Reference no: EM133385008
Mr. T. is a 56-year-old African American male long-distance truck driver who presented with exertional chest tightness and shortness of breath for the past two weeks. He has a history of type 2 diabetes, and hypertension, and quit smoking 20 cigarettes a day one year ago. His home medications include aspirin 81 mg daily, lisinopril 10 mg of daily, metformin 1000 mg twice daily, and hydrochlorothiazide 25 mg daily. His vital signs are stable. His electrocardiogram (ECG) shows normal sinus rhythm at 74 bpm, and criteria for left ventricular hypertrophy with nonspecific ST and T-wave changes. His blood sugar was 304 and Lispro insulin 6 units was administered per sliding scale protocol. After about 25 minutes, I approached the patient to administer the scheduled medications. The patient appeared lethargic, struggling to get words out, and diaphoretic, with shivers. Recheck blood glucose was 44mg/dL. Glucagon I gm IVP was administered, bringing the glucose level to 75 mg/dL. The patient was able to tolerate eating crackers and orange juice.
- Consider the principles of pharmacokinetics and pharmacodynamics.
- Think about how pharmacokinetic and pharmacodynamic factors altered his anticipated response to a drug.
- Consider factors that might have influenced the patient's pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
- Think about a personalized plan of care based on these influencing factors and patient history in your case study.