excretion and metabolism

 excretion and metabolism

To begin with, it is vital to understand that both excretion and metabolism constitute the processes through which drugs are eliminated from our bodies. The major drug elimination routes are often liver metabolism and renal excretion. It is also worth noting that genetic polymorphisms are one of the various drug-metabolizing enzymes, and it includes cytochrome P450 enzymes. It is worth noting that mutations in the gene coding regions are highly likely to result in alterations in the protein structure or gene expression, and this has a direct impact on the quality and the quantity of the proteins.

Concerning the enzymes, similar mutations are likely to affect the rate, protein function, and kinetic constants. On the same note, it is also evident that changes that happen in the drug-enzyme and the drug-receptor interactions as a result of the structural alterations of enzymes or receptors are also highly likely to result in the variations in the drug responses. Polymorphisms that occur in the genes that are responsible for the transport of drugs can also affect the pharmacokinetics and Pharmacodynamics of the administered drugs, and I turn its concentration in the plasma and, consequently, its concentration in the tissues that are being targeted by the administered drugs. Drug responses that are altered can also be linked to reduced repairing capabilities for mutations that are always triggered alkylating agents as a result of malfunctioning of the enzymes that repair the DNA. These protective effects can be affected by genetic polymorphisms, and it results in protein structures that are altered and reduced expression in the enzymes that are responsible for the glutathione biosynthesis.

Pharmacokinetics and Pharmacodynamics impacting Drug Therapy

In the development of an effective drug therapy, it is vital to understand the basic principles that are involved in the pharmacokinetics and Pharmacodynamics. Genetics has a crucial role to play in the pharmacokinetics and Pharmacodynamics due to hormones that impact them either directly or indirectly. As a result, this will affect the amount of drug that is required by the body without necessarily causing toxicity at the same time.

Improving the Patient’s Drug Therapy plan

I this case, the reason for the nine-pound weight gain is not definite, and as a result, it calls for further investigation to determine the cause for the weight gain. One of the significant ways for the prevention and the treatment of obesity remains is making healthier and sensible diet choices combined with regular physical activities. This is not enough as there has been a rise in the cases of obesity over recent years. To improve the treatment of obesity in patients, I would administer two drugs that include phentermine and orlistat since the Food and Drug Administration has approved them for the treatment of obesity and overweight. It is worth noting that the two drug s have their side effects such as fecal urgency and cardiac side effects, respectively, which makes only a select population use them.

Alternatively, to improve drug therapy, topiramate and phentermine extended-release and lorcaserin would be vital in the management of obesity. It is also referred to as Qsymia, and it is recommended for use in addition to a low-calorie diet wit recommended physical activity.

Topiramate is mostly used as an antiepileptic drug and is believed to be beneficial for the treatment of obesity since it enhances the activity of neurotransmitter gamma-aminobutyric acid. The acid operates through self-modulation of voltage-gated ion channels and through the inhibition of carbonic anhydrase or the kainite excitatory glutamate receptors. Despite the fact that the mechanism of action for the drug is not precise yet, it has been proven to be efficient in the treatment and management of obesity cases.

Recent studies have suggested that patients are likely to adhere to treatment regimen using combination drugs; thus, reducing the number of medications the patient must remember to take (e.g., combining atenolol with HCTZ). Also, health coaching and case management can bridge the gap of understanding and compliance with these patients. It also addresses the gap by equipping people with the knowledge, skills, and confidence to manage their chronic conditions.

Lastly, since obesity is a consequence of lifestyle choices, I would advise patient AO to watch his diet and recommend him a daily calorie intake to help in the management of his weight. On the same note, I would insist that the patient should take physical activities with utmost seriousness so that they can improve their drug therapy and impact the results that they will get in the long run.