Evaluate how a typical drug, when orally administered, may be handled differently by two patients:
· Ms. Jones is a 30-year old female personal trainer that is 5’4” tall weighting 110lbs. She drinks socially regularly and sometimes more than a bit when she meets with her bi-weekly book club.
· Mr. Smith is a 65-year old software tester who is 6’ tall and weighs 235lbs. He drinks only occasionally.
When taking medication, no two people’s bodies are alike.
The dosage depends on the person and the way it is given.
Our text tells us that several different factors can alter the rate at which drugs are metabolized, either increasing or decreasing the rate of drug elimination from the body.
In general, genetic, environmental, cultural, and physiological factors are the most relevant.
First, it is now becoming apparent that genetic variations may affect how different people respond to medications.
Genetic DNA testing can now identify how a person may metabolize several drugs of different therapeutic classes, including antidepressants, analgesics, and antipsychotics.
In general DNA testing using a simple mouth swab can identify whether a person is a normal metabolizer of a specific drug, a slow metabolizer, or a fast metabolizer.
Results provide a scientific basis for understanding why a person might have an unexpectedly toxic reaction after therapeutic doses of a drug or, on the other hand, might fail to respond to what was thought to be a therapeutic dose (Advokat, Comaty, and Julien, p.52).
“Knowledge about the relationship between the time course of drug action in the body and its pharmacological effect is essential for
- predicting the optimal dosages and dose intervals needed to reach a therapeutic effect,
- maintaining a therapeutic drug level for the desired period of time and
- determine the time needed to eliminate the drug. The relationship between the pharmacological response to ad drug and its concentration in blood is fundamental to pharmacology. With psychoactive drugs, the level of drug in the blood closely approximates the level of drug at the drug’s site of action in the brain. The knowledge of a drug’s half-life is important because it tells us how long a drug remains in the body. It takes four half-lives for 94 percent of a drug to be eliminated by the body and six half-lives for 98 percent of the drug to be eliminated. At that point, a person is, for most practical purposes, drug-free. It is important to remember that even though the blood level of the drug is reduced by 75 percent after two half-lives, the drug persists in the body at low levels for at least six half-lives. The so-called drug hangover is a result” (p.57).
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Varied drug administration (Response to Bettye James)
You make a logical argument concerning the various reasons that prompt the need for different people to require different dosages.
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