Drug Tx Flashcards
26 wks - 1 month after birth
Perinatal
5-52 wks after birth
Infant
> 1 yr old
Child
Gastric pH _________ during first 24 hrs after birth.
Decreases
Gastric emptying delayed during first __________ days after birth
2
GFR __________ by 50% during first week after birth
Increases
GFR attains adult levels between _________ months
6-12
Metabolism in neonate is dependent on drug treatment/environmental exposure of
Mother
0-4 wks
Neonate
Phenytoin and Indomethacin will displace
Bilirubin
30% decrease in GFR. 60% reduction in urine flow rate. Variable effects on electrolytes (may cause hyponatremia)
Indomethacin
Most common diuretic given to neonates
Furosemide
Immature kidney has decreased
Perfusion (receives 5% of CO at birth)
Neonates display a delayed response to
Furosemide
Dosages calculated from _________ are more accurate
Surface area
Dosages by body weight can
Under estimate dose
Noxious or unwanted response that occurs at a dose that’s usually therapeutic
Adverse drug rx
Unexpected response of the immune system
Hypersensitivity reaction
CO declines 1%/yr after the age of
30
GFR declines 0.5%/yr after age of
20
Tubular secretion decreases
0.5%-1%/yr
Less absorption of ferrous sulfate and ketoconazole in elderly b/c of
Increased stomach pH
Use of ________ lowers absorption of cimetidine, digitalis, tetracycline, and phenytoin
Antacids
Diazepam, flurazepam, and amiodarone
Lipid soluble drugs
Ethanol, procainamide, and atendol
Water soluble drugs
______ binds to muscle Na-K ATPase
Digoxin
_________ can be decreased by renal disease, uremia, acidic states, and low protein diet
Protein binding
Acetyl Salicylic acid can displace binding of
Warfarin
Barbiturates, diazepam, flurazepam, nortriptyline, propanolol, theophylline, chlordiazepoxide have age related
Decrease in hepatic clearance
Ethanol, lorazepam, nitrazepam, oxazepam, warfarin, and Salicylates all are
Worked on by phase 2 rxs and do no have age related decreased in hepatic clearance
Increased receptor response in elderly to
Opiates and benzodiazepines
Greater sedation in elderly with
Morphine or diazepam
Greater incidence of complications with ________ in elderly
Diuretics
_____ can cause potassium and magnesium depletion
Thiazides
_____ can cause potassium depletion
Furosemide
______ have increased responsiveness to phenothiazines
Elderly
Chlorpromazine can worsen _____ in elderly
Orthostatic hypotension
_____ requires renal excretion and dose must be adjusted in elderly
Lithium
Black box warning for using typical and atypical ____________ in elderly
Dopamine antagonists
