Factors Influencing Pharmacokinetics and Pharmacodynamics A patient’s age can affect pharmacokinetics and pharmacodynamic processes (Thürmann, 2020). Mrs. J is an 84-year-old patient and is, therefore, considered geriatric.

Elderly patients usually have decreased renal function, decreased enzymatic activity, and decreased hepatic function, as evidenced by the patient’s liver and kidney function tests. Metoprolol and lisinopril undergo hepatic metabolism; therefore, a decrease in hepatic function will increase the concentration of the drugs that accumulate in the systemic circulation (Olvera et al., 2022). Mrs. J was, therefore, highly susceptible to experiencing side effects and toxicity. Renal function is responsible for the excretion of drugs from the body system.

Decreased renal function in the elderly, as seen in Mrs. J’s renal function test, causes a decrease in drug excretion hence accumulation of the drug in the body. Lisinopril and metoprolol are excreted by the kidneys (Morris & Dunham, 2022). Consequently, Mrs. J was likely to experience exaggerated side effects. Additionally, ethnicity influences pharmacokinetics and pharmacodynamic processes. Mrs. J is an African American. Studies show that angiotensin-converting enzyme inhibitors such as lisinopril are less effective in African Americans; therefore, Mrs was scheduled for follow-up appointments to check on her blood pressure control (Holt et al., 2022).

Plan of Care

Changes in the pharmacokinetic and pharmacodynamic processes impact a patient’s recommended therapy. Mrs. J’s therapy aimed to control her blood pressure and prevent further organ damage. Dose adjustments for the prescribed drugs were necessary to ensure little or no side effects while achieving the therapeutic target. Adjustments were made by decreasing the dose of lisinopril and metoprolol and decreasing their frequency. Mrs. J was also advised on non-pharmacological interventions such as exercising, dietary changes, decreased sodium intake, and stress management and relaxation techniques.

References

Holt, H. K., Gildengorin, G., Karliner, L., Fontil, V., Pramanik, R., & Potter, M. B. (2022). Differences in Hypertension Medication Prescribing for Black Americans and Their Association with Hypertension Outcomes. Journal of the American Board of Family Medicine: JABFM, 35(1), 26–34. https://doi.org/10.3122/jabfm.2022.01.210276

Morris, J., & Dunham, A. (2022). Metoprolol. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532923/