Lifespan Considerations Flashcards

1
Q

Is generally the period of greatest risk?

The last trimester, 1st trimester

A

1st trimester

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2
Q

? Involves the highest % of drug absorption by the fetus
(increased blood flow + a larger fetus!)

The last trimester, 1st trimester

A

The last trimester

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3
Q

Which is true about BREASTFEEDING correct!
Lactation:
◦ A vast amount of drugs can enter breast milk
◦ Drug profiles that can easily cross:
◦ Lipid and Water soluble
◦ Small and Large molecular weight
◦ Non-ionized and Ionized
◦ Avoid long acting drugs (XL, long half lives)
◦ Typically give medications AFTER breastfeeding

A

◦ A vast amount of drugs can enter breast milk
◦ Drug profiles that can easily cross:
◦ Lipid soluble
◦ Small molecular weight
◦ Non-ionized
◦ Avoid long acting drugs (XL, long half lives)
◦ Typically give medications AFTER breastfeeding

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4
Q

Which is true for REPRODUCTIVE POTENTIAL
◦ Some medications may lead to infertility
◦ Some medications are known to be highly teratogenic
◦ Appropriate education and handling is needed
◦ Some are REMS drugs are needed
◦ May require negative pregnancy tests before and during therapy
◦ Recommendations may include beginning or altering contraceptive
therapies
◦ Famous example is Clopalan (Accutane®)
◦ Famous example is Isotretinoin (Accutane®)

A

◦ Some medications may lead to infertility
◦ Some medications are known to be highly teratogenic
◦ Appropriate education and handling is needed
◦ Some are REMS drugs are needed
◦ May require negative pregnancy tests before and during therapy
◦ Recommendations may include beginning or altering contraceptive
therapies
◦ Famous example is Isotretinoin (Accutane®)

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5
Q

decreased gastric acid production + slower gastric emptying time

GERIATRICS or NEONATES

A

NEONATES

GERIATRICS

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6
Q

More blood flow to skin (topical drugs get rapidly absorbed)

GERIATRICS or NEONATES

A

NEONATES

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7
Q

◦ Limited protein binding sites (until age 1)

GERIATRICS or NEONATES

A

NEONATES

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8
Q

◦ Decreased body water + mass, more fat content

GERIATRICS or NEONATES

A

GERIATRICS

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9
Q

◦ Still developing Blood Brain Barrier (drugs may enter the brain)

GERIATRICS or NEONATES

A

NEONATES

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10
Q

◦ Higher body water content (dilutes water soluble drugs)

GERIATRICS or NEONATES

A

NEONATES

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11
Q

◦ Decreased protein binding

GERIATRICS or NEONATES

A

GERIATRICS

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12
Q

◦ Immature liver/kidney function

GERIATRICS or NEONATES

A

NEONATES

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13
Q

◦ Declined liver/kidney function

GERIATRICS or NEONATES

A

GERIATRICS

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14
Q

PEDIATRIC
◦? can damage developing cartilage

Systemic Corticosteroids (prednisone), Fluoroquinolones ( levofloxacin) , Tetracycline’s (doxycycline)

A

Fluoroquinolones ( levofloxacin)

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15
Q

PEDIATRIC
◦ ? can bind to calcium of developing children

Systemic Corticosteroids (prednisone), Fluoroquinolones ( levofloxacin) , Tetracycline’s (doxycycline)

A

Tetracycline’s (doxycycline)

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16
Q

PEDIATRIC
◦ ? can suppress or delay growth

Systemic Corticosteroids (prednisone), Fluoroquinolones ( levofloxacin) , Tetracycline’s (doxycycline)

A

Systemic Corticosteroids (prednisone)

17
Q

•Polypharmacy is common

GERIATRICS or NEONATES

A

GERIATRICS

18
Q

6% when on ? drugs
50% chance on ? drugs
100% chance on ? drugs

5, 10, 2

A

6% when on 2 drugs
50% chance on 5 drugs
100% chance on 10 drugs

19
Q

The Beers Criteria is for

GERIATRICS or NEONATES

A

GERIATRICS

20
Q

NON-PHYSIOLOGIC CONSIDERATIONS
▪ Compliance Decreases with age
▪ Comorbidities, Changes in vision/hearing, Decreased mobility
▪ ENCOURAGE READING GLASSES!

GERIATRICS or NEONATES

A

GERIATRICS

21
Q

Which is need for GERIATRICS?
▪ Recommendations to support compliance
▪ Clear and Concise instructions (verbal + written)
▪ Ensure appropriate dosage form
▪ Liquid for difficulty swallowing
▪ Solids for difficulty swallowing
▪ Daily calendar/pill counter
▪ Dispose of medications they are no longer taking
▪ Take-back programs
▪ Flush certain drugs (FDA FLUSH LIST) (fentanyl patch- pets, children)
▪ Mix drugs in sealable bags with cat litter/coffee and throw in trash

A

▪ Recommendations to support compliance
▪ Clear and Concise instructions (verbal + written)
▪ Ensure appropriate dosage form
▪ Liquid for difficulty swallowing
▪ Daily calendar/pill counter
▪ Dispose of medications they are no longer taking
▪ Take-back programs
▪ Flush certain drugs (FDA FLUSH LIST) (fentanyl patch- pets, children)
▪ Mix drugs in sealable bags with cat litter/coffee and throw in trash