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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
Pregnancy category C
- animal studies indicate a risk to the fetus | - Risk v. Benefit must be determined
26
Pregnancy category D
risk to human fetus has been proven - risk v. benefit must be determined - it could be used in life threatening situations
27
Pregnancy category X
risk to human fetus has been proven | -risk outweighs the benefit
28
most common indications for use of medications during pregnancy
- nutritional supplements with iron - vitamins - minerals
29
herbal preparations are...
not generally recommended during pregnancy
30
RN who is providing care to children...
-must make certain adaptations in care both in administration of meds and the evaluation of the therapeutic and adverse effects of the meds
31
Pediatric variables that affect drug dosing
- age - weight - height - anatomical and physiological characteristics (organ maturing) - health status
32
Absorption is pediatrics
as they grow and develop, absorption of meds generally becomes more effective
33
Less developed absorption in neonates and infants.....
must be considered when dosing and administering drugs
34
Slowing absorption in adolescent years may be caused by...
- poor nutritional habits - changes in physical maturity - hormonal differences
35
absorption is initially influenced by...
route of administration
36
Period of life that is most affected by changes in absorption
-neonatal and infancy due to GI immaturity
37
irregular peristalsis associated with immaturity or symptoms of vomiting or diarrhea....
decreases absorption time
38
SubQ and IM routes...
absorption occurs at the tissue level
39
topical meds in pediatrics
- may be altered by the condition of the skin tissue - children's skin is thinner and more porous - absorption may be enhanced
40
Distribution in pediatrics
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
increased levels of extracellular fluids in children leads to...
increased tendency for children to become dehydrated and change the distribution of water-soluble medications
42
decreased body fat in...
neonates and young infants than in older children
43
metabolism in pediatrics
depends greatly on maturation level of the child and varies from child to child
44
less than 2 years old...
decreased levels of hepatic enzymes and results in slower metabolism of medications
45
hepatic metabolic activity is lower in...
neonates and matures at age 1 to 2
46
children inherently have...
higher metabolic rates than adults | -metabolism occurs more rapidly
47
due to higher metabolic rates in children than adults, medication...
requirement may be higher than in adults
48
GFR
test used to check how well the kidneys are working
49
children and half-lives
half-life of medication may be different in children
50
children medication is usually ordered like...
"a dose per unit of weight"
51
key issue when administering medication to children
- confirming identification of patient | - most effective: armband
52
primary concern when administering meds to infants
- maintaining safety with minimum restraint necessary - administering correct dosage - providing care with as much comforting as possible
53
most pediatric medications are...
-oral by syringe
54
polypharmacy
administration of many drugs together
55
polypharmacy more common in OAs because...
1. multiple providers 2. herbal therapy 3. OTC meds 4. discontinued prescription drugs
56
polypharmacy can cause.....
confusion, falls, malnutrition, renal and liver dysfunction, and nonadherence
57
absorption in OAs
slowed due to decreased blood flow and GI motility
58
acidic drugs are...
poorly absorbed because increased alkaline gastric secretions
59
enteric-coated tablets dissolved in alkaline fluid can...
break down more rapidly
60
with OAs, drugs...
stay in GI tract longer due to decreased GI motility which leads to delayed onset
61
_________ and ________ may not be absorbed as readily in OAs
iron and calcium
62
Distribution in OAs
loss of protein-binding sites leads to increased free drug which leads to increased chance for ADR
63
OAs experience a loss of body water...
and water-soluble drugs become more concentrated in the body
64
OAs have increased body fat, so...
the amount of lipid-soluble drugs is absorbed into fat causing decrease in desired drug effect
65
hepatic blood flow decreased in OAs...
by 40-50%
66
drug clearance by hepatic metabolism is affected more in...
OA males than females
67
liver dysfunction in OAs leads to...
decrease enzyme function which leads to decreased liver ability to metabolize and detoxify -risk of drug toxicity
68
______ and ______ is decreased in OAs, affecting blood flow to the liver and kidneys
cardiac output and blood flow
69
after 65 yrs old, nephron...
function may decrease by 35%
70
after 70 yrs old, blood flow....
to kidneys decreases by 40%
71
With OAs, serum creatinine may be within normal values because....
lack of muscle mass, but there still could be decrease in renal function
72
normal CRcl for OA
80-130 mL/min

Pharm Exam 1 (5 decks)

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