Pharmacokinetics Case Study

a. What elements of his history would alert the nurse to possible problems with pharmacokinetics?

A 60 year man has no major medical problem, but he is having alcohol for years. Alcohol affect the pharmacokinetics (i.e. how body handles the medication or the study of the drug movement throughout the body.) of drug by altering gastric emptying or liver metabolism. Liver is the primary site for drug metabolism and alcohol also metabolized through liver. Nurse has to get medical history which is very important especially for the substance abuse.

b. What interventions might the nurse expect during the medication phase of this procedure?

As a nursing intervention, nurse informed consent prior to treatment, give adequate information and explanations about the procedure and medications, managed the symptoms like anxiety/fear, pain, sleep problem, assessment of needs, etc.

Nurse has to be very alert about his medication, because if he is having his OTC medication, any dietary supplements or herbal

remedies, which can interact with alcohol or other drug and leading to increase the risk of illness, injury, or death.
Nurse has to start the medication with lower dose for alcohol consumption person to avoid the potential adverse effects.

Mostly lipid soluble drug pass through plasma membrane, but sometime small water soluble agent like alcohol or urea enter through pores in plasma membrane and there is possibility to enter blood-brain barriers and fetal-placenta barrier. Mainly two types of condition exist with alcohol consumption. First one is pharmacokinetics, in which alcohol interference with metabolism of drug in liver by altering the function of hepatic microsomal enzyme system, which may alter drug action and accelerate their excretion without its effectiveness. Second one is pharmacodynamics, in which alcohol enhance the effect of drug, mainly on central nervous system. In colonoscopy, doctor would like give general anesthesia which depress the CNS as well. Those patients who are having alcohol on regular basis, enhance the sedative effect, which finally impair mental

illness.
c. What system (s) should the nurse assess following the delivery of any medications for this patient?
In colonoscopy, patient need higher dose of anesthetic drugs than the patient go not consume any alcohol. Post- treatment monitoring is very important for the patient. Nurse has to get vital sign (i.e. BP, RR, pulse, SpO2, temperature) in timely manner. Nurse who are care for patients that are experiencing substance abuse should watch for withdrawal symptoms.
Reference
Adam, M. P., Holland, L. N., & Urban, C. Q. (2017). Core Concept of Pharmacology. In Pharmacology for Nursing: Pearson
Cite
http://www.rroij.com/open-access/impact-of-alcohol-on-drug-metabolism-and-alcohol--drug-pharmacokinetic-interactions-in-alcoholics-.php?aid=77666