Pharmacokinetics and Pharmacodynamics
For the past ten months, I have been providing medical care to a patient who was brought into our behavioral health unit as he awaits his placement into a health facility that is run by the state. The patient has a history of self-harming behavior and schizophrenia, and this condition had created the need for the patient to visit the institution numerous times ever since his initial diagnosis when he was an adolescent. He has been receiving several doses of Clozapine as a way of trying to find out which medication yields the best results. The main reason for trying out Clozapine with the patient is because the medication has been seen to improve the condition of the patient in the past, and this created some hope for future success. However, over the past several weeks, the patient has been complaining that he has been experiencing discomfort in his chest area, and the medical team has conducted an electrocardiogram (EKG) on him. However, even after the electrocardiogram, the patient has been complaining that the discomfort in his chest area has been becoming worse.
Clozapine loosely transiently binds to D2 dopamine receptors in the body. However, it should be noted that the impacts of this loose and transient binding to the dopamine receptors are still not well known. This medication has also been known to bind itself to D1, D3, D4, and D5 receptors, which could also include the limbic system (Chan et al. 2020).
Clozapine has a high absorption rate into the body, and the first pass metabolism reduces the bioavailability of the administered dose by up to approximately 60% (Mustafa, 2020). There is very little evidence to support the claim that food has an effect on the bioavailability of the medication after the dose is administered. Under steady conditions, clozapine has an elimination half-life of approximately 14 hours.
The administration of doses should be carefully monitored by a cardiologist due to the prevalence of myocarditis induced by clozapine (Mustafa, 2020). Medical staff should be well trained on the risks that could arise as well as have training in implementing mandatory care plans, which should include monitoring echo and electrocardiograms whenever a patient is admitted into the facility. Neutropenia, as well as how clear the airways are, should be monitored during this time.