pharm patient considerations chap 4

Question 1

how do drugs cross the placenta

Answer 1

diffusion

Question 2

factors affecting drug safety during pregnancy

Answer 2

• drug properties
  -gestational age (1st tri at greater risk)
  -maternal factors

Question 3

drug transfer to fetus is most likely to occur in which trimester

Answer 3

3rd

Question 4

what is the primary route of maternal drug excretion

Answer 4

kidney

Question 5

drug levels in breast milk are usually ___ than maternal circulation

Answer 5

lower

Question 6

absorption is ___ in infants

Answer 6

increased cause peristalsis is decreased

Question 7

first pass elimination in infants

Answer 7

reduced so there’s more free drug cause the liver is underdeveloped

Question 8

distribution in infants

Answer 8

increased because theres more body water, dilution of water soluble drugs

Question 9

does protein binding increase or decrease in infants

Answer 9

decreased

Question 10

blood brain barrier in infants

Answer 10

underdeveloped so more drugs enter the brain

Question 11

neonatal metabolism

Answer 11

liver is immature so there are less enzymes produced

Question 12

drug metabolism in older children

Answer 12

increased, may need higher dose

Question 13

excretion in neonatals

Answer 13

decreased, liver is underdeveloped

Question 14

factors affecting ped drug dosages

Answer 14

skin- thin and permeable
stomach- lacks acid to kill bacteria
lungs- weaker mucus barriers
body temp- less regulated= dehydration
immature liver and kidneys

Question 15

what unit to weigh for peds

Answer 15

kilograms

Question 16

what unit to use for height

Answer 16

centimeters

Question 17

body weight dosage units

Answer 17

mg/kg

Question 18

considerations for older adults

Answer 18

polypharmacy, nonadherence, chronic illness, motor defects

Question 19

gastric ph in older adults

Answer 19

less acidic

Question 20

gastric emptying in older adults

Answer 20

slow

Question 21

absorptive surface of GI tract in older adults

Answer 21

reduced

Question 22

older adult drug distribution

Answer 22

• lower water content
• increased fat

Question 23

protein production in older adults

Answer 23

decreased by liver, less albumin, more free drugs

Question 24

metabolism in older adults

Answer 24

decreased, less enzymes produced

Question 25

half life in adults

Answer 25

prolonged

Question 26

excretion in older adults

Answer 26

decreased glomerular filtration rate, decreased number of intact nephrons

Question 27

what is the beers criteria

Answer 27

drugs that should be avoided in older adults

Question 28

polymorphism

Answer 28

person can have different characteristics regardless of culture

Question 29

what is included in ethnocultural assessment

Answer 29

language, health practices, past use of meds, use of over the counter drugs, herbal remedies, response to illness, religion, support, diet