Age Related Dosing

Question 1

What population of pts. has decreased sensitivity to beta-adrenergic stimulation and decreased total body H2O?

Answer 1

Geriatric

Question 2

Increased gastric pH, decreased intestinal blood flow/mobility/surface area, decreased gastric emptying rate are absorption changes in what pt population?

Answer 2

Geriatric

Question 3

How does change in body composition in elderly affect VD?

Answer 3

• Decreased total body H2O -> decreased VD of water-soluble drugs
• Increased VD of fat -> increased VD of fat-soluble drugs
• Decreased serum albumin -> more active drug

Question 4

What does decreased hepatic mass/blood flow affect in the elderly?

Answer 4

Phase I metabolism by liver

Question 5

What does decreased fx cells in kidney, decreased renal blood flow, and decreased GFR affect in the elderly?

Answer 5

Renal elimination

Question 6

What is the best measurement of renal fx?

Answer 6

12-24 hr creatinine clearance determination

Question 7

What pharmacodynamic changes occur in the elderly?

Answer 7

• decreased baroreceptor sensitivity
• CNS changes (increased risk of tardive dyskinesia w/ antipsychotics, increased sensitivity to anticholinergics)
• receptor alterations

Question 8

How is absorption in peds changed?

Answer 8

Decreased gastric acidity, decreased gastric/intestinal motility

Question 9

Which type of administration is not recommended in peds?

Answer 9

IM

Question 10

Increased total body water, decreased protein binding, and decreased fat occur in what pt population?

Answer 10

Distribution changes in peds

Question 11

How is metabolism different in neonates?

Answer 11

Phase I rxns working at 50-75% capacity and glucuronidation takes up to 1 yr to develop

Question 12

When do peds reach 50% of adult GFR?

Answer 12

By 1 month of age

Question 13

What is equal to post-menstrual age (PMA) and is the time from conception to birth?

Answer 13

Gestational age (GA)

Question 14

What is the term for the age from birth to present?

Answer 14

Postnatal age (PNA)

Question 15

What is the term for age since conception to present?

Answer 15

Postconceptional age (PCA)

Question 16

What do penicillins, cephalosporins, aminoglycosides, probenecid, aspirin, furosemide and thiazides need to be adjusted for?

Answer 16

GA and weight

Question 17

What are these drugs: ACEI, amphetamines, androgenic hormones, barbiturates, carbamezepine, diethylstilbestrol, ethanol, isotreitinoin, lithium, thalidomide, warfarin?

Answer 17

Recognized teratogens

Question 18

Alcohol use, IDDM, SLE, smoking, and iodide deficiency are all what?

Answer 18

Maternal conditions that are recognized teratogens

Question 19

CMV, Rubella, Varicella, and Syphilis are all what?

Answer 19

Intrauterine infx that are recognized teratogens

Question 20

Sulfonamides, ceftriaxone, and antihistamines are contraindicated in who?

Answer 20

Neonates

• Sulfonamides and ceftriaxone -> kernicterus

Question 21

What can aspirin in < 15 yo cause?

Answer 21

Reye’s syndrome

Question 22

Fluoroquinolones is contraindicated in who?

Answer 22

Children (not sure but causes cartilage erosions in premature animals)

Question 23

Tetracyclines is contraindicated in who?

Answer 23

Kids < 8 yo -> tooth discoloration