Pharmacotherapy in the lifespan

Question 1

Pharmacokinetics

Answer 1

Focuses on the movement of drugs throughout the body after they are administered: absorption, metabolism, distribution, excretion

Question 2

Pharmacodynamics

Answer 2

The area of pharmacology concerned with how drugs produce change in clients and the differences in client responses to medications

Question 3

Pharm care in infancy (0-12 months)

Answer 3

Safety of the infant
Proper dosing of prescribed drugs
Teaching parents how to administer medications properly

Question 4

Nursing considerations in infancy

Answer 4

Oral medications should be administered slowly
Medications are often prescribed in milligrams per kilogram per day (mg/kg/24h)
Because the liver and kidneys are immature, drugs will have a greater impact due to their prolonged duration of activity
Immunizations needed; natural immunity from mother in utero begins to decline

Question 5

What IM site is usually contraindicated in infants?

Answer 5

gluteal

Question 6

How should does be individualized in pediatrics?

Answer 6

age, height, weight, maturational state, body surface area

Question 7

Calculating pediatric drug dosages

Answer 7

Calculates the number of milligrams of drug, based on the child’s weight in kilograms (mg/kg); a unit of time is usually included

Uses child’s height and weight, plotted on a nomogram, to determine surface area

Question 8

Drugs most likely to contribute to drug interactions

Answer 8

Those with high potency
Those with narrow therapeutic index
Those with extensive protein binding
Those that effect vital organ functions: hepatic metabolism

Question 9

Med administration with toddlers (1-3 years old)

Answer 9

Curiosity!!
Child-resistant containers
Check dosing
Storage of drugs and harmful agents
Never tell children that medicine is candy
Be mindful what you mix medications with

Give short and concrete explanations followed by immediate med administration

Question 10

Med administration with preschool children (3-5 years old)

Answer 10

Refining gross and fine motor skills; developing language abilities
Can sometimes comprehend that medications are administered to help them feel better

Question 11

Med administration for school-aged children (6-12 years old)

Answer 11

Rapid physical, mental, and social development; thinking processes become more progressively logical and consistent
Longer more detailed explanations may be of value; child has some reasoning
Help child feel like they are participating

Question 12

Med administration with adolescents (13-18)

Answer 12

Able to think in abstract terms
Appreciate thorough explanations of their treatment; may be reluctant to admit lack of knowledge
Be sensitive to need for self-expression, privacy, individuality
Examples of medical concerns requiring medications: skin problems, headaches, menstrual symptoms, sports-related injuries
Education regarding: contraception, appetite suppressants, laxatives, amphetamines, anabolic steroids

Question 13

Absorption of meds in older adults

Answer 13

Increased gastric pH, delayed gastric emptying, decreased peristaltic rate

Question 14

Excretion of meds in older adults

Answer 14

Laxatives used to compensate for slower peristalsis may caused medications to be rapidly excreted from the body before they can provide their full therapeutic benefit

Question 15

Distribution of meds in older adults

Answer 15

The liver’s production of enzymes decreases, thereby decreasing hepatic drug metabolism, and resulting in increased serum drug concentration. More drug is available for distribution and the effects of the drug may be prolonged
The ratio of body fat to water increases; affecting distribution and storage of fat-soluble drugs and vitamins
An aging cardiovascular system causes decreased cardiac output and less efficient blood circulation
Percentage of body water decreases, contributing to dehydration and changes in drug concentration

Question 16

Metabolism of meds in older adults

Answer 16

The ratio of fat to muscle increases