Chapter 3- Drug Action Across The Life Span Flashcards
0
Q
Define genetics
A
The study of how living organisms inherit the characteristics or traits of their ancestors
1
Q
True or False
A person’s genetic composition serves as the basic foundation for all drug responses and their duration of action in the body through out the person’s lifetime
A
True
2
Q
What are important inheritances from genetics?
A
Metabolic pathways and susceptibility to illness
3
Q
Define genome
A
The complete package of genetic coding of an organism
4
Q
How many chromosomes are donated by the biologic mother and father?
A
23 each
5
Q
A large molecule named Deoxyribonucleic or DNA carries?
A
Genetic information
6
Q
Genes are
A
Instructions that are contained in segments of DNA
7
Q
Define polymorphism
A
Naturally occurring variations in the structures of genes and the instructions that they give the organism
8
Q
The study of how drug response may vary according to Inherited differences is known as
A
Pharmacogenetics
9
Q
What factors affect ADME?
A
Age, gender, organ function, drug therapy, and drug interactions
10
Q
Less than 38 weeks of gestation
A
Premature
11
Q
0 to 1 month
A
Newborn or neonate
12
Q
One to 24 months
A
Infant or toddler
13
Q
3 to 5 years
A
Young Child
14
Q
6 to 12 years
A
Older child
15
Q
13 to 18 years
A
Adolescents
16
Q
19 to 54 years
A
Adult
17
Q
55 to 64 years
A
Older adult
18
Q
65 to 74 years
A
Elderly
19
Q
75 to 84 years
A
The aged
20
Q
85 years or older
A
The very old
21
Q
True or False
Man and woman do not respond to medications differently
A
False
22
Q
Gender specific medicine is
A
Science that studies differences in the normal function of man and woman and how people of each gender perceive and experienced disease
23
Q
How can the absorption of medicines given by IM may be affected?
A
Differences in muscle mass, blood flow to muscles, and muscle activity in patients who are bedridden
24
Why are topical administration usually more effective in infants
The outer layer of skin is not fully developed so this skin is more hydrated and water-soluble drugs are absorbed more readily
25
Why do babies get diaper rash?
Plastic acts as an occlusive dressing that increase hydration of the skin. Water soluble drugs are absorbed more readily in hydrated skin
26
True or False
| Inflammation increases the amount of drug absorbed
True
27
True or False?
Time release tablets, enteric-coated tablet, and sublingual tablets should not be crushed because it will increase absorption and potential for toxicity
True
28
Chewable tablets should not be given to everyone even children who
Have loose teeth
29
What factors influenced GI absorption?
Gastric pH, gastric emptying time, motility of the G.I. tract, enzymatic activity, blood flow of the mucous lining of the stomach and intestines, permeability and maturation of mucosal membranes and concurrent disease process
30
What is the pH for a premature infant?
A pH of 6 to 8
31
What is the pH of Full stomach
Five
32
True or False
| A woman's stomach empty more slowly than a man
True
33
What is the total body water content of a preterm infant?
83%
34
What is the total body water content Of an adult man?
60%
35
What is the total body water content of an older adult person?
50%
36
Complete the sentence
| As we age, lean body mass and total body water..
Decrease
37
Complete this sentence
| As we age, total fat content...
Increases
38
What are some drugs that are highly fat soluble?
Antidepressants, phenothiazines, benzodiazepines, and calcium channel blockers
39
Complete the sentence
| Drugs that are highly fat-soluble....
Require a longer onset of action and accumulate in tissue, prolonging their action and increasing the potential for toxicity
40
Give two examples of water-soluble drugs
Ethanol and aminoglycoside antibiotics
41
Why must highly fat-soluble medicines be given in smaller dosage to low birth weight infants?
Because there is less fat tissue to bind the drug, leaving more drug to be active at receptor sites
42
What disease states can lower albumin levels?
