NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
Walden University NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS – Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
Whether one passes or fails an academic assignment such as the Walden University NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
The introduction for the Walden University NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
Need a high-quality paper urgently?
We can deliver within hours.
How to Write the Body for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
After the introduction, move into the main part of the NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
Stuck? Let Us Help You
Completing assignments can sometimes be overwhelming, especially with the multitude of academic and personal responsibilities you may have. If you find yourself stuck or unsure at any point in the process, don’t hesitate to reach out for professional assistance. Our assignment writing services are designed to help you achieve your academic goals with ease.
Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW.
Sample Answer for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
I had a recent clinical experience where a patient of mine was sensitive to
medications. She had recently had high blood pressure in the 200’s and acute
kidney failure. She was given IV hydralazine and labetalol in the emergency room.
She had a reaction to the medication and her heart rate dropped into the 20’s and
she became unresponsive. The emergency room staff performed chest
compressions and administered to the patient, and she was transferred to the ICU.
A case study writes about adverse effects of hydralazine and notes “Hydralazine
was chosen for its antihypertensive effect and 2 mg were administered intravenously
(IV). Within a brief period of time (30-45 sec) the patient developed a profound
bradycardia from 52-10 beats/min occasioned by premature ventricular contractions
(PVCs)” (Wehner & Romanauskas, 1981). A different case study notes a similar
adverse effect of labetalol, “She was thought to have an anaphylactoid reaction and
was treated intravenously with fluids, diphenhydramine (50 mg), and
methylprednisolone (250 mg), without initial improvement. While urinating in the
bedpan, she developed bradycardia and hypotension, with a pulse of 30/min and a
blood pressure of 60/40. Trendelenburg’s position and 2 L of normal saline were
needed to restore her blood pressure to normal, although her bradycardia resolved
spontaneously” (Ferree, 1986).
This patient had orders to receive hydralazine IV to maintain a blood pressure of
140/80 so that she could have a kidney biopsy. “Most patients who undergo renal
biopsy have hypertension, but hypertension is almost never considered a single or
leading indication for biopsy” (Stompór & Perkowska-Ptasińska, 2020).
I diluted the hydralazine and pushed it over 10 minutes minimum and monitored the
patient closely. I checked her blood pressure 15-30 minutes after administration and
monitored her heart rate. She did not have any adverse reaction to the hydralazine
when I administered it. I instructed the patient to use her call light button if she had
any strange reactions or felt odd. I kept the physician updated on the patient’s blood
pressure and heart rate throughout the night. The patient was able to transfer to a
medical-surgical floor for a lower level of care.
References
FERREE, C. E. (1986). Apparent Anaphylaxis from Labetalol. Annals of Internal
Medicine, 104(5), 729–730. https://doi-org.ezp.waldenulibrary.org/10.1059/0003-
4819-104-5-729_2Links to an external site.
Stompór, T., & Perkowska-Ptasińska, A. (2020). Hypertensive kidney disease: a true
epidemic or rare disease? Polish Archives of Internal Medicine, 130(2),
130–139. https://doi-org.ezp.waldenulibrary.org/10.20452/pamw.15150Links to an
external site.
Also Read:
ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS
PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS
ASTHMA AND STEPWISE MANAGEMENT
PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
COMPARING AND CONTRASTING PHARMACOLOGIC OPTIONS FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER
WOMEN’S AND MEN’S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS
OFF-LABEL DRUG USE IN PEDIATRICS
Sample Response for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
Hello!! You have provided an insightful and impeccable post. Some patients tend to report insensitivity to medications prescribed. As a result, their health conditions remain undertreated because insensitivity to medications leads to medication non-compliance. These patients are usually frustrated by insignificant progress in their treatment outcomes and in turn ruin therapeutic relationship with healthcare providers and make them feel dissatisfied with the treatment process. Essentially, treatment should be guided by the aim to enhance the wellbeing of patient instead of arriving at a fixed therapeutic drug dose. One strategy to deal with issue is to begin slow and continue slow by beginning medication below the recommended beginning dose (Swanson et al., 2020). For example, consider starting on 1 mg of Hydralazine instead of the typical 2mg. Healthcare professionals should also try to understand dynamic factors that lead to the patient’s insensitivity to medications. This can be achieved by calling allergist / immunologis to assess the patient. The evaluation is critical in identifying classes of medications that makes the patient insensitive and create a detailed personalized plan for future drug use.
