The efficiency of a drug is a result of its pharmacokinetics and pharmacodynamics ( Alrasheed & Dzimiri, 2016) . Pharmacodynamics refers to the physiological and biochemical impacts of a drug and the mode of drug action and the association between the drug’s levels and impacts (Arcangelo, 2017). On the other hand, pharmacokinetics refers to the how drugs interact with the body with regard to its assimilation, metabolism, and the drug’s excretion aspects (Laureate Education, 2012 ). The patient in this case is taking drugs for hypertension, hyperlipidemia and type 2 diabetes all which need different medications in their management.
Ethnic variations in pharmacodynamics and pharmacokinetics can happen in this case from medication administration by a certain route that causes a different sequence in the drug’s uptake, transportation, metabolism and elimination out of the body (Johnson, 2000). Studies show that ethnic variations can occur through two different ways of delivering medication in the body. There are significant ethnic variations in oral clearance of drugs that in systemic clearance of certain medication. This can be explained by looking at the pre-systemic aspects playing part in oral administration of drugs as opposed to administering the drugs intravenously.
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In the same way, changes in the frequency of dose taken or the period taken can have major effects on ethnic variations in pharmacodynamics and pharmacokinetics results (Johnson, 2000). In addition, even in similar dose regimen, the varying dosages as seen in the different dosages for the drugs used in treating hypertension in this case can lead to changes in pharmacodynamics and pharmacokinetic reactions in different ethnic groups. This is caused by the fact that at different dosages, drugs can present varying rates of release; drugs may be released at varying sites or may possess varying retention periods at different parts of the body.
As a result, the above discussed changes in the pharmacokinetic and pharmacodynamics processes because of ethnicity may affect the patient’s proposed medication plan. The pharmacokinetics processes changes will determine how the drugs administered move all over the body. The different drugs proposed have different mechanisms of moving throughout the body and therefore, in consideration of this factor, the medication plan will be affected. On the other hand, changes in pharmacodynamics processes will most affect the drug therapy in this case. Glipizide for example is found to cause to increase lipid levels in the body and increase in weight. Considering that the patient in the case study has hyperlipidemia, hypertension and a history of strokes, the use of Glipizide on the patient should be dealt way with because of its effects on the body especially if the patient is from an ethnic population characterized by obesity and high lipid levels.
Considering the pharmacokinetic and pharmacodynamics changes, the drug therapy can be improved by combining the therapy with appropriate diet and exercise. I would modify the drug therapy plan. This is because of the pharmacodynamics effects of Glipizide on lipid levels in the body and considering that the patient is already diagnosed with hyperlipidemia and hypertension. Studies show that compared to Glipizide, Metformin is seen to cause a major decrease in different cardiovascular conditions (Johnson, 2000). It has been identified to cause a significant reduction in cardiovascular events in patients who are an increased risk of cardiovascular conditions as compared to Glipizide. In addition, metformin is known to cause a reduction in weight in diabetic patients as compared to Glipizide which cause a weight accumulation in diabetic patients because of its mechanism of action (Johnson, 2000). In this case therefore, Metformin may have a potential benefit on the patient’s conditions especially on the outcomes of both diabetes and cardiovascular outcomes.
References
Alrasheed, M. M., & Dzimiri, N. (2016). Ethnicity and Response to Drug Therapy. Cholesterol Lowering Therapies and Drugs . Doi: 10.5772/64819
Arcangelo, V. P. (2017). Pharmacotherapeutics for advanced practice: A practical approach . Philadelphia: Wolters Kluwer Health.
Johnson, J. (2000). Predictability of the effects of race or ethnicity on pharmacokinetics of drugs. Int. Journal of Clinical Pharmacology and Therapeutics, 38 (02), 53-60. Doi: 10.5414/cpp38053
Laureate Education, Inc. (Executive Producer). (2012). Hypertension and hyperlipidemia . Baltimore, MD: Author.
