Case Study Analysis

Age-related factor on pharmacokinetics and pharmacodynamics of drugs

Pharmacokinetics is the study of what human bodies do to various types of drugs injected in them, whereas pharmacodynamics is the study of what drugs do to peoples’ bodies. In this case, therefore, pharmacodynamics emphasises the physiologic, molecular, and biochemical drug’s effects of drugs as a result of chemical and binding interactions. On the flip side of it, pharmacokinetics focuses on the clearance, distribution, absorption, and metabolism of drugs. Worth noting is that age is one of the ordinary and fundamental factors that healthcare professionals like nurses should consider while prescribing medications to patients (García-Quintanilla et al., 2019).

M is 89 years old and, therefore, is undoubtedly an elderly person. The virtue of being an elderly person comes with a lot of anatomical and physiological changes in their lives of bodies. One of the impacts of old age is the reduced ability of those individuals to manage the stress that comes with life successfully. Moreover, during the old age process, there is a rise in the inter-individual variations in physical responses. Aging is a collective period that refers to the summative cumulative local effect at the elderly’s tissue, molecular, and cellular levels. The impact of such an array of changes is aging. Even though there is no clear definition of ageing, some process features are acknowledgeable. The acknowledgeable features are some of the minute structures that are, however, capable of conducting the specific physiological organ functions where they are found, such as the neurons and the alveoli. The second feature is interacting with various body regulatory systems that foster functional integration between organs and cells.

How age impact the pharmacokinetics and pharmacodynamics of drugs

Changes in the process will affect M’s absorption rate, fast-pass metabolism, bioavailability, and protein binding. It is essential to acknowledge that, being 89 years old, it is likely that M’s organs, like the liver and kidney, have reduced efficiency; therefore, it is unlikely for them to sustain some of the drug’s half-life, such as furosemide. Important to acknowledge is that in ageing patients, there was a close linkage between this longer half-life and lower renal clearance. Therefore, the decline in the impacts caused by furosemide with respect to individuals seems to result from the decrease in tubular secretion. When there is a decline in renal plasma flow, tubular secretion is likely to occur among patients.

In most cases, age is a fundamental factor affecting drug pharmacokinetics and pharmacologic characteristics. Therefore, ageing reduces the body’s homeostatic aptitude by changing the functional and structural characteristics of body organ structures and systems. A rise in the number of reduced eliminations and distribution of drugs among the aged population is a result of the changes in hepatic functions, renal functions, and body composition (Brem et al., 2021). These are some of the critical factors that play a pivotal role in the changes in a drug’s pharmacokinetic profiles. The elimination of the drug and the decline in the body’s metabolic rate are responsible for the drugs’ increased half-life and risks associated with drug toxicity and reactions.

How changes in processes affect the recommended therapy for patients

A lot of research on ageing, particularly the effects of ageing on pharmacokinetics and pharmacodynamics, suggests that there are a lot of observable features in the pharmacokinetics with age, which is suggested to minimize renal clearance among older populations. This usually makes them very resistant and sensitive to medication. Moreover, exceptionally renally excreted medications such as verapamil, hydralazine, hydrochlorothiazide, and glipizide are more susceptible to such fate in cases of reduced or minimal renal function due to age (Alffenaar et al., 2020). Additionally, ageing also has a lot of detrimental impacts on pharmacodynamics medication properties, primarily through a large increase in the drugs’ insensitivity among the elderly. In most cases, this is usually a result of the elderly’s body impairment, which affects the body’s homeostatic mechanisms. It is, therefore, imperative to clearly understand age-related pharmacokinetics and pharmacodynamics to have evidence-based medical prescriptions, particularly those related to evidence-based medical cardiovascular medications, to ensure their efficacy and safety.

The medications’ excretion, absorption, metabolism, and distribution are commonly affected by age-related factors, therefore the pharmacokinetic profile. There is a general increase in body fats as individuals age, while there is a decline in the body water amount. The impact is increased lipophilic drug distribution and volume and clearing their half-life. The decline in the concentration and amount of serum albumin as an individual approaches old age are additional factors that jeopardize the prescription and administration of medicine to the elderly.

Modifying Furosemide drug to fit M

In order to monitor M’s response to treatment, particularly furosemide, it is fundamental to monitor the patient’s health or clinical state, urine output, fluid intake, electrolytes such as magnesium and potassium, kidney function, and fluid intake. The kidney function tests include serum blood tests and creatinine nitrogen level assessment. It is fundamental to note that replete electrolytes like magnesium and potassium immensely participate in electrolyte depletion, especially when using furosemide in diuretic purposes. Therefore, stopping this drug or reducing its use in case laboratory tests show some clear evidence of kidney problems (Lee et al., 2021). Likewise, patients using furosemide medications in ambulatory healthcare need close monitoring to evaluate their responses to medications and treatments, heart and kidney functions, and intermittent electrolytes to manage furosemide and replete the electrolytes as required. Some of the modifications that will be implemented include;

• Advising M to drink a lot of water aimed at improving renal functioning.
• Always monitor the drug reactions in the patient.
• Minimize the Furosemide dosage to about 20mg to help faster distribution, bioavailability, protein bindings, and absorptions.

Recommendations aimed at improving the patient’s therapeutic outcomes

Dosage adjustment of medications with regular plasma monitoring is usually advised to be administered to the elderly, particularly with reduced renal functions. In cases where the risks or impacts outweigh or supersede the benefits, people are advised to discontinue medication. Medication discontinuation is also shown when older people require medical attention, which is likely to cause possible interaction with their body statin, resulting in detrimental impacts. Simultaneous administration of Levothyroxine with Celecoxib by impacting their metabolism immensely increases the risks of myopathy. Therefore, there is a need to use alternative medications to Celecoxib to improve patient’s health outcomes.

References

Alffenaar, J. W. C., Gumbo, T., Dooley, K. E., Peloquin, C. A., Mcilleron, H., Zagorski, A., … & Migliori, G. B. (2020). Integrating pharmacokinetics and pharmacodynamics in operational research to end tuberculosis. Clinical Infectious Diseases, 70(8), 1774-1780.

Brem, A., Viardot, E., & Nylund, P. A. (2021). Implications of the coronavirus (COVID-19) outbreak for innovation: Which technologies will improve our lives?. Technological forecasting and social change, 163, 120451.

García-Quintanilla, L., Luaces-Rodríguez, A., Gil-Martínez, M., Mondelo-García, C., Maroñas, O., Mangas-Sanjuan, V., … & Fernández-Ferreiro, A. (2019). Pharmacokinetics of intravitreal anti-VEGF drugs in age-related macular degeneration. Pharmaceutics, 11(8), 365.

Lee, T. H., Kuo, G., Chang, C. H., Huang, Y. T., Yen, C. L., Lee, C. C., … & Chen, J. J. (2021). Diuretic effect of co-administration of furosemide and albumin in comparison to furosemide therapy alone: an updated systematic review and meta-analysis. PLoS One, 16(12), e0260312.