Pharmacokinetics and Pharmacodynamics in Burn Patients

Running Header: PHARMACOKINETICS AND PHARMACODYNAMICS

Pharmacokineticsand Pharmacodynamics in Burn Patients

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Pharmacokineticsand Pharmacodynamics in Burn Patients

Oneof the major relationships in the healthcare industry is that betweenthe body and drugs administered. This relationship is divided intotwo with Pharmacokinetics and Pharmacodynamics putting both sides ofthe relationship into perspective. Pharmacokinetics describes all theprocesses drugs are taken through by the body, from absorption toexcretion. Pharmacodynamics, on the other hand, refers to all thechanges the drug effects on the body after administration (Hilmer etal., 2007). The two go a long way in determining drug handlingprocedures for different kind of patients.

AsI once experienced, based on pharamacokinetics and phramacodynamics,burn patients tend to eliminate administered drugs at an abnormallyhigh rate. As a result, it is important to administer doses atrelatively shorter intervals as well as increase the dosage so as toavoid inefficacy with regards to the treatment procedures (Scott,2011). Judging by the several burn cases I have handled over time,there is a very wide variation in intra as well as inter-individualaspects for burn victims, all of which are based on pharmacokineticand pharmacodynamic parameters.

Inone particular case, Mr.X came in with about 37% of his bodysuffering from thermal injuries. During the first 48 hours, Iobserved a low filtration rate of glomerular as well ashypoalbuminaemia, hypovolaemia and oedema. This meant low levels ofrenal clearance. The drug distribution rate was also lower. After theinitial 48 hours, the amount of exudate leakages increased and bloodflow towards the liver and kidney increased. It was more of ahyperdynamic state since tests showed an increase inalpha-1-acid-glycoproteins. This ultimately led to a massive changein drug distribution as well as protein binding within Mr.X’s body.As s result, pharmacokinetic parameters variations on anintra-individual basis occurred. On the other hand, inter-individualvariations were not as much due to the relatively low percentage ofburns on the body. The Pharmacodynamic parameters were as a result ofexcessive drug elimination, and this necessitated an increase in drugdosages so as to ensure treatment efficacy. Mr.X was a man in his mid30’s. This helped in the treatment since judging by gender-specifictrauma outcomes, male are more tolerant to burn, as well as blunt,trauma (Kerby et al., 2006). This is in-spite of the highpro-inflammatory cytokine levels in males.

Basedon all these factors, my care plan included administering of PRP(platelet-rich plasma) injections so as to help boost the plateletcount in Mr.X. This went a long way in attaining a homeostaticbalance within the patient’s body hence the ability to hold drugsfor longer. In addition to this, it generally helped in the healingprocess by helping skin grafts effectively hold on and grow back. Onthe other hand, the dose intervals were short and the doses increasedso as to counter the rate at which Mr.X’s body was expellingadministered drugs.

WorksCited:

Hilmer,S. N., Le Couteur, D. &amp McLachlam, A. J. (2007). ClinicalPharmacology in the Geriatric Patient. Fundamentals &amp ClinicalPharmacology. 21(3), 217-230. Retrieved from the Walden Librarydatabase.

Arcangelo,V. P. &amp Peterson, A. M. (2013). Pharmacotherapeutics for AdvancedPractice: A Practical Approach (3rdEd.). Philadelphia: Lippincott Williams &amp Wilkins.

Scott,S. A. (2011). Personalizing Medicine with Clinical Pharmacogenetics.Genetics in Medicine, 13(12). 987-995.

Retrievedfrom: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290900/

Kerby, J., McGwin, G., Chaudry, I.,Schwacha, M., Cross, J., &ampMetzger, J. (2006). Sex Differences in Mortality after Burn Injury:Results of Analysis of the National Burn Repository of the AmericaBurn Association. J Burn Care Res, 27, 451-455.