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HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Drug Therapy Across the Life Span - Ch. 11, 12 & 13 > Flashcards

Drug Therapy Across the Life Span - Ch. 11, 12 & 13 Flashcards

1
Q

What are the different lifespans that should be taken into consideration regarding drug therapy?

A

Pregnancy
Breast-feeding
Pediatric
Geriatric (65yrs old and older)

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2
Q

What are drugs that are dangerous to fetal development/pregnancy?

A

Teratogen

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3
Q

Teratogen

A

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

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4
Q

What period of pregnancy is at greatest danger for drug-induced developmental defects?

A

First Trimester

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5
Q

What developmental defects can occur during the first trimester?

A

Congenital gross malformations because of enormous cell multiplication and differentiation

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6
Q

What developmental defects occur during the second and third trimesters?

A

Disruption of function not gross anatomy
e.g, brain development

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7
Q

What are breastfed infants at risk for exposure to?

A

Drugs consumed by mother

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8
Q

Is breast milk a usual excretion route?

A

NO

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9
Q

What are some contraindicated drugs to use while breastfeeding?

A

Cancer chemotherapy
Immunosuppressants

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10
Q

What should be limited during breastfeeding?

A

Alcohol, smoking (nicotine) and caffeine

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11
Q

What are the pediatric consideration subgroups?

A

Premature infants
Full term infants
Neonates
Infants
Children
Adolescents/Young adults

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12
Q

premature infants

A

Less than 37 weeks gestational age

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13
Q

Full term infants

A

37-40 weeks gestational age

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14
Q

Neonates

A

First 4 postnatal weeks

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15
Q

Infants

A

Weeks 5 to 52 postnatal

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16
Q

Children

A

1 to 12 years old

17
Q

Adolescents/Young Adult

A

12 to 18 years old

18
Q

What should be taken into consideration during absorption in pediatrics?

A

Gastric environment is less acidic
Gastric emptying is slowed - slow peristalsis
First pass effect is reduced (neonates) - immature liver
Topical absorption is faster through the skin
Intramuscular absorption is faster and irregular

19
Q

What should be taken into consideration during distribution in pediatrics?

A

Total body water changes in different age groups
Protein binding decreased bc decreased protein made in immature liver
Immature blood-brain barrier allows more drugs to cross into their brain

20
Q

What is the total body water (TBW) in full-term infants?

A

70%-80%

21
Q

What is the total body water in premature newborns?

A

85%

22
Q

What is the total body water in children 1-12 years of age?

A

64%

23
Q

Greater TBW means?

A

Fat content is lower

24
Q

What should be taken into consideration during metabolism in pediatrics (Newborns, neonates, infants)?

A

The immature liver does not produce enough microsomal enzymes (CYPs) so the metabolism is reduced

25
Q

What should be taken into consideration during metabolism in pediatrics (Older children)?

A

May have increased drug metabolism requiring higher doses

26
Q

What should be taken into consideration during excretion in pediatrics?

A

Kidney immaturity (up to ~1 year) affects perfusion, glomerular filtration rate and tubular secretion = reduced excretion of drugs

27
Q

What are other pediatric considerations?

A

Skin is thin/permeable
The stomach lacks acid to kill bacteria
Lungs lack mucus barriers
Body temps poorly regulated and dehydration occurs easily
Liver and kidneys are immature, impairing metabolism and excretion

28
Q

What should be taken into consideration for geriatric patients?

A

Use of medication is common
20-40% of all perscription drugs, >40% of OTC drugs

Polypharmacy

29
Q

What should you take into consideration with geriatric people who have a polypharmacy?

A

Chronic illness and conditions
Increase risk of drug interactions, adverse effects
Some drugs given to treat adverse effect due to drug interactions

30
Q

Which population is more sensitive to drugs?

A

Geriatric (compared to young adults)

31
Q

Why are geriatric populations more sensitive to drugs?

A

Pharmacokinetic changes
Complex health conditions
Polypharmacy
Drug regime adherence

32
Q

What cardiovascular changes occur in Geriatric populations?

A

Decreased CO, Decreased blood flow to organs

33
Q

How is drug pharmacokinetics altered due to cardiovascular changes in Geriatric populations?

A

Decreased absorption
Decreased distribution

34
Q

What gastrointestinal changes occur in Geriatric populations?

A

Increased pH
Decreased peristalsis - delayed gastric emptying, slower lower GI tract

35
Q

How is drug pharmacokinetics altered due to gastrointestinal changes in Geriatric populations?

A

Altered absorption

36
Q

How is drug pharmacokinetics altered due to liver changes in Geriatric populations?

A

Decreased cytochrome P-450, decreases metabolism

37
Q

How is drug pharmacokinetics altered due to kidney changes in Geriatric populations?

A

Reduced function causes a decrease excretion of water soluble drugs and metabolites

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (15 decks)

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