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Pharm 313 > Lifespan Considerations > Flashcards

Lifespan Considerations Flashcards

1
Q

3 different types of tolerance

A
  1. pharmacodynamic tolerance
  2. metabolic tolerance
  3. Tachyphylaxis
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2
Q

Response from drug decreases with increase dosing

A

Tachyphylaxis

-have to have drug free time to replenish effectiveness

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3
Q

Require increase amount of drug to achieve same effect/pain relief

A

Pharmacodynamic tolerance

  • ex: opioids, alcohol
  • what we most think of related to tolerance
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4
Q

Accelerated rate of drug metabolism

A

Metabolic Tolerance

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5
Q

Any response to a drug that is based solely on individuals psychological reaction to the idea of taking the drug

A

Placebo

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6
Q

Study of relationship between genetic variation and how our body responds to medication

A

Pharmacogenomics

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7
Q

3 genetic metabolic classifications related to P450

A
  • ultra metabolizers
  • extensive metabolizers (normal)
  • poor metabolizers
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8
Q

What is the benefit of pharmacogenomics?

A

better match drug to person to achieve response needed

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9
Q

Kidney disease affects which stage of medication in the system

A

Excretion

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10
Q

Kidney failure changes drug half life from ____ hours to ____ hours

A

1.5 , 25

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11
Q

2 measures of kidney function used to adjust medication dose

A
  1. creatinine clearance (24 hour urine + bld)

2. GFR- usually use this

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12
Q

Liver disease affects which stage of medication in the system

A

metabolism

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13
Q

What effects liver metabolism? (conditions)

A
  • ESLD, Cirrhosis, Hep B

- hepatotoxic medications

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14
Q

3 ways that women have different drug metabolism

A
  1. metabolize alcohol more slowly
  2. increase effectiveness of certain opioid drugs
  3. Quinidine causes increase QT interval prolongation
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15
Q

2/3 of all pregnant women take at least ___ medications

A

1

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16
Q

3 physiological changes effecting dosing during pregnancy

A
  1. 3rd trimester = doubled renal bld flow and excretion
  2. Bowel decrease tone and mobility causing increased absorption
  3. increased hepatic metabolism
17
Q

Which drugs cross the placenta?

A

ALL- some just do it easier then others like Lipid Soluble ones

18
Q

Cause of the majority of birth defects?

A

unknown

19
Q

Percent of birth defects caused by drugs

A

< 1%

20
Q

3 factors effecting a drugs effect on baby

A
  1. stage of fetal development
  2. amount of drug ingested
  3. frequency of drug ingested
21
Q

When do gross malformations caused by teratogens in fetus occur?

A

embryonic period- week 3-8

22
Q

When are fxns disrupted by teratogens in fetus?

A

fetal period- week 9-term

23
Q

2 ways to know drugs effects on pregnant women/fetus

A
  1. drug registry

2. Retrospective studies

24
Q

2020 label change for pregnancy and lactation risk categories

A

-includes male and female reproductive harm

25
Q

Lactation increased risk of drug doing harm to baby

A
  • fat solubility
  • oral bioavailability
  • half life
26
Q

Lactation decreased risk

A
  • molecular size
  • protein binding availability
  • acidity
27
Q

How to decrease infant risk during lactation

A
  1. take drugs immediately after breast feeding
  2. avoid drugs that have a long half life
  3. choose drugs that tend to be exliucded from milk
  4. avoid drugs known to be hazardous
28
Q

Pediatrics age range

A

<16 yrs of age

29
Q

2 ways to determine dose for pediatrics

A
  1. area BSA (body surface area * adult dose / 1.73 m2)

2. Weight (mg/kg/day)

30
Q

Pedes have delayed elimination resulting in

A

prolonged response

31
Q

Pedes have organ immaturity until age

A

1

32
Q

kids have elevated drugs levels causing

A

more intense reponse

33
Q

Metabolism in pedes….

A

increase until age 2 and then gradually declines

34
Q

Topical absorption is ____ in pedes

A

greater

35
Q

No BBB until age

A

1

36
Q

1 way to help medication adherence in kids

A

education

37
Q

CYP450 and poor metabolizers- active drug and pro drug

A

Active drug: increase toxicity

Prodrug: decrease effect

38
Q

CYP450 and ultrarapid metabolizer- active drug and pro drug

A

Active drug: decrease effect

Prodrug: increase toxicity

39
Q

During the first two weeks of conception what are the risks from teratogenic drugs?

A

All or none effect: spontaneous abortion or proceed normally

Pharm 313 (26 decks)

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