TBL1

Question 1

pharmacodynamic tolerance

Answer 1

gradually needing more dosing to get same level of effectiveness

Question 2

metabolic tolerance

Answer 2

body metabolizing drugs differently, increased

Question 3

tachyphylaxis

Answer 3

response decreases with repeated dosing

Question 4

placebo

Answer 4

reaction based on psychological response; “power of mind”

Question 5

describe how these individual variations can affect response to drugs: kidney disease, liver disease, genetics, diet

Answer 5

kidneys: decreased excretion - accumulates - monitor GFR
liver: decreased metabolism
genetics: people have certain genes that can affect metabolism
diet: healthful diet can promote therapeutic response; poor diet does the opposite; starvation can impact protein binding

Question 6

factors that influence patient adherence to medication therapy

Answer 6

manual dexterity, cognitive abilities, intellectual abilities, cost of drugs, attitudes towards drugs, drug-drug and drug-food interactions

Question 7

physiological changes that occur during pregnancy that impact the pharmacokinetics of a drug

Answer 7

kidneys: increased perfusion (increases excretion)
liver: increase perfusion (increases metabolism)
decrease tone and motility of the GI tract (things slow down which increases absorption)

Question 8

when do teratogens have the most impact on fetus in terms of development? why?

Answer 8

1st trimester - organ development occurring

Question 9

impact of teratogens on a fetus depends on what factors?

Answer 9

timing, amount, frequency of drug ingested

Question 10

how can we minimize risk to infant during breastfeeding in regards to drugs?

Answer 10

• take drugs immediately after breastfeeding
• choose drugs that have a long half life
• choose drugs that don’t penetrate into milk (ones with low molecular weight penetrate; ex: ETOH)
• choose drugs that are not a known harm to infants

Question 11

what age are pediatrics most at risk for ADRs? why?

Answer 11

birth until 1 year - organs are immature until this point

Question 12

how do we adjust drug dosing for children? which method is most accurate?

Answer 12

based on weight or body surface area (most accurate)

Question 13

what type of absorption is much greater in children?

Answer 13

topical

Question 14

how can we promote med adherence in children?

Answer 14

• make it taste good :)
• education and demonstration
• ensure caregivers have proper measurement system
• system for multiple caregivers

Question 15

describe physiological changes in older adults that impact response to drugs

Answer 15

• decreased organ function (kidneys and liver)
• decreased muscle mass
• increased body fat
• decreased GI motility and delayed gastric emptying (slowed down so more drug absorbed)

Question 16

factors that impact ADRs in older adults

Answer 16

• polypharmacy
• declining organ function
• co-morbidities

Question 17

factors that promote med adherence in older adults

Answer 17

• easy open bottles
• simplified system / plan
• reminder system
• clear instructions