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Pharmacology > Lifespan considerations > Flashcards

Lifespan considerations Flashcards

1
Q

Kidney disease

A

Excretion is impaired

  • cumulative kidney dysfunction
  • creatinine clearance is a 24 urine sample compared to blood sample
  • GFR is close correlative.
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2
Q

Liver disease

A

-impacts metabolism
- cirrhosis
- hepatotoxic drugs cause liver damage
-

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3
Q

Tolerance

A
  • decreased responsiveness to a drug

- pharmacodynamic tolerance: increased doses are required over time to get same response

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4
Q

Metabolic tolerance

A

One category of tolerance - accelerated drug metabolism

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5
Q

Tachyphylaxis

A

Response from a drug decreases from repeated doses.

  • nitro patches
  • drug free time to replenish
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6
Q

Placebos

A
  • individuals psychological response to taking the medication
  • positive or negative
  • could be a good thing
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7
Q

Pharmacogenomics

A
  • study of genes affect individual drug responses
  • altered drug metabolism
  • do genetic testing for individuals
  • ultra, extensive,poor metabolizers
  • no benefit no toxicity, benefit toxicity, no benefit and toxicity,
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8
Q

Gene drug interactions

A
  • based on genetic variation some people may or may not be able to take a drug
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9
Q

Ultrarapid metabolizer

A

Decreased effect in active drug

Increase toxicity in pro drugs

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10
Q

Extensive metabolizer

A

Normal response

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11
Q

Poor metabolizer

A

Increased toxicity in active drug

Decreased prodrug administered

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12
Q

Gender

A

Females metabolize alcohol slower than men

  • certain opioid analgesics are more effective in women than men
  • quinidine causes a greater QT interval in women
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13
Q

Race

A

Genetic variations and ethnic group

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14
Q

Adherence factors

A
  • belief that the drug will work
  • manual dexterity
  • visual acuhity
  • intellectual ability
  • psychological State
  • attitude towards drugs
  • ability to pay
  • interactions with drug to drug of food to drugs
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15
Q

What happens in then 3rd trimester

A

-Renal blood flow doubled and renal excretion accelerated

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16
Q

Other pregnancy changes

A
  • Tone and mobility of bowel is decreased which leads to prolong transit. (Increased level of drug in body)
  • Increased hepatic metabolism
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17
Q

Do all drugs cross the placenta?

A

Yes!

  • lipid soluble will pass though easier
  • polar, ionized, protein won’t
  • withdrawal can be seen in babies when they are born
  • assume
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18
Q

Teratogenic

A
  • less than 1% of defects are caused by drugs

- 25% is caused by genetics

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19
Q

Contributing factors:

A
  • when drug is taken during pregnancy

- amount of ingested and frequency of ingestion.

20
Q

Development

A 
Conception - week 2 
-all or nothing organ development 
- embryonic : gross malformations produced by teratogens 
- fetal period: 9;week to term 
Functions are disrupted by exposure
21
Q

What to do when you are taking a teratogenic med?

A
  • identify first exposure

- monitor for effects

22
Q

How to know if drugs are’s are during pregnancy

A
  • drug registries

- retrospective studies

23
Q

Pregnancy categories

A

-A is the safest while D&X cause the most harm

24
Q

Pregnancy lactation labeling

A
  • risk summary

- female male reproductive potential ( drugs can have teratogenic effects)

25
Q

Lactation risk

A
  • drugs can be excreted in breast milk

- can effect infant

26
Q

How do you decrease lactation risk?

A
  • take drugs immediately after breast feeding
  • avoid drugs that have a long half-life
  • choose drugs that tend to be excluded from milk and are least likely to affect the infant
  • avoid drugs known to be hazardous
27
Q

Pediatrics are at the risk of what?

A

They are under 16 and have an increased risk for adverse rxns

28
Q

Pediatric dosing

A

Based on body surface or weight

-mg/kg/day div q12h

29
Q

Bsa

A

Body surface area x adult dose / 1.73 m^2

30
Q

Organ immaturity is profound in?

A

Infants until age 1

31
Q

Elevated drug levels in peds

A

More intense response

32
Q

Delayed elimination in peds

A

Prolonged response

33
Q

Metabolism in peds

A

Markedly faster until Age 2 then it declines .

Increase dose or intervals

34
Q

Is topical absorption much greater in kids

A

Yes

35
Q

Bbb is not form till what age

A

Year 1

36
Q

Certain drugs should not be given to kids. T or f?

A

T

37
Q

Med adherence in kids

A
  • education
  • demonstration
  • what to do child spit or spills meds
  • system of multiple caregivers
  • ease of measuring (using the right tool)
  • make it taste good
38
Q

31% of all prescriptions are consumed by?

A

Older adults

39
Q

More ADR and drug drug interactions

A

Due to poly pharmacy

40
Q

Older adult organ fuction

A

Declines

41
Q

Variation in older adults

A

Some are healthy and some are very sick

42
Q

Co- morbidities

A

Are increased in older adults

43
Q

Major physiological concerns

A
  • Decreased muscle mass increased body fat: effects drug storage and less sites for protein binding
  • hepatic metabolism decreases: reduced bf to liver, decreased activity
  • decreased gastric emptying
  • decreased kidney fxn
44
Q

Beers criteria

A

List of drugs older people should not use based on ADR

45
Q

START/STOPP

A

Start: info about drugs that should be given to elderly due to EVidnece
STop: should not be prescribed to adults

46
Q

Med adherence in older adults

A
  • simplified drug regimens
  • clear concise verbal written instructions
  • appropriate dosage form
  • clearly labeled and easy to open container
  • daily reminders
  • support systems
  • frequent monitoring
  • others: expenses, side effects, drug is not needed, or dose is not right

Pharmacology (14 decks)

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