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Pharmacology > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

During which trimester are the greatest percentage of maternally absorbed drugs get to the fetus?

A

The last trimester

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2
Q

Which three factors contribute to the safety or potential harm of drug therapy during pregnancy?

A
  1. drug properties
  2. fetal gestational age
  3. maternal factors
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3
Q

What are drug characteristics that increase the likelihood of drug transfer via breastfeeding?

A
  1. fat solubility
  2. low molecular weight
  3. high concentration
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4
Q

Are maternal drug levels higher in breastmilk or maternal circulation?

A

maternal circulation

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5
Q

neonate

A

birth to 1 month

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6
Q

infant

A

1 month to 12 months

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7
Q

child

A

1 and 12 years of age

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8
Q

LIfespan considerations for the pediatric patient

A
  1. absorption
  2. distribution
  3. metabolism
  4. excretion
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9
Q

Category A

A

Studies indicate no risk to the human fetus

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10
Q

Category B

A

Studies indicate no risk to the animal fetus; information for humans is not availible

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11
Q

Category C

A

Adverse effects reported in the animal fetus; information for humans is not availible

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12
Q

Category D

A

Possible fetal risk in humans has been reported; however, in selected cases consideration of the potential benefit versus risk may warrant use of these drugs in pregnant women

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13
Q

Category X

A

Fetal abnormalities have been reported, and positive evidence of fetal risk in humans is available from animal and/or human studies. These drugs are not be used in pregnant women.

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14
Q

Neonatal and pediatric considerations for absorption

A
  • gastric pH less acidic
  • gastric emptying slowed
  • intramuscular absorption faster and irregular
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15
Q

Neonatal and pediatric considerations for distribution

A
  • greater total body water means lower fat content
  • decreased level of protein binding
  • immature blood-brain barrier- more drugs enter the brain
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16
Q

Neonatal and pediatric considerations for metabolism

A
  • liver immature, does not produce enough microsomal enzymes

- older children may have increased metabolism, requiring higher doses than infants

17
Q

Neonatal and pediatric considerations for excretion

A
  • kidney immaturity affects glomerular filtration rate and tubular secretion
  • decreased perfusion rate of the kidney may reduce excretion of drugs
18
Q

When are teratogens most deadly to fetuses?

A

First trimester

19
Q

Factors affecting pediatric drug dosages

A
  • Skin is thin and permeable
  • Stomach lacks acid to kill bacteria
  • Lungs have weaker mucus barriers
  • Body temperatures less well regulated, and dehydration occurs easily
  • Liver and kidneys are immature, impairing drug metabolism and excretion
  • Body surface area method
  • -Uses the West nomogram
  • Always use weight in kilograms, not pounds
  • Body weight dosage calculations
  • -uses mg/kg
20
Q

Methods of dosage calculation for pediatric patients

A
  • body surface are method
  • always use weight in kilograms, not pounds
  • always use centimeters, not inches
  • body weight dosage calculations
  • -uses mg/kg
21
Q

Considerations for older adult patients

A
  • high use of medications
  • polypharmacy
  • noncompliance, nonadhherence
  • increased incidence of chronic illnesses
  • sensory and motor deficits
22
Q

Older adult considerations for pharmokinetics

A
  • more sensitive to drugs than younger adults and with greater variation in pharamacokinetics
  • multiple and severe illnesses
  • multipple-drug therapy
  • poor adherance
23
Q

Cardiovascular changes in older adults

A
  • decreased cardiac output = decreased absorption and distribution
  • decreased blood flow = decreased absorption and distribution
24
Q

Gastrointestinal changes in older adults

A
  • increase pH = altered absorption

- decreased peristalasis = delayed gastric emptying

25
Q

Heptic changes in older adults

A
  • decrease in enzyme production = decreased metabolism

- decreased blood flow = excretion

26
Q

renal changes in older adults

A
  • decreased blood flow = decreased excretion
  • decreased function = decreased excretion
  • decreased glomerular filtration rate = decreased excretion
27
Q

elderly distribution pharmacokinetics

A
  • lower total water percentages
  • increased fat content
  • decreased production of proteins by the liver, resulting in decreased protein binding of drugs
28
Q

elderly metabolism pharmacokinetics

A

-aging liver produces fewer microsomal enzymes, affecting drug metabolism

29
Q

elderly reduced blood flow to the liver/excretion pharmacokinetics

A
  • decreased glomerular filtration rate

- decreased number of intact nephrons

30
Q

Rules for the elderly!

A

-start with low dosages and go slow with increasing dosages

Pharmacology (19 decks)

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