References
Swanson, K. M., Zhu, Y., Rojas, R. L., St. Sauver, J. L., Bielinski, S. J., Jacobsen, D. J., … & Borah, B. J. (2020). Comparing outcomes and costs among warfarin-sensitive patients versus warfarin-insensitive patients using the right drug, right dose, right time: using genomic data to individualize treatment (RIGHT) 10K warfarin cohort. PloS one, 15(5), e0233316. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233316
Sample Answer 2 for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
Patient Scenario
Jane Doe is a 32-year-old G4P4 who vaginally delivered a viable female infant at 0804 this morning. Two hours post-delivery the patient comes over to the postpartum unit, and report is obtained from the labor & delivery (L&D) nurse. This same nurse attended her delivery and cared for her throughout her recovery. She reported that the patient had an uncomplicated delivery, infant weighed 3573 grams, a first-degree perineal laceration was noted and repaired, her quantitative blood loss was 250 milliliters. The patient has an 18 gauge IV in her left hand. Her fundus is noted to be firm, midline, and at the level of the umbilicus. The patient is planning to breastfeed her infant. The L&D nurse states that the patient attempted but was unable to void after the delivery prior to transferring to postpartum. The patient denies any pain currently. Jane Doe had an adequate and uncomplicated course of prenatal care. Her medical history includes gestational hypertension for which she has been taking Labetalol 200mg twice daily during her pregnancy, lupus, anxiety, and depression. She is unmedicated for the latter diagnoses. Her blood pressures have been closely monitored and have been under control in the 130s/70s-80s throughout her pregnancy. She does admit to smoking 1/2 pack per day for the last 15 years but has no history of drinking alcohol. Her BMI is within normal range, and she has no family history of hypertension. Her vital signs upon admission to postpartum are T:98.3, P:110, BP:165/93, RR:20, SpO2:99% on room air. The patient’s vital signs were stable during her labor, delivery, and recovery with only slightly elevated blood pressure but nothing of concern. The patient’s lab work and urinalysis that was obtained prior to delivery was all within normal limits. Jane Doe is given her morning dose of Labetalol 200mg at the time of admission. The nurse will reassess her blood pressure 1 hour after administration and report to the doctor.
Factors Influencing Pharmacokinetics
The antihypertensive drug Labetalol is an alpha-beta blocker. Its use is recommended for treating gestational hypertension as it is safe for pregnant women and their unborn child. It is also safe for breastfeeding mothers. Labetalol relaxes blood vessels leading to a decrease in blood pressure and heart rate (Khan, 2020). The extent of decrease in blood pressure depends on the route of administration of Labetalol. In oral administration, a drop in blood pressure can be seen 20 minutes to 1 hour after administration, while effects from IV administration can be seen in just minutes. Labetalol is absorbed rapidly via first pass metabolism into the blood plasm through the liver or gastrointestinal tract. The highest concentration levels are seen at around 1-2 hours post administration. Labetalol’s half-life is approximately 3-3.5 hours after administration. The bioavailability is shown to correlate with the age of the patient with values of only 30% seen in patients aged 30-40. My patient falls in this age range at 32 years old. The bioavailability is noted at higher levels in older patients doubling to 60% at the age of 80. This percentage is also noted to increase when the medication is taken with food. The liver is responsible for excretion of Labetalol. After a dose of Labetalol is administered to a patient, the hepatic system rids the blood stream of approximately 85% of the medication. Excretion of Labetalol is dependent on the quality of hepatic blood flow. Labetalol is metabolized through conjugation to glucuronide metabolites and is excreted via urine and bile in feces (Abdullah & Yusof, 2019).
