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PHARMACOLOGY > Reading 02 : Drug Therapy Across Lifespans > Flashcards

Reading 02 : Drug Therapy Across Lifespans Flashcards

1
Q

What proportion of pregnant women take at least one medication during pregnancy?

A

Two-thirds of pregnant women take at least one medication; many take more.

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2
Q

Do all drugs cross the placenta?

A

Yes, all drugs cross the placenta.

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3
Q

Why are drugs used during pregnancy?

A

To treat pregnancy-related conditions (e.g., nausea, constipation) and chronic disorders.

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4
Q

Have the risks of most drugs used during pregnancy been determined?

A

No, the risks for most drugs used during pregnancy have not been determined.

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5
Q

Why is it important to balance risk and benefits when using drugs during pregnancy?

A

Because the health of the fetus depends on the health of the mother; conditions that threaten the mother’s health must be addressed.

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6
Q

What is the origin of the word “teratogen” and what does it mean?

A

The Greek word “teras” means “monster”; teratogen literally means “to create a monster.”

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7
Q

What are examples of birth defects caused by teratogens?

A

(A) Cleft Lip
(B) Clubfoot
(C) Hydrocephalus

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8
Q

Do all birth defects result in physical deformities?

A

No, they can also include neurobehavioral and metabolic anomalies.

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9
Q

Can drugs taken by lactating women be excreted in breast milk?

A

Yes, drugs can be excreted in breast milk.

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10
Q

How does the concentration of a drug affect the risk to an infant?

A

The higher the concentration of a drug, the higher the probability of harm to an infant.

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11
Q

Is there extensive research on the safety of drugs taken during breastfeeding?

A

No, very little systematic research has been done, and only a few drugs are known to be hazardous.

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12
Q

What percentage of drugs are ineffective in children despite being effective in adults?

A

About 20%.

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13
Q

What percentage of drugs cause unanticipated side effects in children?

A

About 30%, with some side effects being potentially lethal.

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14
Q

What percentage of drugs require different dosages for children compared to adults?

A

About 20%.

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15
Q

What is critical to achieving timely and accurate dosing in pediatric medication?

A

Informed participation of the child’s parents or guardian, and if possible, active involvement of the child.

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16
Q

What are the key components of effective education for pediatric medication adherence?

A

(A) Dosage size and timing,
(B) Route and technique of administration,
(C) Duration of treatment, and drug storage,
(D) The nature and time course of desired response, and
(E) The nature and time course of adverse response.

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17
Q

ow much more common are adverse drug reactions (ADRs) in the elderly compared to younger adults?

A

ADRs are 7 times more common in the elderly than in younger adults.

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18
Q

What percentage of hospital admissions among older individuals are due to ADRs?

A

About 16% of hospital admissions among older individuals are due to ADRs.

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19
Q

What percentage of all medication-related deaths are accounted for by the elderly?

A

The elderly account for 50% of all medication-related deaths.

20
Q

What are common nonspecific symptoms of ADRs in the elderly?

A

Dizziness and cognitive impairment.

21
Q

Is aging the direct cause of ADRs in the elderly?

A

No, ADRs in the elderly are due to multiple factors, not aging per se.

22
Q

What are the most common factors contributing to ADRs in the elderly?

A

(A) Drug accumulation due to reduced renal function
(B) Polypharmacy
(C) Greater severity of illness
(D) Multiple pathologies
(E) Greater use of drugs with a low therapeutic index (e.g., digoxin)
(F) Increased individual variation due to altered pharmacokinetics
(G) Inadequate supervision of long-term therapy
(H) Poor patient adherence

23
Q

Are the majority of ADRs in the elderly avoidable?

A

Yes, the majority of ADRs in the elderly are avoidable.

23
Q

Why is it important to take a thorough drug history in elderly patients?

A

To include all medications, including over-the-counter drugs, and reduce the risk of ADRs.

24
Q

How should drug therapy be initiated in elderly patients to minimize ADRs?

A

By starting with low doses.

25
Q

How can monitoring help reduce the incidence of ADRs in the elderly?

A

By monitoring clinical responses and plasma drug levels to adjust dosages rationally.

26
Q

What is a key strategy to reduce ADRs in the elderly?

A

Employing the simplest regimen possible.

27
Q

How can periodic review help in reducing ADRs in the elderly?

A

By reviewing the need for continued drug therapy and discontinuing medications as appropriate.

28
Q

Why should elderly patients be encouraged to dispose of old medications?

A

To prevent the use of outdated or unnecessary drugs that may cause ADRs.

29
Q

Why is promoting adherence important in elderly patients?

A

To ensure accurate and timely drug use, thereby reducing the risk of ADRs.

30
Q

Why is it important to monitor for drug-drug interactions in elderly patients?

A

To reduce the risk of ADRs caused by interactions between multiple medications.

31
Q

What percentage of elderly patients fail to take their medicines as prescribed?

A

As many as 40% or more of elderly patients.

31
Q

What are the different forms of medication nonadherence among elderly patients?

A

(A) Never filling prescriptions
(B) Failing to refill prescriptions
(C) Not following the prescribed odsing schedule

32
Q

What are the possible consequences of nonadherence to medication?

A

(A) Therapeutic failure (underdosing or erratic dosing)
(B) Toxicity (overdosing)

33
Q

Which is more common: therapeutic failure due to underdosing or toxicity due to overdosing?

A

Therapeutic failure due to underdosing (90% of cases).

34
Q

hat percentage of nonadherence cases in elderly patients are intentional?

A

About 75%.

34
Q

What are some factors contributing to unintentional nonadherence to medication in elderly patients?

A

(A) Forgetfulness
(B) Failure to comprehend instructions (due to intellectual, visual, or auditory impairment)
(C) Inability to pay for medications
(D) Use of complex regimens

35
Q

What is the principal reason for intentional nonadherence among elderly patients?

A

The patient’s conviction that the drug is not needed in the dosage prescribed.

36
Q

What are other reasons contributing to intentional nonadherence?

A

(A) Unpleasant side effects
(B) Expense on the medication

37
Q

How can simplifying the regimen help improve adherence in elderly patients?

A

By reducing the number of drugs and doses per day.

38
Q

Why is clear communication important in promoting medication adherence?

A

To help the patient understand the treatment plan through concise verbal and written instructions.

39
Q

How does choosing an appropriate dosage form promote adherence?

A

By selecting a formulation that is easier for the patient to take, such as a liquid for those who have difficulty swallowing.

40
Q

Why should drug containers be labeled clearly and be easy to open?

A

To accommodate patients with impaired dexterity, such as those with arthritis.

41
Q

What tools can help elderly patients remember to take their medications?

A

Calendars, diaries, or pill counters.

42
Q

How can financial considerations affect medication adherence?

A

Ensuring the patient can afford the medication and has access to a pharmacy.

43
Q

How can support systems help in promoting medication adherence?

A

Enlisting the help of a friend, relative, or visiting healthcare professional.

44
Q

What should healthcare professionals monitor to ensure adherence?

A

Therapeutic responses, adverse reactions, and plasma drug levels.

PHARMACOLOGY (7 decks)

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