Emphysema is a type of chronic obstructive pulmonary disease that results from deteriorating air sacs, which causes them to collapse. This reduces the surface area for air exchange, which causes difficulty in breathing. Several medications that aim at increasing the surface area by restoring the firmness of the air sacs are available for personal or physician administration. They do not cure the condition, but relieve symptoms and sustain life. This also means that the individual has to live a healthy life and avoid activities that put a strain on the lungs, such as smoking. Medication for the condition could be aerosols or oral steroids. When choosing the type of drug to prescribe, the physician must be aware of the role that ethnicity plays in drug absorption, metabolism, distribution, and elimination (Mak, Keeley, & Gruffydd Jones, 2017). Some common trade names for these drugs include Adair and prednisone, which are a combination of vasodilators, anticholinergics, beta-antagonists, and corticosteroids.
Ethnicity determines the pharmacodynamics and pharmacokinetics of a drug by varying its distribution and effect due to differences in body mechanisms. The differences are mainly due to genetic makeup. Belonging to a certain ethnic group means that the molecular coding of proteins, which determines genetic makeup, is in line with the external factors such as climate and the available diet (Ramamoorthy, Pacanowski, Bull, & Zhang, 2015). This explains why some races are more prone or resistant to certain diseases compared to others. In the region they are born, the condition could have been an epidemic. Thus the body has mechanisms to protect itself before the disease occurs.
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The frequency of alleles responsible for the metabolism of a certain drug determines how fast a drug is metabolized and utilized. Taking an example of prednisone, the more alleles an individual has that code for the enzymes and transporters of the drug, the faster its metabolism, and effect. The total plasma concentration will also be higher in that individual compared to another who has less allele (Boots & Haenen, 2015). The allele could be a normal or mutant allele. A mutant allele means that the individual’s body has had to undergo mutation as a process of natural selection because the individual faces a higher risk of infection with a particular disease.
Whites have also been shown to have a higher clearance rate of drugs that treat emphysema compared to Blacks; age held constant. They have a 50% clearance rate for theophylline, which has been attributed to genetic makeup (Xiong, & Li, 2018). Despite the higher clearance rates, absorption, metabolism, and circulation remain relatively constant, which makes a dose re-adjustment unnecessary. The drug is only eliminated after being utilized, irrespective of the ethnicity of the patient. Whites are more prone to the condition, so the body has naturally prepared itself to quickly metabolize drugs that alleviate its symptoms. This could be attributed to the fact that Western countries are colder compared to African ones.
To ensure Blacks are not susceptible to poisoning due to low clearance rates, the physician could advise on other methods to aid clearance other than reducing the dose. Reducing the dose makes the medication less effective. They could include avoiding drugs that slow down the elimination of the drugs. Emphysema drugs are clearance by cytochrome p450 (Boots and Haenen, 2015), thus avoiding other drugs that utilize the same enzymes could aid fasten their clearance. It could also include intake of more fluid to reduce the toxicity of the drug remnants.
References
Boots, A. & Haenen, B. (2015). Oxidative metabolism in chronic obstructive pulmonary disease. European respiratory journal, 2 (3) page 51-54
Mak, V., Keeley, D., & Gruffydd Jones, K. (2017) . Treatment guidelines for COPD—Going for GOLD . Primary Care Respiratory Update , 4 (2), 19-24.
Ramamoorthy, A., Pacanowski, M. A., Bull, J., & Zhang, L. (2015). Racial/ethnic differences in drug disposition and response: review of recently approved drugs. Clinical Pharmacology & Therapeutics , 97 (3), 263-273.
Xiong, S., & Li, L. (2018). The effect of CYP1A2 gene polymorphism on the metabolism of theophylline. Experimental and therapeutic medicine , 15 (1), 109-114.