Factors Influencing Pharmacodynamics
Labetalol is a dual action medication. It is both an alpha1-adrenergic antagonist and a beta-adrenergic antagonist. Labetalol selectively antagonizes alpha1-adrenergic receptors and non-selectively antagonizes beta-adrenergic receptors, therefore the activity ratio of alpha to beta blockage when administered via the oral route is 1 to 3. When administering via the intravenous route the ratio is 1 to 7 (Miller et al., 2022). When Labetalol is administered, alpha1-adrenergic antagonism occurs which lowers blood pressure by vasodilation and a decrease in vascular resistance. Continued vasodilation from Labetalol use will not decrease stroke volume or cardiac output. Beta-adrenergic antagonism causes a decrease in the patient’s heart rate. Labetalol stops adrenergic stimulation of β-receptors in the smooth muscles, cardiac muscles, and bronchial muscles. This blockade is what causes a decrease in systemic blood pressure. This process also elicits some of the side effects caused by Labetalol such as bronchospasms. For this reason, Labetalol is contraindicated in patients with asthma (Abdullah & Yusof, 2019).
Personalized Plan of Care
The plan moving forward for Jane Doe was to recheck her blood pressure 1 hour after administration of Labetalol 200mg. Her blood pressure remained elevated at 160/99. I notified the provider who increased her Labetalol dose to 300mg three times daily. At this time, I administered the extra dose of 100mg of Labetalol to equal the newly ordered dosage, and her blood pressure was rechecked again in 1 hour. The patient’s blood pressure did respond to the extra dose of Labetalol, and her blood pressure dropped to 135/80. Increasing the strength and frequency of the medication kept the concentration levels in her body at a higher percentage throughout the day to control her blood pressure. Going forward, her blood pressures were checked every four hours or more frequently as needed throughout her stay. The nurses on each shift assessed for edema, changes in vision, and daily weight checks were performed. Gestational hypertension is high blood pressure that develops after 20 weeks gestation, and it usually subsides after delivery of the infant. In this patient’s case, the blood pressure did not immediately return to normal range. She will likely have to remain on the Labetalol for the next couple weeks. She will follow up in the office with her OBGYN in 1 week for a blood pressure check. There are a few factors that could have caused this. The patient could have an overabundance of fluid onboard from receiving intravenous fluids before, during, and after her delivery. The patient also has a history of lupus which puts her at greater risk for gestational hypertension. Gestational hypertension also makes this patient more susceptible for developing chronic hypertension later in life. The patient’s history of smoking for the past 15 years is a major factor that can contribute to hypertension. I educated her on smoking cessation. If this patient’s blood pressure had not decreased our next plan of action would have been to transfer her back to Labor & Delivery and begin a magnesium drip to control her blood pressure. This is recommended for emergency treatment to reduce the risk of preeclampsia induced seizures (Morgan, 2021).
References
Abdullah, A., & Yusof, M. (2019). Labetalol: A brief current review. Pharmacophore. https://pharmacophorejournal.com/article/labetalol-a-brief-current-reviewLinks to an external site.
Gestational hypertension: Causes, symptoms & treatment. (2022). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4497-gestational-hypertensionLinks to an external site.
Hypertension during pregnancy and after delivery: Management, cardiovascular outcomes and future directions. (2018, September 28). American College of Cardiology. https://www.acc.org/latest-in-cardiology/articles/2018/09/28/08/08/hypertension-during-pregnancy-and-after-deliveryLinks to an external site.
Khan, A. (2020, April 10). Taking Labetalol in pregnancy: Is it safe, risks & side effects. FirstCry Parenting. https://parenting.firstcry.com/articles/taking-labetalol-in-pregnancy-is-it-safe/Links to an external site.
Miller, M., Kerndt, C. C., & Maani, C. V. (2022, July 12). Labetalol – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK534787/Links to an external site.
Morgan, J. (2021, February 23). Postpartum hypertension: When a new mom’s blood pressure is too high | Heart | Your pregnancy matters | UT southwestern Medical Center. UT Southwestern Medical Center | The #1 Best Hospital in DFW. https://utswmed.org/medblog/postpartum-high-blood-pressure/Links to an external site.
