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316 Pharmacology > Exam 1: Lifespan considerations > Flashcards

Exam 1: Lifespan considerations Flashcards

1
Q

2 populations that are more sensitive to drugs than other patients

A

Patients who are very young or very old respond differently to drugs than the rest go the population

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2
Q

What causes drug sensitivity in the very young?

A

Organ stsem immaturity

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3
Q

What causes drug sensitivity in elderly?

A

Organ system degeneration

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4
Q

Geratrics makes up what % of the US population

A

20%

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5
Q

Elderly individuals consume % prescribed & OTC

A

30 % prescribed

more than 40% OTC

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6
Q

Issues with geriatric medication

A
  • Increasing severity of illnesses
  • multiple chronic illnesses
  • Excessive prescribing
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7
Q

Adverse drug effects are ___ more common in elderly patients than younger adults

A

7X more common to experience adverse drug reactions

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8
Q

Geratrics have a greater use of

A

Drugs with a low therapeutic index

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9
Q

Polypharmacy

A

> 5 prescribed medications

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10
Q

____% of elderly patents do not takes drugs as prescribed

A

40%

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11
Q

How to promote adherence

A

Simplify
Clear and concise instructions
Right dosage
Label largely

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12
Q

Geriatric patients have an altered

A

Absorption, distribution, metabolism and excretion of drugs

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13
Q

Geriatric patients experience gradual decline in organ function, especially the

A

Renal and hepatic function

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14
Q

Decline in organ functions has what effect on body?

A

Increased sensitivity to drugs and wide individual variations in reposer to drug

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15
Q

What happens to the rate of absorption for geriatric patients

A

rate of absorption is often slowed

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16
Q

Factors that result in delayed drug response

A
  • Delayed gastric emptying time
  • decrease GI motility
  • decrease gastric acidity
  • decrease absorptive surface area
  • decrease splanchnic blood flow
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17
Q

changes in distribution for Geratrics patients

A 
Increase % body fat
Decrease % of lean body mass
D total body water 
D serum albumin 
D Cardiac output
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18
Q

An increase in fat for elderly patients provides what

A

storage for lipid soluble drugs which causes a decrease plasma levels of some drugs

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19
Q

the longer the drug remains in the body, concerns for

A

toxicity

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20
Q

Decrease amount of total body water causes

A

Increase concentration of water soluble drugs, which intensifies effects of some drugs

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21
Q

Decrease in serum albumin causes

A

decrease protein binding and possible competition among drugs for binding sites, which increase free drugs and intensifies effects of drugs

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22
Q

Changes in metabolism for Geratrics patients

A

Decrease..

  • Hepatic blood flow
  • hepatic mass
  • activity of hepatic enzymes
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23
Q

Physiological changes of metabolism result in

A

Decrease in first pass metabolism

Prolonged bioavailability of some drugs

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24
Q

Changes in excretion Geratrics patients

A

Decrease

  • renal blood flow
  • GFR
  • tubular secretion
  • number of nephrons
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25
Q

Physiological changes in excretion result in

A

Decrease excretion of drugs, which increase accumulation and leads to potential for adverse reactions

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26
Q

How many pregnant women take medication

A

2/3 of pregnant women take at least one medication

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27
Q

Common pregnancy related conditions include

A

Nausea
Constipation
Gestational diabete
pre-eclampsia

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28
Q

Pregnancy disorder

A

Hypertension
diabetes
epilepsy and infectious disease

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29
Q

Pregnant women frequently take drugs of abuse such as

A

alcohol, cocaine, methamphetamine, and heroin

30
Q

Benefits of treatment for pregnant women must

A

balance/outweigh the risks

31
Q

does risk apply to the fetus as well?

A

Yes, fetus and mother

32
Q

The health of the fetus depends

A

on the health of the mother

33
Q

Pregnancy and asthma

A

Asthma is more dangerous to pregnant women than the medication, women who fail to take medication are 2x more likely to stillbirth

34
Q

By the third trimester, what happens to renal blood flow for women?

A

blood flow increases by 50% -> increase GFC ->accelerated clearance of drugs -> dosage must increase

35
Q

Plasma proteins in pregnant women are diluted because of

A

Increase plasma volume

36
Q

Tone and motility of bowel decrease in pregnancy, causing

A

intestinal transit time to increase, which causes a possible delayed drug response

37
Q

almost all drugs can

A

cross the placenta

38
Q

The assumption about drugs in pregnant women

A

any drug taken during pregnancy will reach the fetus

39
Q

Factors that determine drug passage across the membranes of the placenta are

A

the same factors the determine drug passage across all other membranes

40
Q

teratogenesis

A

Formation of physical abnormalities

41
Q

mutagenesis

A

induction of genetic changes

42
Q

Drug dependent mother =

A

drug dependency baby

43
Q

What is secondary to opiates for pain relief during pregnancy

A

neonatal respiratory depression

44
Q

What happens during the embryonic period

A

Basic shape of internal organs and other structures is being establish

45
Q

Exposure to teratogens during the embryonic period will result in

A

Gross malformations

46
Q

What is important during the fetal period

A

Development of the brain

47
Q

Teratogen exposure during the fetal period usually disrupted

A

function rather than anatomy, learning deficits and behavioral abnormalities are concerns

48
Q

When did FDA require drug labels to include ability to cause birth defects and other effects on reproduction and pregnancy

A

1975

49
Q

Category A pregnancy risk category

A

Remote harm

50
Q

Category B pregnancy risk category

A

Slightly more harm

51
Q

Category C pregnancy risk category

A

Greater risk than B

52
Q

Category D pregnancy risk category

A

Proven risk of fetal harm

53
Q

Category X pregnancy risk category

A

Proven to show definite risk of fetal abnormality

54
Q

Nearly all drugs can enter

A

breast milk

55
Q

Factors that ermine entry into the breast milk are the

A

same factors that determine passage of drugs across membranes

56
Q

While most drugs can be detects in breast milk,

A

concentrations are generally too low to be harmful

57
Q

Strategies to minimize risk for pregnant women taking medication

A

-Dose immediately after breast feeding
avoid long half life
choose drug lear likely to affect infant
avoid drugs that are known to be hazardous

58
Q

Premature infants

A

less than 36 week

59
Q

full term infants

A

36-40 weeks

60
Q

neonates

A

first 4 postnatal weeks

61
Q

Infants

A

Weeks 5 to 52 postnatal

62
Q

Children

A

1-12 years

63
Q

Adolescents

A

12-17

64
Q

Children metabolize drug ____ than adults

A

faster

65
Q

What determines pediatric dosages

A

weight (mg/kg)

66
Q

In neonates & Young infants, drugs responses may

A

be unusually intense and prolonged

67
Q

protein binding capacity is

A

limiting early in life

68
Q

The BBB is not fully developed at birth which causes

A

neonates to be especially sensitive to drugs that affect the CNS

69
Q

Drug metabolizing capacity of neonate is

A

low because do not have fully developed CYV450-enzyme system

70
Q

renal excretion of drugs in neonates is

A

low

71
Q

What can be used as a quick estimation of pediatric weight and drug doses for emergencies

A

Broselow color-coded tools

316 Pharmacology (19 decks)

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