Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.

Patient Case

My clinical experience included a woman aged 62 years who had been suffering from type 2 diabetes for 10+ years. Although she was given metformin 500mg orally two times daily, her blood sugar levels continued to rise despite this medication. This patient was a victim of hyperlipidemia and hypertension. She also had gastroesophageal reflux (GERD) symptoms.

Influencing Factors

Several factors could have influenced the patient’s pharmacokinetic and pharmacodynamic processes. One of the factors is age, which may have altered the patient’s drug response due to changes in renal and hepatic function that could affect drug metabolism and excretion. Additionally, T2DM is a progressive disease, and the patient’s condition may have altered the pharmacodynamic response to metformin. The patient’s hyperlipidemia and GERD could also influence the patient’s pharmacokinetic processes and drug absorption.

A Personalized Care Plan

Based on the patient’s history and influencing factors, a personalized plan of care for this patient could include close monitoring of blood glucose levels and titration of metformin dosage to optimize glycemic control. A comprehensive evaluation of the renal and liver function is recommended to assess for any possible changes in drug metabolism or excretion. Lifestyle modifications such as exercise and diet should be discussed with the patient to help manage T2DM/hyperlipidemia.

The patient’s GERD should be considered in selecting the appropriate drug therapy. To manage GERD, the doctor may recommend an antacid and proton pump inhibitor. Given the fact that there are multiple medical conditions, the provider needs to monitor patients for possible drug interactions with metformin and potential adverse reactions.

To sum it all, personalized patient care should be based on pharmacokinetic (and pharmacodynamic) factors. This includes age, gender, comorbidities, as well genetic variations. Healthcare providers are able to tailor drug therapy in order to maximize outcomes and minimize the chance of drug interactions or adverse drug reactions.


Lehne, R. A., Rosenthal, L. D., & Burchum, J. R. (2018). 9th edition of Pharmacology in Nursing Care. St. Louis, MO: Elsevier.

Wright, J. D., & Boudreau, R. A. (2021). The Pathophysiologic Approach to Pharmacology: Nursing Pharmacy. Philadelphia, PA: F.A. Davis Company.

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