Pharmacokinetics and Pharmacodynamics Essay
Introduction
I initially worked in a dialysis center and even though dialysis is a specialized area of healthcare service delivery; I must admit that I learned a lot. I cared for a patient who had chronic kidney failure (CKF) and was undergoing hemodialysis. One of the most important drugs that were prescribed to this patient was Neurontin (Gabapentin) and it was particularly prescribed for neuropathy and pain (Raouf et al. 2017). Normally, the oral dosage of Gabapentin for adults begins with 300mg not to exceed 2400mg per day. Pharmacokinetics and Pharmacodynamics Essay Paper
Pharmacokinetics and Pharmacodynamics
The metabolism and excretion of drugs in patients diagnosed with CKD particularly those undergoing hemodialysis is complex. The pharmacodynamics and pharmacokinetic processes of drugs prescribed to patients with CKD are greatly influenced by a decrease in the GFR (glomerular filtration rate) that subsequently decreases the renal clearance and this reduces the excretion of drugs eliminated by the kidney. This implies that failure to make appropriate adjustments to drug dosages increases the likelihood of toxicity.
The article by Lea-Henry et al (2018) highlights kidney disease as a global comorbid condition that changes how drugs are absorbed, distributed, metabolized, and excreted. The researchers further emphasize that prescribing drugs to this population requires providers to have optimal knowledge on the medication, the level that kidney disease has altered the physiological mechanisms and pharmacokinetic principles which alter how dosing regimens are designed. Age is also a significant factor that influenced the pharmacokinetics and pharmacodynamics of gabapentin in this patient. Patients older than 40 years of age have a decreased creatinine clearance rate and GFR. However, the latter is influenced by lower production of creatinine since older adults have less muscle mass and are not physically active. However, serum creatinine levels are usually within the normal limits and this can easily mislead an NP who assumes that the levels of serum creatinine reveal normal renal functioning. Therefore, as age advances, the elimination of gabapentin decreases and this requires NPs to reduce drug dosages to prevent toxicity. Pharmacokinetics and Pharmacodynamics Essay Paper