Sample Response for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
Hello Joni! Your post is interesting and highly detailed. Labetalol is one of the preferred anti-hypertensives drugs to treat hypertension in pregnancy (Wiles et al., 2021). As you rightly noted, this medication is a beta-blocker. It functions by influencing nerve impulses response in some body parts such as the heart. In turn, the heart reduces rate of beating and lowers blood pressure. The labetalol’s alpha1-receptor antagonistic activity makes the blood pressure to be lowered in the standing position compared to the supine position. However, this can lead to symptoms of postural hypotension (Braunthal & Brateanu, 2019). As such, healthcare professional should consider the postural component when positioning the patient to administer the intravenous labetalol treatment. Clinician should also not allow the patient to move in a standing position unchecked until the capacity to do so is safely determined. This medication should only be provided with physician’s prescription. Patient education is essential in addressing concerns about medication, highlighting possible side effects and adverse reactions, and the mode of administration. An interprofessional team approach is also critical in enhancing healthcare outcomes of the patient.
References
Braunthal, S., & Brateanu, A. (2019). Hypertension in pregnancy: Pathophysiology and treatment. SAGE open medicine, 7, 2050312119843700. https://doi.org/10.1177/2050312119843700
Wiles, K., Damodaram, M., & Frise, C. (2021). Severe hypertension in pregnancy. Clinical Medicine, 21(5), e451. Doi: 10.7861/clinmed.2021-0508
Sample Answer for NURS 6521 PHARMACOKINETICS AND PHARMACODYNAMICS
You did a great job explaining pharmacokinetics, how the body acts on the drug, and pharmacodynamics, how the drug acts on the body (Grogan & Preuss, 2022; Marino et al., 2023). Providers must understand these processes and consider how patient factors such as age, genetics, ethnicity, disease processes, renal and hepatic function, and patient behaviors such as diet and alcohol use can affect these processes (Rosenthal & Burchum, 2021). You discussed how elderly patients are at increased risk for drug toxicity due to slowed metabolism and excretion from age-related changes and drug-drug interactions from polypharmacy. Another factor that could have affected the pharmacokinetic processes of this patient could be if the patient was malnourished (Rosenthal & Burchum, 2021). Since hepatic enzymes that metabolize medications need multiple cofactors to metabolize a medicine effectively, malnourishment can delay drug metabolism and cause drug accumulation leading to toxicity (Rosenthal & Burchum, 2021).
Additionally, since most medications metabolize in the liver, if the patient had liver failure, their liver’s ability to metabolize drugs would diminish and active drug levels would build up in the blood. The increased active drug levels could also cause toxicity (Rosenthal & Burchum, 2021). Liver failure and ascites can decrease albumin levels, affect medication protein binding, and can cause more active medicine to circulate, leading to toxicity (Grogan & Preuss, 2022). Thus, advanced age, polypharmacy, malnutrition, and liver failure could all affect pharmacokinetic processes for this patient.
A patient’s care plan must consider all unique patient factors and pharmacokinetic and pharmacodynamics processes. For example, if the patient is at increased risk for slowed metabolism due to liver failure, the initial dosage should be low (Rosenthal & Burchum, 2021). Furthermore, other medications metabolized by the liver and possibly competing for metabolism may also need reduction (Rosenthal & Burchum, 2021). Providers should review all patient medications at least annually and determine if they are all necessary and if they can decrease any dosages (Rosenthal & Burchum, 2021). In addition to regularly monitoring the complete blood count, providers should also monitor liver function, kidney function, and albumin levels if this patient has liver failure. Kidney function requires monitoring because kidney failure can occur secondary to liver failure (Rosenthal & Burchum, 2021). Furthermore, clozapine can cause dyslipidemia, obesity, and diabetes, increasing a patient’s risk for cardiovascular disease (Rosenthal & Burchum, 2021). Thus, regular electrolyte, lipid, and glucose screenings are also essential.
References
Grogan, S. & Preuss, C.V. (2022, June 23). Pharmacokinetics. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK557744/Links to an external site.
