APA Format 1 page 3 references 1 from walden university library due 8/9/18 
 
In my clinical experiences in the past five years included many geriatric patients.  One patient, in particular, comes to mind when I reflect on the patient’s history and the pharmacokinetic and pharmacodynamic processes and how age and lifestyle choices were a factor.  Often, older patients take more medications than younger generations because of the likelihood of having numerous medical disorders.  Geriatric patients may have drugs that are a short or long-term prescription, but each one affects the patient.
Pharmacodynamics
M.M. was a 70 y.o. patient in our clinical setting that had a medical diagnosis of hypertension.  This patient was on metoprolol, a frequently used beta blocker.  M.M. was also a smoker with a half a pack a day 40-year history.  This patient reported attempts of smoking cessation a few times throughout the years but was not successful.  Throughout caring for this patient, he voiced understanding the importance of smoking cessation and was receptive to patient education concerning smoking cessation.
According to NSW Government (n.d.), medication levels can vary if a person smokes and interactions are caused by constituents of tobacco smoke inducing cytochrome P450 enzymes in the liver affecting absorption, distribution, metabolism, or elimination of the medication.  Beta blockers have a moderate effect on patients who use tobacco, therefore, may require a higher dose of the medication NSW Government (n.d.).  If the patient decides to quit smoking, they may experience possible bradycardia and hypotension, resulting in requiring a lower dose NSW Government (n.d.).  Beta blockers decrease blood pressure by blocking central and peripheral beta receptors, resulting in reduced cardiac output and sympathetic outflow (Arcangelo, Peterson Wilbur,