NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics DQ: Pharmacokinetics and Pharmacodynamics

 

Working in an intermediate care unit, I get to see patients from all races with different healthcare needs and conditions. One obvious thing observed from the so many patients that come into the facility is the prevalence of diabetes, hypertension and chronic obstructive pulmonary disease (COPD) in patients ages 20 years and above. Though the diseases are common, the types of medications used in treating them may differ in dose, brand, and pricing. When prescribing medications for an individual patient, the physician considers the effects of the drugs and the mechanism of their action on that particular patient.

Let us consider a 75-year-old male patient who is admitted for uncontrolled Diabetes. The patient has a past medical history of Diabetes type II and takes metformin to control his glucose but had not been able to afford the refills for his medication. On admission the patient presented with a blood glucose of 288 mg/dl and was ordered Lispro on a low dose sliding scale with blood glucose monitoring before meals and at bedtime. The patient was assigned to a young nurse who had recently just started working on the unit.

DQ Pharmacokinetics and Pharmacodynamics

Just before the lunch trays came in, the nurse went to review the patients’ blood glucose levels the nurse tech had checked. Without paying much attention, the nurse drew up 8 units of lispro insulin and administered it to the patient for what she thought was a blood sugar of 288mg/dl. After about 20 minutes the nurse discovered that the patient was sweating a lot and had an increased heart rate with slight shivers. The young nurse called the attention of an older nurse and explained all the care she had provided to the patient prior to discovering his current state. The two nurses reviewed the documentation on the computer and saw that the patients’ last blood glucose check was 98mg/dl and not 288mg/dl as the young nurse had thought it was. The older nurse immediately got a glucometer and checked the patients’ blood glucose which was now 52mg/dl, and also discovered that the patient had not eaten anything. The older nurse immediately followed the establishment’s protocol and administered 1 gram of glucagon to the patient, checked his blood glucose which had gone up slightly and then administered another gram, checked his blood glucose again, and then provided the patient with a small cup of orange juice and a cracker.

 

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