Variations in Drug ResponseUsing the knowledge you gained from the readings, evaluate how a typical drug, when orally
administered, may be handled differently by these two patients:
•
•
Ms. Jones is a 30-year-old female personal trainer that is 5’ 4” tall weighing 110lbs. She
regularly drinks socially and sometimes more than a bit when she meets with her biweekly book club.
Mr. Smith is a 65-year-old software tester who is 6’ tall and weighs 235lbs. He drinks
only occasionally.
Assume no other significant medical history or issues with either patient. In your analysis,
compare how the two patients will metabolize the drug considering weight, gender,
distribution of body water and body fat, age, metabolic state, and alcohol use. Explain how
these factors impact the pharmacokinetics of the drug (half-life, dosage, route of
administration, and elimination of the drug). Evaluate the impact on the risk-benefits
analysis of the use of this drug.
What I need: Guided Response: Review several of your colleagues’ posts and
respond substantively to at least two of your peers by 11:59 p.m. on Day 7 of the week. You
are encouraged to post your required replies earlier in the week to promote more meaningful
interactive discourse in this discussion. Assess your peers’ responses for the correctness of
their statements, their integration of the pertinent aspects of each patient’s situation, and
their views of the risk-benefits analysis. Please use information from the required resources
to support your statements. Continue to monitor the discussion forum until 5:00 p.m.
Mountain Standard Time (MST) on Day 7 of the week and respond to anyone who replies to
your initial post.
Student one: Tamra Loftis
Hi Dr. Green and class,
Ms. Jones, a 30-year-old personal trainer, is 5’ 4” tall and weighs 110 pounds. She drinks
alcohol regularly in social settings with a tendency to overindulge. Since she is a personal
trainer, it is assumed she properly hydrates and leads an active lifestyle. Her alcohol
consumption may impact the pharmacokinetics of any type of drug she may also use.
Drug absorption, distribution, metabolism, and elimination (ADME) depend upon
gender, weight, age, metabolic state, and alcohol use (Advokat et al., 2018). A female tends to
exhibit higher blood ethanol concentrations than a male who has consumed the same
amount of alcohol (Chan & Anderson, 2014). Other factors influencing the effectiveness of a
drug are dosage, maintaining a therapeutic drug level, and determining drug elimination
time (Advokat et al., 2018). The way the drug is administered should also be considered. Oral
medication directly enters the digestive system as does alcohol, which may lead to
gastrointestinal problems and intoxication.
In the case of Mr. Smith, a 65-year-old software tester, he is 6’ tall, weighs 235 pounds,
and occasionally drinks. Although Mr. Smith does not consume alcohol regularly, his ADME
will differ from Ms. Jones’ as he is older, less active, and overweight. Age can affect the
pharmacokinetics of alcohol as well as other types of drugs. Males over 60 tend to have
higher blood alcohol levels than men under 40 when consuming the same amount of ethanol
(Chan & Anderson, 2014). So, even if he does not consume alcohol while taking another
drug, Mr. Smith’s ADME should still be monitored.
Monitoring the half-life of a drug and regular-interval dosing leads to “predictable
accumulation of with a steady-state concentration reached after about six half-lives, which is
proportional to dose and dosage interval,” determining drug therapy when blood levels are
monitored in relation to therapeutic results (Advokat et al., 2018). Alcohol use and age cause
changes to various organ systems in the body including hypertension, and impairment of
motor or cognitive functions which can result in pharmacokinetic interactions (Chan &
Anderson, 2014). Either patient may experience drug interactions such as sedation,
tachycardia, impaired psychomotor performance, and general intoxication (Chan &
Anderson, 2014). Regular blood tests should be performed to access the patient.
Have a great weekend!
Tammy
References
Advokat, C. D., Comaty, J. E., & Julien, R. M. (2018). Julien’s primer of drug action: A
comprehensive guide to the actions, uses, and side effects of psychoactive drugs (14th
ed.). Worth Publishers.
Chan, L., & Anderson, G. D. (2014). Pharmacokinetic and Pharmacodynamic Drug
Interactions with Ethanol (Alcohol). Clinical Pharmacokinetics, 53(12), 1115-36.
https://www.proquest.com/scholarly-journals/pharmacokinetic-pharmacodynamic-druginteractions/docview/1640741682/se-2
Student Two:
Dawn Turnquist
Ms. Jones is described as a physically active, lean woman who drinks socially. In general,
women secrete less gastric acid, reducing gastrointestinal transit times (Whitley & Lindsey,
2009). It would take longer for Ms. Jones’s body to dissolve the drug in her stomach.
Mr. Smith is described as an older, less active, and larger man who drinks occasionally. Men
statistically have more enzymes present to oxidize alcohol, which can reduce the effect of
alcohol (Advokat et al., 2018). Enzymes that metabolize alcohol also metabolize other drugs.
Drinking occasionally triggers a small amount of these enzymes to metabolize alcohol,
leaving a larger amount to metabolize medications and other particles. Increased drinking
requires more of these enzymes to prioritize alcohol metabolism over other molecules
(Weathermon & Crabb, 1999). When taking the medication sober, metabolism will occur at
an increased rate. Because Ms. Jones drinks more than Mr. Smith, Mr. Smith will metabolize
the drug faster than Ms. Jones.
Body fat increases with age. Older and larger individuals with more fat storage can retain
lipophilic drugs longer. Mr. Smith is older and larger than Ms. Jones so he would retain the
drug longer (Le, 2022). However, lean individuals would still possess visceral fat which
contributes to abnormal drug metabolism. without assuming Ms. Jones has a large amount of
visceral fat, Mr. Smith will retain the drug longer.
In these cases, the drug was administered orally. Food influences absorption rate, and some
drugs do not survive the stomach acid to reach the action site. Depending on the drug a
different route of administration may be considered for optimum effects. Pharmacokinetics
effect the potency of a drug and will contribute to dosage adjustments for each individual.
The half life of the drug helps determine the time needed for steady state concentration. It is
half the time required for a drug to be eliminated from the body (Advokat et al., 2018). As
aging occurs, the kidneys eliminate less byproducts and waste. Urine is the most common
elimination route so this may cause the drug to take longer to leave the body.
Advokat, C. D., Comaty, J. E., & Julien, R. M. (2018). Julien’s primer of drug action: A
comprehensive guide to the actions, uses, and side effects of psychoactive drugs (14th
ed.). Worth Publishers.
Le, J. (2022). Overview of Pharmacokinetics. Merck
Manual. https://www.merckmanuals.com/professional/clinicalpharmacology/pharmacokinetics/drug-metabolismLinks to an external site.
Weathermon, R., & Crabb, D. W. (1999). Alcohol and medication interactions. Alcohol
research & health : the journal of the National Institute on Alcohol Abuse and
Alcoholism, 23(1), 40–54.
Whitley, H., & Lindsey, W. (2009). Sex-based differences in drug activity. American family
physician, 80(11), 1254–1258.
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