Individual Variations and Lifespan Considerations

Question 1

individual variation due to kidney disease

Answer 1

slow excretion – longer half life

Uses the creatinine clearance

Question 2

individual variation due to liver disease

Answer 2

slower metabolism

can be due to liver dysfunction or hepatotoxic medications

Question 3

decreased responsiveness to a drug as a result of repeated exposure

Answer 3

tolerance

Question 4

an individual on a chronic dose of a medication will need higher doses over time to produce the same effect

Answer 4

pharmacodynamic tolerance

Question 5

accelerated drug metabolism leading to this type of tolerance

Answer 5

metabolic tolerance

Question 6

the receptors’ response to a drug decreases with repeated dosing

Answer 6

tachyphylaxis

there has to be a drug free time to resume effectiveness

Question 7

t/f placebo effects are always positive

Answer 7

false. patients can believe a drug is bad.

Question 8

study of how genes affect individual drug responses

Answer 8

pharmacogenomics

Question 9

CYP phenotype:
↑ toxicity with active drug
↓ effect with prodrug

Answer 9

poor metabolizer

the prodrug isn’t metabolized into the active form

Question 10

CYP phenotype:

expected response with active and prodrugs

Answer 10

extensive metabolizer

Question 11

CYP phenotype:
↓ effect with active drug
↑ toxicity with prodrug

Answer 11

ultrarapid metabolizer

prodrug is metabolized too much into the active form

Question 12

AFABs metabolize alcohol more [slowly/quickly] than AMABs

Answer 12

slowly

AFAB: assigned female at birth
AMAB: assigned male at birth

Question 13

t/f race and ethnicity can alter drug metabolism

Answer 13

Race is a poor predictor but can have some effects

Question 14

name a few factors that can affect adherence

Answer 14

• belief the drug will work (or that they need it)
• manual dexterity
• visual acuity
• intellectual ability
• psychologic state
• attitude towards drugs
• ability to pay
• drug/drug interactions
• drug/food interactions

Question 15

t/f: 1/3 of pregnant people take medications

Answer 15

false, 2/3 are on at least one medication

Question 16

in the third trimester, renal excretion [increases/decreases]

Answer 16

increases due to doubled renal blood flow

Question 17

t/f: 70% of drugs cross the placenta

Answer 17

false, all drugs can cross the placenta

Question 18

t/f: 25% of birth defects are genetic

Answer 18

true

Question 19

t/f: <1% of birth defects caused by trugs

Answer 19

true

Question 20

period of pregnancy most susceptible to gross malformations

Answer 20

conception through embryonic period

Question 21

drugs should be taken [before/after] breastfeeding

Answer 21

after

Question 22

t/f: kids respond the same as adults to drugs

Answer 22

false

Question 23

two ways to dose for children

Answer 23

weight or body surface area

Question 24

how long does organ immaturity last?

Answer 24

until age 1

Question 25

children absorb [more/less] topicals

Answer 25

more

Question 26

percent of all prescriptions are for older adults

Answer 26

31%

Question 27

this organ system declines with aging and has a significant effect on drug pharmacokinetics

Answer 27

kidney

Question 28

adverse drug reactions are ___ times more likely in the elderly

Answer 28

7

Question 29

two criteria for prescribing for older adults

Answer 29

Beers

START/STOPP

Question 30

Most accurate method to measure dosage with children

Answer 30

body surface area