Lilley Ch 3 (lifespan considerations)

Question 1

four lifespan changes that have dramatic effects on four phases of pharmacokinetics

Answer 1

• pregnancy
• newborn
• pediatric
• older adult

Question 2

what trimester is the fetus at greatest risk of adverse affects of drugs (and birth defects)

Answer 2

1st trimester

Question 3

what trimester is the fetus absorbing the greatest percentage of a drug

Answer 3

3rd trimester

Question 4

3 subsections in prescribing information

Answer 4

1. pregnancy
2. breastfeeding
3. reproductive

Question 5

drug risk category: controlled studies in humans show no risk to fetus

Answer 5

Class A

Question 6

drug risk category: animal studies show no risk to fetus, no controlled studies in humans

Answer 6

Class B

Question 7

drug risk category: no controlled studies in animals or humans

Answer 7

Class C

Question 8

drug risk category: evidence of human risk to fetus, but benefits may outweigh risks

Answer 8

Class D

Question 9

drug risk category: controlled studies in animals and humans show fetal abnormalities, risk outweighs any possible benefit

Answer 9

Class X

Question 10

birth to one month

Answer 10

neonate

Question 11

one month to twelve months

Answer 11

infant

Question 12

one year to twelve years

Answer 12

child

Question 13

important things to note about drug absorption in infants and children

Answer 13

• gastric pH less acidic until 1-2 y.o.
• gastric emptying slowed
• immature liver: first pass effect reduced
• intramuscular absorption faster and irregular

Question 14

important things to note about drug distribution in infants and children

Answer 14

• greater total body water means lower fat content
• decreased level protein binding (more free floating drugs: more drug interactions)
• immature blood-brain barrier (more drugs enter brain)

Question 15

important things to note about drug metabolism in infants and children

Answer 15

• immature liver: slower metabolism of meds

- older children have increased metabolism

Question 16

important things to note about drug excretion in infants and children

Answer 16

-immature kidney: slower excretion

Question 17

simultaneous use of multiple medications

Answer 17

polypharmacy

Question 18

important things to note about drug absorption in older adults

Answer 18

• gastric pH less acidic

- gastric functions slowed

Question 19

important things to note about drug distribution in older adults

Answer 19

• lower total body water percentages
• increased fat content
• decreased protein binding of drugs

Question 20

important things to note about drug metabolism in older adults

Answer 20

-liver: slower metabolism

Question 21

important things to note about drug excretion in older adults

Answer 21

-kidneys: decreased excretion

Question 22

list of meds inappropriate for patients 65+

Answer 22

beers criteria

Question 23

characteristics of peds patients that have significant effect on drug dosage

Answer 23

• skin is thinner and more permeable
• stomach lacks acid to kill bacteria
• lungs have weaker mucous barriers
• body temp less well regulated
• liver and kidneys are immature