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Pharmacology > Chapter 3 Life Span Considerations > Flashcards

Chapter 3 Life Span Considerations Flashcards

1
Q

Is there more risk for older adults toward the end of their life or infants at the beginning of life?

A

both populations are always at risk so the importance of accuracy with medication is no different

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2
Q

During which trimester during a pregnancy is the baby at greatest risk for drug-induced developmental defects

A

first trimester

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3
Q

how do drugs and nutrients cross the placenta?

A

primarily by diffusion

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4
Q

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

A

last trimester

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5
Q

during first trimester there is the greatest risk of damage because of what reason?

A

because of rapid cell proliferation

lots of structural things happening with baby so during this time a lot of congenital damage can be done

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6
Q

Maternal factors like the kidney and liver function of the mother and how the mother metabolizes the drugs she ingests, plays a huge role in what happens with the baby in the _____ semester

A

3rd semester

because this is the time that the greatest % of maternally absorbed drugs reach the fetus

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7
Q

if a mother has kidney or liver disease or impairment how would this affect the fetus?

A

that would mean that more drugs/nutrients etc would be remaining in the blood stream so more than needed would reach the fetus

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8
Q

Is it important to identify the mothers that have kidney or liver disease while pregnant?

A

yes

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9
Q

the FDA has implemented pregnancy safety categories

true or false?

A

true

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10
Q

What determines how easily a drug can cross into a mother’s milk or even into the placenta earlier on?

A

it depends on *Fat solubility

                      * Molecular weight
                      * non-ionization
                      * high concentration
                      * organ function of the mother
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11
Q

Are breast fed infants at risk for exposure to drugs consumed by the mother?

A

yes

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12
Q

What ratio do we need to consider during breast-feeding?

A

consider risk to infant vs therapeutic benefit to mother ratio
(benefits vs risk)

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13
Q

Intramuscular absorption in an infant or small child is ______ and _________

A

faster and irregular

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14
Q

In Neonatal and pediatric considerations, what is the most important thing to know about first-pass elimination?
(hint: why would higher-doses of drugs kill the baby?

(HL on PP)

A

It is reduced due to immature liver and reduced enzymes, meaning it is still developing and can’t handle large volumes of drugs so it can’t metabolize them therefore more of the drug will stay in circulation in the baby
(not changed and altered in the liver like it would be for adults)

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15
Q

Is the Gastric pH less or more acidic in a neonatal or pediatric patient (babies)?

A

less acidic

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16
Q

does the Gastric pH of a baby cause the Gastric area to empty more quickly or slowly?

A

slower, the pH is not as acidic as an adult

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17
Q

small person needs a small dosage.

true or false?

A

true

medication amount based on weight and body surface

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18
Q

the younger the person, the _______ percentage of total body water
(HL on PP)

A

greater

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19
Q

Greater total body water= _____ (lower or higher)fat content

HL on PP

A

lower

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20
Q

In Neonatal and peds considerations, there is a decreased level of protein binding due to a decreased production from their ________ _____
(HL on PP)

A

immature liver

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21
Q

In Neo and Peds considerations, what is the reason for more drugs being able to enter their brains?
(HL on PP)

A

immature blood-brain barrier

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22
Q

During distribution in neonatal and ped. patients, less drug are rendered inactive so more free drug availability in circulation due to what?
(HL on PP)

A

immature body systems of little ones

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23
Q

Less fat content on babies means less __________ and _______

HL on PP

A

less absorption and storage

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24
Q

the immature liver of a neonate or ped. patient does not produce enough of which type of enzymes?

A

microsomal enzymes

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25
Q

With neonate and peds., we do not have the high first-pass effect (in liver) where the drugs can become inactivated so there’s a risk with infants/peds for toxicity and liver damage
true or false

A

true

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26
Q

What do we always need to factor in while doing neonate and pediatric dosing?

A

the fact that there isn’t that first pass effect that we’re used to factoring in for adult patients while preparing meds

27
Q

Is there a difference in the metabolism of infants compared to older children?
(hint: think of tylenol and the amount you give a newborn compared to a toddler and so on)
(HL on PP)

A

yes, as they get older there is a gradual increase in metabolism so the medication dosage will slowly increase
(based on age, weight, liver maturity, intestinal maturity)

28
Q

The kidneys in neonate/peds are immature and this affects what pertaining to function of the kidneys?
(hint: GFR, TS)
(HL on PP)

A

immaturity of kidneys affects…

  • Glomerular Filtration rate (lower rate)
  • Tubular secretion
29
Q

The decreased perfusion rate of the kidneys in neonate/peds may reduce _________ of _____

A

excretion of drugs

30
Q

Name the #1 organ for excretion no matter what age you are

A

kidney

31
Q

lower glomerular filtration rate (GFR) means lower what?