Rosenthal, L. D. & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses
and physician assistants (2nd ed.). Elsevier.
N6521 Week 1 Discussion
A 56-year-old man is involved in a motorcycle collision on interstate 95. He suffered a total degloving injury to his right lower extremity. He presented to the Emergency Department alert and oriented, GSC of 15. Vital signs were stable, and he was able to communicate with staff. After his trauma workup and CT scans patient was taken to the operating room for a above the knee amputation and pelvis fracture ex fix application. CT scan results also showed a grade 1 liver and kidney laceration and splenic rupture. He subsequently had a splenectomy and there was no intervention for the liver injury. The kidney laceration was to the left kidney, and it was removed. Upon admission to the intensive care unit the patient remained intubated and sedated and serial labs were collected. His blood pressure was supported with a norepinephrine infusion and multiple blood product transfusions. His liver and kidney function were impaired, continuous renal replacement therapy (CRRT) was initiated. The plan for this patient was to resuscitate and stabilize and prepare for trip back to OR for wash out of guillotine amputation and pelvic fixation.
Laboratory testing is important to establish if medications are effective and within safe limits. This patient would need close monitoring for medications that are excreted in the kidneys or liver considering the injuries to both. There is already decreased kidney function due to nephrectomy so diligence to protect the other kidney is necessary. The admission labs showed that kidney function was impaired hence the initiated of CRRT. According to Rosenthal (2021), four pathologic conditions modify drug responses, acid-base imbalance, liver disease, kidney disease and altered electrolyte status. The help prevent toxicity and further damage medication dosages were lowered. Atkinson et al. (2022), stated that the extracorporeal clearance created by renal replacement therapy adds an additional route for drug elimination.
The patient was hypothermic mainly from the CRRT, so a warming device was applied to help patient maintain normothermia. The white blood count was elevated, and blood cultures showed evidence of bacterial growth. There was a fungus identified in one of the cultures, so patient needed an antifungal medication, this was hard to dose considering the patient needed a certain dosage to combat the fungus but also needed to decrease dosage to prevent injury. Zhou et al., (2022) stated that in a study of patients aged 45 or older, more male patients were affected versus females of drug induced liver injury, males 51.38% and females 38.09%.
We kept the patient sedated and intubated for several days, he went back and forth to OR multiple debridement and washout outs as well as fixation of fractures and revision of amputation. After a week, CRRT was stopped, and the patient was extubated and transferred to the surgical floor. It was identified that the patient needed a psych consult to help him deal with altered body image issues as well as post-traumatic stress disorder caused by the accident and injury.
References
Atkinson, A. Nolin, T.D., Allen, J. (2022). Pharmacokinetics in patients requiring renal
replacement therapy, Atkinson’s Principles of Clinical Pharmacology (Fourth Edition),
https://doi.org/10.1016/B978-0-12-819869-8.00018-5.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice
nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Zhou ZX, Yin XD, Zhang Y, Shao QH, Mao XY, Hu WJ, Shen YL, Zhao B, Li ZL.
(2022).Antifungal drugs and drug-induced liver injury: A real-world study leveraging the
FDA adverse event reporting system database. Front Pharmacol. 2022 Apr
28;13:891336. doi: 10.3389/fphar.2022.891336.
NURS 6521 DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL DISORDERS
Decision Tree For Neurological And Musculoskeletal Disorders
Alzheimer’s disease is defined as a neurological ailment that begins slowly and worsens with time. This health condition is linked to 70% of dementia cases worldwide (Son et al., 2019). The absence of memory relating to current events is the most common first sign. Other signs of the condition include mood swings, confusion, low self-esteem, linguistic problems, and behavioral abnormalities (Iniesta et al., 2022). All bodily functions gradually deteriorate, finally leading to death. The important thing to remember is that while Alzheimer’s disease cannot be cured, it may be controlled to improve the patient’s quality of life.
