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HLSC 222- midterm 1 > Drug Therapy Across the Life Span > Flashcards

Drug Therapy Across the Life Span Flashcards

1
Q

how much pregnant patients take at least one medication?

A

2/3s

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2
Q

Kidney changes in pregnancy

how does it affect drugs

A

third trimester renal blood flow is doubles

  • accelerated clearance of blood
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3
Q

Liver changes in preg.

A

hepatic metabolism of drugs increase

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4
Q

GI tract

A

tone and motility decrease

increases transit time= more time for drugs to be absorbed

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5
Q

Adverse reactions during pregnancy

Heparin (anticoagulant)

A

osteoporosis

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6
Q

Adverse reactions during pregnancy

Warfarin (anticoagulant)

A

fetal hemorrhage

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7
Q

Adverse reactions during pregnancy

Aspirin (antiplatelet)

A

increases risk of serious bleeding during childbirth

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8
Q

Adverse reactions during pregnancy

Misoprostol

A

spont. abortion

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9
Q

Adverse reactions during pregnancy

heroin, alcohol, etc.

A

drug dependent infant

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10
Q

Adverse reactions during pregnancy

Opioid pain relievers during delivery

A

depress neonate respiration

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11
Q

Teratogenesis

A

birth defects.
- physical AND neurobehavioral, and metabolic abnormalities

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12
Q

What are the 3 major period in fetal development?

A

1) preimplantation: conception to week 2

2) embryonic period: 3-8 weeks

3) fetal period: week 8 through term

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13
Q

Teratogens exposure on

1) preimplantation period

2) embryonic period

3) fetal period

A

1) all or nothing –> high dose results in death

2) gross malformations

3) function rather than gross anatomy
- growth and development of the brain

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14
Q

proven teratogens

A

thalidomide: fast acting teratogen (single dose can cause malformation)

alcohol: repeated high doses for gross malformation

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15
Q

FDA categories for a drugs probable risk to fetus

A

Category A: least dangerous- studied on pregnant patients

B, C, D:
progressively more dangerous

Category X
- MOST dangerous
- fetal risk far OUTWEIGHS therapeutic benefit

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16
Q

factors that determine entry into breast milk?

A
  • lipid soluble drugs
  • highly polar, ionized drugs or protein bound do not
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17
Q

what should nursing mothers do if they cannot avoid drug in pregnancy?

A
  • dose after feeding
  • avoid drugs with long half life
  • avoid sustained-release drugs
  • use lowest effect dosage
18
Q

what primarily causes drug sensitivity in young pt?

A

organ system immaturity
- increased risk of ADR

19
Q

pediatric patients

A

up to 16 yoa

20
Q

premature infants

A

less than 36 weeks (9 months)

21
Q

full term infants

A

36-40 weeks (9-10 months)

22
Q

neonates

A

first 4 postnatal weeks (1st month)

23
Q

Infants

A

5-52 weeks (1-12 months)

24
Q

Children

A

1-12 years

25
Q

Adolescence

A

12-16

26
Q

how do drugs affect neonates

A

Elevated drug levels = more intense response

Drug elimination delayed = response prolonged

27
Q

iv injections in infants compared to adults

A

remains above minimum effective concentration for much longer

28
Q

subcutaneous injection in infants vs adults

A

both maximal level and duration are greater

29
Q

absorption in neonates and infants

A

gastric emptying is prolonged and irregular
-stomach: enhanced due to delayed gastric emptying
- intestinal absorption: delayed

IM
- first days postnatal: slow erratic due to low BF through muscles
- infancy: more rapid than adults and neonates

Transdermal Admin
- infants: more rapid and complete
–> stratum corneum thin and blood flow to skin is greater

30
Q

Distribution in Neonates and Infants

A

Protein binding: limited (decreased albumin)
- less binding = greater free levels of drug

BBB: not fully developed = easy access to CNS

31
Q

Metabolism in neonates/ infants

A

metabolized in liver

drug metabolizing capacity of newborns is low = neonates extra sensitive

32
Q

Excretion neonates/ infants

A

most excreted by Kidney

renal drug excretion REDUCED

33
Q

metabolizim in children vs adults

A

metabolize faster

BBB not fully developed = easy access to CNS

34
Q

Adverse Drug Rxn in children

A

organ system immaturity

35
Q

Dosage Determination in children

A

Body surface Area BSA

36
Q

What percent of older adults of all perscription drugs and
OTC

A

20-40%

> 40%

37
Q

major issues with older adults

A

1) altered pharmacokinetics
2) multiple and severe illnesses
3) Multidrug therapy
4) poor adherence to

38
Q

absorption in seniors

A

rate of absorption is slower- delayed gastric emptying
- drug response delayed

39
Q

Distribution factors for seniors

A

1) increased body fat
2) decreased lean body mass
3) decreased total body water
4) reduced serum albumin

40
Q

Metabolism in seniors

A

hepatic drug metabolism declines
- DRUG ACCUMULATION
-**ADR in seniors

41
Q

ADRs in seniors factors

A

1) drug accumulation secondary to reduce renal function

2) polypharmacy

3) greater sensitivity to illness

4) comorbidities

HLSC 222- midterm 1 (10 decks)

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