HL on PP

A

lower excretion of drugs

32
Q

lower excretion of drugs leads to===========>

HL on PP

A

toxicity

excessive amount in blood stream

33
Q

List some factors affecting pediatric drug dosages

A
  • skin is this and permeable
  • stomach lacks acid to kill bacteria
  • lungs have weaker mucous barriers
  • body temps not as regulated, dehydration occurs easily
  • liver and kidneys immature impairing drug metabolism and excretion
34
Q

What is the most common body weight dosage calculation associated with pediatrics?
(HL on PP)

A

mg/kg

NEVER in lbs

35
Q

What is used in estimating the body surface area of infants and young children?

A

West Nomogram

36
Q

What age is considered the older adult?

A

older than age 65

37
Q

does use of over the counter medications increase or decrease with the elderly (older adult)?

A

increase

38
Q

There is an increase in polypharmacy with older adults (65+). What does that mean?

A

they are taking multiple kinds of medications including Rx from many different physicians, over the counter, and even herbal remedies etc

39
Q

elderly go to many different physicians for many different medications. Why can this be a problem?

A

they aren’t doing medication reconciliation so they have no idea what all the patient is taking and whether or not there will be adverse effects if they’re mixed

40
Q

Babies have immature organ function, while the elderly have a _______ in organ function
(meaning both do not metabolize or excrete like a healthy adult)

A

decline

41
Q

As we age we have an ________ (increase or decrease) in chronic illnesses which means an ________ (increase or decrease) in meds

A

increase illness

increase meds

42
Q 
for older adult (elderly)..
decrease CO (cardiac output) = \_\_\_\_\_\_\_\_ absorption and distribution
A

decrease

43
Q

for older adult..

decreased Blood flow = ________ absorption and distribution

A

decrease

44
Q

for older adult (elderly)…

is their GI (gastrointestinal) pH higher or lower?

A

higher (more alkaline)

45
Q

the higher GI pH of elderly patients affects what step of medications making their way through your system?

A

higher gastrointestinal pH means lower absorption of meds (not broken down as much)

46
Q

define peristalsis

A

involuntary contraction and relaxation of muscles of intestine or other canals.

47
Q

Elderly (older adults) have LOW peristalsis, this causes a delay in what?

A

Gastric emptying

48
Q

What happens to the older adults enzyme production and blood flow?

A

decreases

49
Q

How does the decrease in enzyme production and decreased blood flow affect the metabolism of older adults?

A

decreased metabolism

50
Q

which organ is hepatic pertaining to?

when they say renal, which organ is that pertaining to ?

A
  • the liver

* the kidneys

51
Q

How does low blood flow affect the Renal system of older adults?

A

low excretion

52
Q

How does low GFR in the renal system affect the older adult?

A

low excretion

53
Q

What happens to enzyme production and blood flow in the Hepatic (liver) system of elderly people

A

there is a decrease of enzyme production and decrease in blood flow==========> leads to decrease in metabolism

54
Q

when they say there is an affect on a patients metabolism, which main organ and they most likely referring to?

A

the liver

55
Q

when there is a statement about an increase or decrease in excretion, what main order are they most likely associating this with?

A

kidney

56
Q

can the use of laxatives accelerate the GI motility of older adults?

A

yes

57
Q

What happens to the GI tract of older adults?

A

pretty much everything pertaining to it decreases/slows, absorbs less, takes longer, blood flow reduced

58
Q

In the older adult, do they have lower or higher body water percentages?

A

lower

59
Q

In the older adult, do they have higher or lower fat content?

A

higher

increased fat

60
Q

Older adults have a decreased production of proteins by the liver, which also means they have a decreased amount of protein binding. How does this affect how drugs are metabolized and excreted?

A

it means there is an increased amount of free drugs circulating===========> toxicity

61
Q

The aging liver of the older adult produces fewer microsomal enzymes. What does this affect?
(hint: what is the liver responsible for)
(HL on PP)

A

drug metabolism

62
Q

What do microsomal enzymes do?

A

metabolize drugs in the liver

63
Q

When youre an older adult, you have reduced blood flow to the liver due to a decrease in _______ ______

A

(CO) Cardiac Output

64
Q

Give the two main reasons why the older adult has issues with excretion

A

decrease in GFR (glomerular filtration rate)

decrease number of intact nephrons

Pharmacology (7 decks)

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