Chapter 8, 9 and 10 Pharmacology across the lifespan Flashcards
what two factors cause a change in absorption during pregnancy***
Increased levels of progesterone and estrogen
how do increased levels of progesterone in pregnant women effect absorption**
higher progesterone increases pulmonary blood flow which creates a higher absorption of respiratory agents
how does increased levels of estrogen effect absorption of medication**
Increased levels of estrogen causes delayed gastric emptying and increased stomach acid which can either increase or decrease absorption time of oral medication
How is distribution of medication affected by pregnancy**
total body water increases which causes fewer plasma proteins to be available to bind to “free drug” in the plasma
how is excretion affected during pregnancy***
is enhanced during pregnancy so dosage of medication needs to be altered
what substances can freely pass from mother to fetus across the placental membrane
Vitamins
Fatty Acids
Glucose
Electrolytes
How is metabolizam altered during pregnancy***
Metabolizam is significantly altered during pregnancy however there isn’t much known about how specifically
what kind of drugs can be taken without a prescription during pregnancy
There are NO types of drugs that should be taken without a prescription during pregnancy
what is a category A drug for pregnant women
Drug that is safe during pregnancy
What is a category B drug for pregnant women
A drug that is also considered safe
what is a category C drug for pregnant women
drugs that have insufficient data to determine safety or cause of birth defects and should be avoided
What are category D and X drugs for pregnant people
Drugs that are avoided due to the potential for serious birth defects
the amount of drug that is passed from breast milk to infant depends on multiple factors
Plasma drug level
Solubility of the drug
Molecular size and protein binding
Drug ionization
Drug half life
what kind of drugs should women take while they are brest feeding
All drugs should be avoided unless approved by a health care provider
what effect does topical medication have on breastfeeding infants
usually topical medication applied to the skin has no effect on breastfeeding infants
What are physiological factors that are different in pediatric patients that effects Absorption
Increased gastric Ph
Delayed gastric emptying
Slowed gastric motility
Low blood flow to skeletal muscles (making IM administration slow and erratic)
Skin of infants is thin and highly permeable
What are physiological factors that are different in pediatric patients that effects distribution
Proportion of water to fat (babies have very high water content may need to have a higher dose to maintain adequate serum levels)
Underdeveloped Blood brain barrier (drugs can more easily get in and cause toxicity)
Immature liver function (Free drug has no proteins to bind to)
What are physiological factors that are different in pediatric patients that effects metabolism
Immature liver reduces how quickly the body can metabolize drugs
at what age do metabolic rates reach adult levels
3-5 years old
What are physiological factors that are different in pediatric patients that effects excretion
Pediatric patients have underdeveloped kidneys so any drug excreted by this route will stay in the body longer
how are medication dosages measured for pediatric patients***
mg/Kg/per day and NOT age
What age is neonatal period of development
First 28 days of life
what medications are extremely common in poisonings for toddlers***
Analgesics
Cough syrup
Topical ointments
Vitamins
What are physiological factors that are different in geriatric patients patients that affects Absorption
less motility of GI system so drugs remain in the GI tract for longer and have more time to produce adverse effects
less blood flow to GI system so drugs are absorbed slower
What are physiological factors that are different in geriatric patients patients that affects Distribution
Older people have more body fat (which causes lipid soluble drugs to be stored in the body for longer)
Older people have less body fluid (so drugs are less diluted therefore water soluble drugs have higher serum concentrations and can produce more adverse effects)
What are physiological factors that are different in geriatric patients patients that affects Metabolism
Liver function declines (Higher concentrations of “free drug”)
Increased permeability of blood brain barrier
What are physiological factors that are different in geriatric patients patients that affects elimination
Renal function declines significantly
what are three drugs that older people have an increased response to
Anticholinergics
CNS depressants
Warfarin
What are two drugs that old people have a decreased response to
Beta receptor antagonists
beta receptor agonists
