Patient-Focused Considerations and Patient Education Flashcards
How do drugs cross the placenta
Diffusion
What 3 factors affect drug safety in pregnancy
Drug properties, Fetal gestational age, Maternal factors
What is a concern of drug therapy while breast feeding and what does exposure depend on
Breastfed infants are at risk for exposure to drugs consumed by the mother. Exposure depends on volume of consumed milk
What’s the difference between a premature baby, newborn baby and infant
Premature-born before 38 weeks
Newborn-younger than 1 month
Infant-1 month to 1 year
What are 5 differences in absorption pharmacokinetics for neonates and pediatrics?
Gastric pH is less acidic until 1-2 years, Gastric emptying slowed, First-pass elimination reduced, Reduced bile salt formation, IM absorption is faster and irregular
What are 4 differences in distribution pharmacokinetics for neonates and pediatrics
Immature BBB means more drugs enter the brain, Decreased level of protein binding, Greater total body water means lower fat content, Total body water differences result in increased distribution and dilution of water-soluble drugs
What are 3 differences in metabolism pharmacokinetics for neonates and pediatrics
Liver immature so doesn’t produce enough microsomal enzymes, Older children may have increased metabolism, meaning they need more frequent admin or dosage than infants. Genetic differences due to mothers consumption during pregnancy can impact metabolism
What are 2 differences in elimination pharmacokinetics for neonates and pediatrics
Kidney immaturity affects eGFR and tubular secretion. Decreased perfusion rate of the kidneys may reduce excretion of drugs
What are the 5 factors affecting pediatric dosages?
Skin is thin and permeable, Stomach lacks acid to kill bacteria, Lungs have weaker mucus barriers, Body temps are less well regulated and dehydration occurs easily, The liver and kidneys are immature, impairing drug metabolism and excretion.
What are 4 differences in dosage calculations for pediatric patients
Body SA method. Weight always in kg not lbs, Height in cm not in, Body weight dosage calculations use mg/kg.
What are 5 differences in absorption pharmacokinetics for older adults?
Gastric pH less acidic, Gastric emptying slowed, GI tract movement slowed due to decreased muscle tone and activity, blood flow to GI reduced, Absorptive surface of Gi reduced.
What are 3 differences in distribution pharmacokinetics for older adults
Lower body water %, increased fat content, decreased production of proteins by the liver so decreased protein binding (more free drugs in circulation)
What are 3 differences in metabolism pharmacokinetics for older adults
The aging liver produces fewer microsomal enzymes, Blood flow to liver is reduced, Prolonged half-life of many drugs (potential for accumulation)
What are 2 differences in excretion pharmacokinetics for older adults
Decreased eGFR, Decreased # of intact nephrons
What is ethnopharmacology and what are the implications of this
Expanding knowledge for understanding specific impact of cultural factors on patient drug response. Ethnocultural assessment needs to be included in patient care
