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Pharm Exam 1 > Special Population Considerations > Flashcards

Special Population Considerations Flashcards

1
Q

ethnopharmacy

A

study of drug responses that may be unique to an individual owing social, cultural, and biologic phenomena

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2
Q

communication

A
  • occurs verbally and nonverbally

- when language is not understood use nonverbal, translators, and do not assume

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3
Q

space

A

americans often desire more personal space

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4
Q

major challenge for space concerns

A
  • use of touch
  • protection of modesty
  • ask patient about preferences
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5
Q

social organization

A
  • groups organized according to social order

- include family whenever appropriate

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6
Q

time

A

-perception of time is shaped by culture

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7
Q

present-oriented

A

more likely to discontinue mainstream prescriptive therapies when they feel well

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8
Q

future oriented

A
  • western european descent

- lead to health practices to prevent illness

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9
Q

environmental control

A

concept of “nature”

  • otherwordly beings (spirits)
  • traditional healers
  • spiritual advisors
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10
Q

biologic variations

A
  • pharmacogenetics
  • human genome project
  • the genographic project
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11
Q

human genome project

A

international collaborative research program

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12
Q

the genographic project

A

general study of all different genes that determine drug behavior

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13
Q

pharmacogenetics

A
  • DNA testing on populations all over the world
  • 99.9% humans are genetically identical
  • suggests not multiple races, but multiple genotypes
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14
Q

genomes

A

complete set of chromosomes and make up a cell’s DNA

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15
Q

polymorphisms

A

DNA variants that occur within a specific population at a frequency greater than 1%

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16
Q

substrate

A

substance that binds to & is metabolized by one or more enzymes

-drugs are chemical substances and a type of substrate

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17
Q

Drugs for nausea and vomiting in pregnancy

A
  • FDA has approved one drug for morning sickness
  • Doxylamine succinate & pyridoxine hydrochloride (Diclegis)
  • ginger helps
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18
Q

drugs for pain in pregnancy

A

acetaminophen

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19
Q

Acetaminophen

A

most commonly ingested nonprescription drug during pregnancy

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20
Q

drugs for heartburn in pregnancy

A

sucralfate

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21
Q

drugs for constipation in pregnancy

A
  • metamucil

- docusate sodium

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22
Q

Pregnancy categories

A

A,B,C,D, and X

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23
Q

Pregnancy category A

A

no risk to fetus

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24
Q

Pregnancy category B

A

no risk in animal studies

-well controlled studies in pregnant women are not available

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25
Q

Pregnancy category C

A
  • animal studies indicate a risk to the fetus

- Risk v. Benefit must be determined

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26
Q

Pregnancy category D

A

risk to human fetus has been proven

  • risk v. benefit must be determined
  • it could be used in life threatening situations
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27
Q

Pregnancy category X

A

risk to human fetus has been proven

-risk outweighs the benefit

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28
Q

most common indications for use of medications during pregnancy

A
  • nutritional supplements with iron
  • vitamins
  • minerals
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29
Q

herbal preparations are…

A

not generally recommended during pregnancy

30
Q

RN who is providing care to children…

A

-must make certain adaptations in care both in administration of meds and the evaluation of the therapeutic and adverse effects of the meds

31
Q

Pediatric variables that affect drug dosing

A
  • age
  • weight
  • height
  • anatomical and physiological characteristics (organ maturing)
  • health status
32
Q

Absorption is pediatrics

A

as they grow and develop, absorption of meds generally becomes more effective

33
Q

Less developed absorption in neonates and infants…..

A

must be considered when dosing and administering drugs

34
Q

Slowing absorption in adolescent years may be caused by…

A
  • poor nutritional habits
  • changes in physical maturity
  • hormonal differences
35
Q

absorption is initially influenced by…

A

route of administration

36
Q

Period of life that is most affected by changes in absorption

A

-neonatal and infancy due to GI immaturity

37
Q

irregular peristalsis associated with immaturity or symptoms of vomiting or diarrhea….

A

decreases absorption time

38
Q

SubQ and IM routes…

A

absorption occurs at the tissue level

39
Q

topical meds in pediatrics

A
  • may be altered by the condition of the skin tissue
  • children’s skin is thinner and more porous
  • absorption may be enhanced
40
Q

Distribution in pediatrics

A

increased body fluid proportion in the very young allows for greater volume of fluid in which to distribute medication and a lower concentration of the drug

41
Q

increased levels of extracellular fluids in children leads to…

A

increased tendency for children to become dehydrated and change the distribution of water-soluble medications

42
Q

decreased body fat in…

A

neonates and young infants than in older children

43
Q

metabolism in pediatrics

A

depends greatly on maturation level of the child and varies from child to child

44
Q

less than 2 years old…

A

decreased levels of hepatic enzymes and results in slower metabolism of medications

45
Q

hepatic metabolic activity is lower in…

A

neonates and matures at age 1 to 2

46
Q

children inherently have…

A

higher metabolic rates than adults

-metabolism occurs more rapidly

47
Q

due to higher metabolic rates in children than adults, medication…

A

requirement may be higher than in adults

48
Q

GFR

A

test used to check how well the kidneys are working

49
Q

children and half-lives

A

half-life of medication may be different in children

50
Q

children medication is usually ordered like…

A

“a dose per unit of weight”

51
Q

key issue when administering medication to children

A
  • confirming identification of patient

- most effective: armband

52
Q

primary concern when administering meds to infants

A
  • maintaining safety with minimum restraint necessary
  • administering correct dosage
  • providing care with as much comforting as possible
53
Q

most pediatric medications are…

A

-oral by syringe

54
Q

polypharmacy

A

administration of many drugs together

55
Q

polypharmacy more common in OAs because…

A
  1. multiple providers
  2. herbal therapy
  3. OTC meds
  4. discontinued prescription drugs
56
Q

polypharmacy can cause…..

A

confusion, falls, malnutrition, renal and liver dysfunction, and nonadherence

57
Q

absorption in OAs

A

slowed due to decreased blood flow and GI motility

58
Q

acidic drugs are…

A

poorly absorbed because increased alkaline gastric secretions

59
Q

enteric-coated tablets dissolved in alkaline fluid can…

A

break down more rapidly

60
Q

with OAs, drugs…

A

stay in GI tract longer due to decreased GI motility which leads to delayed onset

61
Q

_________ and ________ may not be absorbed as readily in OAs

A

iron and calcium

62
Q

Distribution in OAs

A

loss of protein-binding sites leads to increased free drug which leads to increased chance for ADR

63
Q

OAs experience a loss of body water…

A

and water-soluble drugs become more concentrated in the body

64
Q

OAs have increased body fat, so…

A

the amount of lipid-soluble drugs is absorbed into fat causing decrease in desired drug effect

65
Q

hepatic blood flow decreased in OAs…

A

by 40-50%

66
Q

drug clearance by hepatic metabolism is affected more in…

A

OA males than females

67
Q

liver dysfunction in OAs leads to…

A

decrease enzyme function which leads to decreased liver ability to metabolize and detoxify

-risk of drug toxicity

68
Q

______ and ______ is decreased in OAs, affecting blood flow to the liver and kidneys

A

cardiac output and blood flow

69
Q

after 65 yrs old, nephron…

A

function may decrease by 35%

70
Q

after 70 yrs old, blood flow….

A

to kidneys decreases by 40%

71
Q

With OAs, serum creatinine may be within normal values because….

A

lack of muscle mass, but there still could be decrease in renal function

72
Q

normal CRcl for OA

A

80-130 mL/min

Pharm Exam 1 (5 decks)

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