Age Related Dosing Flashcards
What population of pts. has decreased sensitivity to beta-adrenergic stimulation and decreased total body H2O?
Geriatric
Increased gastric pH, decreased intestinal blood flow/mobility/surface area, decreased gastric emptying rate are absorption changes in what pt population?
Geriatric
How does change in body composition in elderly affect VD?
- 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
What does decreased hepatic mass/blood flow affect in the elderly?
Phase I metabolism by liver
What does decreased fx cells in kidney, decreased renal blood flow, and decreased GFR affect in the elderly?
Renal elimination
What is the best measurement of renal fx?
12-24 hr creatinine clearance determination
What pharmacodynamic changes occur in the elderly?
- decreased baroreceptor sensitivity
- CNS changes (increased risk of tardive dyskinesia w/ antipsychotics, increased sensitivity to anticholinergics)
- receptor alterations
How is absorption in peds changed?
Decreased gastric acidity, decreased gastric/intestinal motility
Which type of administration is not recommended in peds?
IM
Increased total body water, decreased protein binding, and decreased fat occur in what pt population?
Distribution changes in peds
How is metabolism different in neonates?
Phase I rxns working at 50-75% capacity and glucuronidation takes up to 1 yr to develop
When do peds reach 50% of adult GFR?
By 1 month of age
What is equal to post-menstrual age (PMA) and is the time from conception to birth?
Gestational age (GA)
What is the term for the age from birth to present?
Postnatal age (PNA)
What is the term for age since conception to present?
Postconceptional age (PCA)
What do penicillins, cephalosporins, aminoglycosides, probenecid, aspirin, furosemide and thiazides need to be adjusted for?
GA and weight
What are these drugs: ACEI, amphetamines, androgenic hormones, barbiturates, carbamezepine, diethylstilbestrol, ethanol, isotreitinoin, lithium, thalidomide, warfarin?
Recognized teratogens
Alcohol use, IDDM, SLE, smoking, and iodide deficiency are all what?
Maternal conditions that are recognized teratogens
CMV, Rubella, Varicella, and Syphilis are all what?
Intrauterine infx that are recognized teratogens
Sulfonamides, ceftriaxone, and antihistamines are contraindicated in who?
Neonates
- Sulfonamides and ceftriaxone -> kernicterus
What can aspirin in < 15 yo cause?
Reye’s syndrome
Fluoroquinolones is contraindicated in who?
Children (not sure but causes cartilage erosions in premature animals)
Tetracyclines is contraindicated in who?
Kids < 8 yo -> tooth discoloration
