According to Lehne (2007) pharmacodynamics is defined as the study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced (Pg. 46). For any medication to be therapeutically effective, variables such as maximal efficacy, relative potency, affinity, age, body weight and composition, must be considered. One would think that Michael Jackson’s transformed appearance, frail body, saddened eyes, behavioral patterns and reported dependency on pain killers would have triggered enough red flags to bring attention to his deteriorating condition. The question, however, remains, "Did his fame and fortune contribute to and/or encourage unethical medical decisions?" Potency is defined by Lehne (2007) as the amount of drug given to elicit an effect, a factor that might have been ultimately responsible for Michael Jackson’s sudden death (Pg. 48). Lehne (2007) also reported that "It is important to note that the potency of a drug implies nothing about its maximal efficacy which refers to the largest effect that a medication can produce" (Pg. 46). With multiple medications prescribed for Michael Jackson, likely through different sources, the potency as well as the maximal efficacy could have resulted in alarming side-effects that, if diagnosed and evaluated on a timely basis by his personal doctor, might have prevented his demise. As this investigation continues, nursing forensics might be able to determine the cause and effect possibilities by evaluating the interaction of the drugs taken and their positive or negative therapeutic effects. Lehne (2007) stated, "When a patient is taking two medications, one drug may intensify the effects of the other" (Pg. 58). This suggests that all risks must be evaluated and discussed with a patient when more than one medication is prescribed. In Michael Jackson’s case, monitoring his diet was likely necessary in order to evaluate whether or not nutrients were properly ingested daily. Given his estimated height of 5′ 8" to 5′ 10" and weight of 112 pounds at death, this analysis might conclude that the type and degree of medications absorbed, coinciding with the lack of a balanced diet, were also contributing factors. Lehne (2007) defined toxicity as an adverse drug reaction caused by excessive dosing (Pg. 65). The media’s public disclosure of toxicology reports for this celebrity should bring greater focus on the potential effects of drug dependency, as well as the specific drugs used, providing both doctors and nurses with increased awareness on abusive habits, particularly when physical characteristics become negatively visible. Sociological traits, such as Jackson not leaving his home for long periods of time particularly with three children in his household, should also be questioned and evaluated. When reflecting on this case, it appears that medication remains a serious problem that requires further research and analysis. Lehne (2007) noted, "Medication error is a preventable event that may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the healthcare professional, patient or consumer" (Pg. 70). Lehne (2007) noted that included among the reasons medication errors exist are: the wrong patient receiving it, the wrong drug applied, the wrong route, the wrong time, the wrong dose (overdose, underdose, extra dose), an omitted dose, the wrong dosage form, the wrong diluent, the wrong strength/concentration, the wrong infusion rate, the wrong technique or the wrong duration of treatment (Pg. 70). Communications among patient, nurse and doctor can also be a factor in the forensic nursing evaluation process. Understanding exactly what was said and done that lead to a fatal outcome is essential for future drug administration. Instead of Michael Jackson retaining one or more private doctors, he may be alive today if he had assembled a team of specialized nurses, personal trainers, a nutritionist to assist his chef and therapists trained in abusive lifestyles to oversee his daily struggles. It is my opinion that high profiled wealthy individuals, should be counseled to secure more than one physiological and psychological specialist so that opinions can be collaborated for that person’s overall well-being. References Lehne, R. A. (2007). Pharmacology for Nursing Care (Sixth Edition). Pgs. 46-70.
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