Reno failure, malnutrition, and cirrhosis
43
Define drug metabolism
The process whereby the body and activates medicine
44
What are the major pathways to drug metabolism
Enzyme systems that is found primarily in the liver
45
How does age affect the liver?
Liver weight, the number of functioning hepatic cells and hepatic bloodflow decreases with age
46
True or False
| There are specific laboratory tests that are available for measuring liver function
False
47
Erythromycin, prednisolone, verapamil, and diazepam metabolize faster in
Women
48
What are the primary routes of drug excretion?
The renal tubes into the urine and the G.I. tract into the feces
49
Define drug excretion
When the metabolites of drug and sometimes the active drug itself are eventually excreted from the body
50
List other minor routes of excretion
Evaporation through the skin, exhalation from the lungs, and secretion into the saliva and breastmilk
51
What happens to the kidneys as the body ages?
Decreased renal bloodflow caused by arteriosclerosis and reduced cardiac output, a loss of glomeruli, and decreased tubular function and concentrating ability
52
Define therapeutic drug monitoring
The measurement of a drugs concentration and biological fluids to correlate the dosage administered and the level of medicine in the body with the pharmacologic response
53
Which assay is commonly used for drug concentration?
Blood serum samples
54
Why is therapeutic drug monitoring and essential in neonates, infants and children?
To ensure that the drugs are within an appropriate therapeutic range
55
What must be adjusted to ensure therapeutic serum concentration
Dosage and frequency of administration
56
List all the conditions that therapeutic drug monitoring is routine
Epilepsy, dysrhythmias, heart failure, and antimicrobal therapy
To prevent toxicities and ensure that dosages are adequate to provide appropriate therapeutic levels
57
When would blood levels of drugs be measured?
If toxicity is suspected
58
How does one test the blood level of a drug for therapeutic monitoring?
One sample is drawn immediately before the next dose is to be administered to obtain the trough. Another is drawn 20 minutes after the medicine has been administered via IV or 60 minutes after the medicine have been administered orally to obtain the peak
59
List examples of parameters
Expected therapeutic actions, expected side effects, reportable adverse effects, probable drug interactions, laboratory results, vital signs
60
What is the nurse expected to do when a peak and trough for an medication has been ordered
The nurse must check the laboratory results in a timely manner and make sure that the prescriber is notified of the laboratory results
61
Children are susceptible to dehydration from
Fever vomiting and diarrhea
62
Why is it difficult to assess the therapeutic response to medicines administered to neonates, infants and young children?
These patients are often nonverbal or cannot tell us where it hurts
63
Define polypharmacy
Multi drug therapy
64
Explain trough and peak
Trough is before the next dose peak is after the med is given
65
List the six rights
1) Right dose
2) Right drug
3) Right person
4) Right documentation
5) Right time
6) Right route
66
Two medications that have a narrow therapeutic window
Digoxin and gentamycin
67
What are the parameters for warfarin
Must know PT and INR
68
What is the INR for warfarin
2 to 3
69
What is the parameter for Heparin?
PTT
70
What is the PTT for heparin?
1 1/2 to 2 1/2 times control
71
Examples of renal function tests
BUN, Creatinine, and GFR
72
What are the parameters for Lovenox
Platelets. Hold if less than 100,000
73
If gastric emptying time increases what happens to the speed of absorption of a drug
The faster the empty time the less time the drug has to be absorbed therefore drug absorption is decreased
74
List accurate methods of measuring oral liquid medication
Medicine cups, droppers provided with a specific medication, or oral syringes to measure liquid forms of oral medications accurately
75
Fill in the blank
| The younger the individual the ____ the percentage of the total body water
Higher
76
Fill in the blank
| Off label use of medication is____?
Legal
77
Fill in the blank
| Lipid soluble drugs have an affinity for fat tissue in the body and will often have a ___ half-life
Longer
78
What is the safest method of initiating newly prescribed medications to a geriatric patient?
Drug dose should be initiated at 1/3 to 1/2 the normal adult dose. Therapeutic drug monitoring should be completed
