Pharmacotherapy and Special Populations Flashcards
Test I Review
These are of prime consideration to drug prescribers and other healthcare professionals.
- These are based on those occurrences seen in particular (selected) group of individuals such as health adults or children within a particular age range and weight.
- May or may not occur in persons outside of this selected group.
Drug actions and expected responses to drug therapy
. There are a number of variables within other groups that differ from the selected group that can alter these actions and responses; among these are: (7)
- Age
- Gender
- Body mass
- Genetics
- Race or ethnicity
- Health Status (pathological conditions)
- Lifestyle
Three groups of individuals differ from the selected group for which most drugs are tested for actions and responses
Neonates, infants and the elder.
Groups of individuals:
• Drug is handle inefficiently
• Organ not yet fully developed to handle distribution, metabolism and excretion
• Stomach lack acid and lung lack mucus barrier
• Poor regulation of body temperature
• Become dehydrates easily
Neonates (birth to 1month)
Groups of individuals:
• Kidney function near that of adult
• Protein-binding ability for drugs near that of adult
• Liver function and blood-brain barrier still immature
Infants (1mo – 1 yr)
Groups of individuals
• Have periods of increased metabolic activities, thus some drugs are more rapidly metabolized and excreted than others (drugs).
• Onset and duration of many drugs are unclear
• 12 year-old who are healthy usually handle drugs in the same way as healthy adults
Children (1-12 yrs.)
Groups of individuals:
• Organ functions may alter absorption, distribution, metabolism and/or excretion of drugs.
• GI changes may occur (include gastric acidity, blood flow, motility) but oral absorption may not be much affected
• Cardiac output may decrease hence slower distribution of drugs to target sites
• Liver enzymes and blood flow decrease hence metabolism slowed
• Kidney has decreased blood flow hence decreased glomerular filtration rate and secretion of drug. Hence risk of drug accumulation increases.
Older Adults (65 years)
This method is used to calculate children’s dose when either the manufacturer has not recommended a child’s dose or the prescriber recommends that this method of dose determination be used.
AGE-BASED DOSAGE CALCULATION
Young’s rule formula.
Age of child x Adult dose = Child dose
/(Age of child +12)
A method of estimating the dose of medicine for a child by multiplying the adult dose by the child’s age in months and dividing the product by 150.
Fried’s rule
Generally, adult doses a based on the average adult of body weight of?
70 kg (150 lb).
BSA expresses a relationship between ___ and ____ and can provide a more precise guide to the maturity of a child’s organ’s and metabolic rate of functioning to drugs than weight alone.
Height & Weight
In general, persons who are heavier than the average adult may require large _____ providing their renal, hepatic and cardiovascular systems can handle a higher dosage.
Therapeutic Doses
Can be used to compute the a child’s dose when there is no manufacturer’s recommended dose or the prescriber desires this approach to determine the dose.
Clarke’s Law
N.B: Clark’s rule used lb not kg.
Clark’s Rule Formula
Child W x Adult Dose = Child Dose
/150
