis of the liver.  He presents to the Emergency Department (ED) with an inguinal hernia that he cannot reduce.  He rates his pain 10/10 on a scale of 1-10, with 0 being no pain and 10 being extreme pain.  The patient appears uncomfortable, complains of dizziness, and constipation.  Social history consists of smoking a pack a day or cigarettes for 25 years, moderate alcohol consumption, daily marijuana use, poor diet, and decreased mood.  His medications are centred around pain control and include the use of narcotics every 4 hours.  The patient is given a dose of Toradol 30mg, intravenously (IV).  After ten minutes, the patient is asking for more pain medication.  Fentanyl 50 mcg, IV is given with no pain relief reported by the patient.  Finally, Hydromorphone 1mg, IV is administered.  After an hour, the patient still reports pain 10/10.

professional writing services near me

Pharmacokinetics and Pharmacodynamics

Pharmacokinetics studies the absorption, distribution, metabolism, and excretion of drugs within the body system (Ball, Dains, Flynn, Solomon, & Stewart, 2019).  The use of pharmacokinetics enables providers to determine the appropriate drug for a patient’s diagnosis.  Pharmacodynamics refers to how the body is affected by the use of certain medications (Fox, Hawney, & Kaye, 2011).  Due to the individualized nature of the human body, finding a drug that responds with minimal side effects are desired. Pharmacokinetics, as it relates to this patient’s pathophysiology, creates difficulty for the patient due to the diagnosis of kidney failure and cirrhosis.  Cirrhosis of the liver prevents the body from absorbing, distributing, and metabolizing the drug.  With significant disease process in effect, it is difficult for the body to absorb the drug at a rate that provides effective pain control.  The first-pass metabolism with hydromorphone is decreased in liver cirrhosis and has a likelihood of high hepatic extraction (Wehrer, 2015).  Whereas, fentanyl, is a protein-bound medication is reportedly unaffected by cirrhosis (Wehrer, 2015).  Though the patient tolerated the fentanyl in our case, no specific relief is found due to the chronic nature of the pain. Decreased kidney function reduces the excretion of drugs from the body creating an accumulation of medication in the entire body (Ball et al., 2019).  Frequent use of medications creates a tolerance to that medication and accelerates the metabolism of the drug.  Tolerance and increased metabolism results in ineffective pain management outcomes (Ball et al., 2019).  The use of opioids for pain management, in this case, may create an antagonist effect causing unwanted consequences such as constipation, the potential for abuse, and withdrawal (Walter, Knothe, & Lotsch, 2016).  Due to the patient’s continued alcohol consumption and disease processes, the use of acetaminophen or ibuprofen is not encouraged (Wehrer, 2015).

Contributing Factors

For the patient above, behavioural and pathophysiological changes are contributing factors for the choice of medications given.  Alcohol use is the highest contributing factor to cirrhosis (Askgaard, Gronbaek, Kjaer, Tjonneland, & Tolstrup, 2015).  This behaviour, as well as smoking, will need to be eliminated to be on the transplant list.  The pathophysiological changes created altered renal excretion and inability of the liver to metabolize medications given for pain control.

Personalized Plan of Care

The plan of care for this patient is to control the pain from the inguinal hernia until it can either be repaired or reduced.  The ability to control pain at a level of 5/10 is the first goal.  A discussion with the patient is necessary to establish realistic goals in light of the chronic conditions.  Focusing on the pain from the hernia is our primary focus.  Initiation of other medications for pain such as Ketamine, Benadryl, or Reglan can decrease pain by 50 per cent.  Lastly, non-medication alternatives such as positioning, distraction, and ice-therapy can provide temporary relief.

     References

Askgaard, G., Gronbaek, M., Kjaer, M. S., Tjonneland, A., & Tolstrup, J. S. (2015). Alcohol drinking pattern and risk of alcoholic liver cirrhosis: a prospective cohort study. Journal of Hepatology, 62(5), 1061-1067. http://dx.doi.org/10.1016/j.jhep.2014.12.005Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Fox, C. J., Hawney, H. A., & Kaye, A. D. (2011). Opioids: Pharmacokinetics and Pharmacodynamics. New York, NY: Springer.Walter, C., Knothe, C., & Lotsch, J. (2016). Abuse-deterrent opioid formulations: Pharmacokinetic and pharmacodynamic considerations. Clinical Pharmacokinetics, 55(7), 751-767. http://dx.doi.org/10.1007/s40262-015-0362-3Wehrer, M. (2015, December 14). Pain management considerations in cirrhosis. U.S. Pharmacist, 40(12), HS5-HS11. Retrieved from https://www.uspharmacist.com/article/pain-management-considerations-in-cirrhosis

Calculate your paper price
Pages (550 words)
Approximate price: -

Why Choose Us

Quality Papers

At Myhomeworkwriters.com, we always aim at 100% customer satisfaction. As such, we never compromise o the quality of our homework services. Our homework helpers ensure that they craft each paper carefully to match the requirements of the instruction form.

Professional Academic Writers

With Myhomeworkwriters.com, every student is guaranteed high-quality, professionally written papers. We ensure that we hire individuals with high academic qualifications who can maintain our quality policy. These writers undergo further training to sharpen their writing skills, making them more competent in writing academic papers.

Affordable Prices

Our company maintains a fair pricing system for all academic writing services to ensure affordability. Our pricing system generates quotations based on the properties of individual papers.

On-Time delivery

My Homework Writers guarantees all students of swift delivery of papers. We understand that time is an essential factor in the academic world. Therefore, we ensure that we deliver the paper on or before the agreed date to give students ample time for reviewing.

100% Originality

Myhomeworkwriters.com maintains a zero-plagiarism policy in all papers. As such, My Homework Writers professional academic writers ensure that they use the students’ instructions to deliver plagiarism-free papers. We are very keen on avoiding any chance of similarities with previous papers.

Customer Support 24/7

Our customer support works around the clock to provide students with assistance or guidance at any time of the day. Students can always communicate with us through our live chat system or our email and receive instant responses. Feel free to contact us via the Chat window or support email: support@myhomeworkwriters.com.

Try it now!

Calculate the price of your order

You will get a personal manager and a discount.
We'll send you the first draft for approval by at
Total price:
$0.00

How it works?

Follow these simple steps to get your paper done

Place your order

Fill in the order form and provide all details of your assignment.

Proceed with the payment

Choose the payment system that suits you most.

Receive the final file

Once your paper is ready, we will email it to you.

Our Homework Writing Services

My Homework Writers holds a reputation for being a platform that provides high-quality homework writing services. All you need to do is provide us with all the necessary requirements of the paper and wait for quality results.

Essays

Essay Writing Services

At My Homework Writers, we have highly qualified academic gurus who will offer great assistance towards completing your essays. Our homework writing service providers are well-versed with all the aspects of developing high-quality and relevant essays.

Admissions

Admission and Business Papers

With Myhomeworkwriters.com, we will help you secure a position at your desired institution. Our essay writing services include the crafting of admissions papers. We will still help you climb your career ladder by helping you write the official papers that will help you secure a job. We will guide you on how to write an outstanding portfolio or resume.

Editing

Editing and Proofreading

Myhomeworkwriters.com has a professional editorial team that will help you organize your paper, paraphrase it, and eliminate any possible mistakes. Also, we will help you check on plagiarism to ensure that your final paper posses quality and originality.

Coursework

Technical papers

My Homework Writers harbors professional academic writers from diverse academic disciplines. As such, we can develop homework writing services in all academic areas. The simplicity or complexity of the paper does not affect the quality of homework writing services.