Drug Therapy Across The Life Span (11,12,13)

Question 1

Teratogen

Answer 1

Drugs and other agents that can disrupt development of the fetus or halt pregnancy

Question 2

Are all drugs teratogenic

Answer 2

No

Question 3

Teratogens impact during first trimester

Answer 3

Greatest danger for drug induced developmental defects
-congenital gross malformations due to enormous cell multiplication and differentiation

Question 4

Teratogens during second/third trimester

Answer 4

Disruption of function
-not necessarily gross anatomy (brain development, brain bleeding)
-may only be seen post birth

Question 5

Breastfeeding and medications

Answer 5

Breastfed infants are at risk for exposure to drugs consumed by the mother
-milk is not a usual excretion route (not a great amount passing through)

Consider risk-to- benefit raito

Question 6

Mother is taking short half life

Answer 6

Won’t last as long in her body, drug is getting rid of quickly

Question 7

Oral bioavailability of breast milk

Answer 7

How well will it absorb in an infants digestive tract

Question 8

Drugs that should be limited during breast feeding

Answer 8

-cancer chemotherapy (kill cells
-immunosuppressants

Question 9

Social aspects of drugs

Answer 9

Alcohol, smoking (nicotine), caffeine
-hard to control caffeine levels
-limit

Question 10

Paediatric absorption

Answer 10

-less acidic
-emptying is slowed = slow peristalsis
-reduced first pass effect due to immature liver
-topical absorption is faster via skin
-intramuscular absorption faster and irregular

Question 11

Paediatric considerations of distribution

Answer 11

-total body water means fat content is lower
-protein binding is decreased due to decreased protein made in an immature liver
-immature BBB allows more drugs to cross into their brain

Question 12

TBW in full term infants

Answer 12

70 to 80 percent

Question 13

TBW in premature newborns

Answer 13

85

Question 14

TBW in children 1 to 12

Answer 14

64

Question 15

Paediatric considerations of metabolism

Answer 15

Immature liver does not produce enough microsomes enzymes (CYP) so drug metabolism is reduced
-mostly newborns

Question 16

Older children and metabolism

Answer 16

May have increased drug metabolism, requiring a higher dose

Question 17

Paediatric considerations of excretion

Answer 17

Kidney immaturity (up to 1 year)
-affecting perfusion, GFR, tubular secretion
-a decreased excretion of drugs

Question 18

Lungs in paediatrics

Answer 18

Lack mucus barriers

Question 19

Body temperatures of paediatrics

Answer 19

Poorly regulated and dehydration occurs easily

Question 20

Geriatric

Answer 20

Older than 65

Question 21

Use of medications in geriatrics

Answer 21

Is very common
-20 to 40 percent of all prescription drugs
-less then 40 percent of over the counter drugs

Question 22

Poly pharmacy and geriatrics

Answer 22

Concurrent multiple medications
-increases risk of drug interactions, adverse effects

-on top of it some more drugs are given to treat adverse effects of drug reactions

Question 23

Geriatric considerations—> sensitivity

Answer 23

-poly pharmacy
-drug regime adherence
-complex health conditions

Question 24

Cardiovascular in geriatrics
Dec in CO and BF to organs causes

Answer 24

A decrease in absorption and distribution

Question 25

Gastrointestinal changes in geriatrics

Answer 25

-Increase of pH altering absorption,

-decrease in peristalsis delaying gastric emptying (slower GI tract, less surface area)

Question 26

Liver changes in geriatric populations

Answer 26

Decrease in cytochrome P-450, and metabolism

Question 27

Kidney changes in geriatrics

Answer 27

Reduced function
-Dec in excretion of water soluble drugs and metabolites

Question 28

Kidney changes in geriatrics

Answer 28

Reduced function
-Dec in excretion of water soluble drugs and metabolites