Question

Case Study 1: 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

First, Select one factor: genetics, gender, ethnicity, age, or behavior. Then explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you selected. Then, describe how changes in the processes might impact the patient’s recommended drug therapy. Finally, explain how you might improve the patient’s drug therapy plan.

Answer 1

Age is one of the factors that affects the change in the processes in drugs.Pharmacodynamics affects not only the therapeutic effects but also the toxic and adverse affects.Pharmacodynamics of any drug depends upon the concentration of the drug at the receptor ,the response at the receptor,post receptor events within cells and homeostatic mechanisms.There will be an increased sensitivity to the effects of the drug but for some drugs there is a decrease in the responsiveness.The pharmacokinetic alterations are easier to measure since they affect the plasma concentration of the drug.The bioavailability of the drug depends on factors including absorption ,metabolism and elimination.The age related changes might make elder patients at greater risk of adverse drug affects.It brings adverse affects in most of the organs.

The hypertension and hyperlipidemia are both cardio-vascular diseases that are diagnosed to the patient.Doxazosin is an alpha-andergenic blocker which relaxes the veins and arteries and would constitute the lower dose of hydralazine.Simvastatin dosage is too high ,usually 40mg is required dosage daily at bed time.Sertraline is used to treat depression and the dosage is within the normal range.The only change in drug plan i would like to prescribe is increase in beta blockers dosage i.e Atenolol to 50 mg daily or use 4mg of doxazosin.