Summary of Case Presentation
The media file case study outlines the examination and treatment of Mr. Akkad, a 76-year-old Iranian geriatric man. His eldest son thought he had strange characteristics and was uninterested in religious activities with his family. Furthermore, the patient forgets things, and confabulation was discovered in his case after numerous memory tests. The patient was given the Mini-Mental State Exam, which revealed scores of 18 out of 30 with primary deficiencies in orientation, recognition, attention, and recollection. The result indicates moderate dementia.
Treatment Decisions
Exelon 1.5mg twice a day is the most recommended initial intervention based on the patient’s history as stated above. Exelon (rivastigmine) is a medication licensed by the Food and Drug Administration to treat mild to moderate Alzheimer’s disease (Abdel-Atty et al., 2021). Previous research supports the drug’s efficacy and safety profile in the elderly with Alzheimer’s disease (Ray et al., 2020). The second choice was to increase the Exelon dose to 4.5 mg twice daily, as advised by most clinical practice guidelines for individuals with high tolerance but low efficacy (Iniesta et al., 2022). The final option was to raise the dosage to 6mg twice daily to encourage maximum success, as the patient still showed limited symptom remission with the earlier intervention (Mirakhori et al., 2022).
Expected Outcome
Exelon, when taken correctly, takes between 8 and 12 weeks to completely treat Alzheimer’s symptoms in senior adults, according to evidence (Son et al., 2019). As a result, the patient was projected to achieve around 50% symptom remission with the first intervention of 1.5mg Exelon twice daily. The dose, however, needed to be titrated to achieve the best results, not exceeding 6mg twice daily (Abdel-Atty et al., 2021). The second and third procedures produced the same results, with no adverse effects.
Difference Between Expected Outcome and Actual Outcome
The patient had a small improvement in Alzheimer’s symptoms, as predicted, with no adverse effects noted with the initial intervention (Ray et al., 2020). After the dose was raised in the second intervention, the patient reported additional symptom remission, but at a slower rate, so the dose was increased in the final intervention, which resulted in optimum remission of Alzheimer’s symptoms, precisely as planned (Iniesta et al., 2022).
Conclusion
Alzheimer’s disease is a frequent ailment that affects the elderly’s quality of life and well-being. Exelon was administered to the patient in the case study at a beginning dose of 1.5 mg, which was titrated to 4.5mg, then 6.5mg twice daily. This medicine was quite helpful in managing the patient’s Alzheimer’s symptoms, with no adverse effects recorded.
References
Abdel-Atty, M. E. A. E.-F., Khalil, W. F., & Mohamed, S. M. (2021). Effect of Curcumin, Exelon and their Combination on Brain in Alzheimer’s Disease-Induced Rats. Journal of Advances in Medicine and Medical Research, 65–78. https://doi.org/10.9734/jammr/2021/v33i330822
Iniesta, M., Schurad, B., Koch, C., Schug, B., Morte, A., Vaqué, A., & De la Torre, R. (2022). Comparative Bioavailability Study of a Novel Multi-Day Patch Formulation of Rivastigmine (Twice Weekly) with Exelon® Transdermal Patch (Daily)- A Randomized Clinical Trial. Current Alzheimer Research, 19(7), 541–553. https://doi.org/10.2174/1567205019666220823105059
Mirakhori, F., Moafi, M., Milanifard, M., & Tahernia, H. (2022). Diagnosis and Treatment Methods in Alzheimer’s Patients Based on Modern Techniques: The Orginal Article. Journal of Pharmaceutical Negative Results, 1889-1907.https://doi.org/10.47750/pnr.2022.13.S01.226
Ray, B., Maloney, B., Sambamurti, K., Karnati, H. K., Nelson, P. T., Greig, N. H., & Lahiri, D. K. (2020). Rivastigmine modifies the α-secretase pathway and potentially early Alzheimer’s disease. Translational Psychiatry, 10(1). https://doi.org/10.1038/s41398-020-0709-x
Son, M., Park, C., Rampogu, S., Zeb, A., & Lee, K. (2019). Discovery of Novel Acetylcholinesterase Inhibitors as Potential Candidates for the Treatment of Alzheimer’s Disease. International Journal of Molecular Sciences, 20(4), 1000. https://doi.org/10.3390/ijms20041000