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Pharm Ch. 3

QuestionAnswer
What is active transport? the active movement of a substance between different tissues viabiomolecular pumping mechanisms contained within cell membranes
What is diffusion? the passive movement of a substance between different tissues from areas of higher concentration to areas of lower concentrations
Elderly? pertaining to a person who is 65 yrs or older
Neonate? pertaining to a person younger than 1 month of age
What is nomogram? a graphic tool for estimating drug dosages using various body measurements
What is pediatric? Pertaining to a person who is 12 yrs or younger
What is polypharmacy? The use of many diffterent drugs concurrently in treating a pt, who often have several health prob
Most of studies are focused on ages from? 13-65
Drugs affect differently of different sides of them? age spectrum
The first trimester of pregnacy? is the period of greatest danger of drug induced development defects
What are the 3 factors that contribute to the safety or potential harm of drug therapy during pregnancy? fetal gestational age, drug properties, and maternal factors
What are the drug properties that impact drug transfer to the fetus? drug's chemistry, dosage, and concurrently administered drugs
What are important drug dosage varaibles? dose and duration of therapy
the fetus is at greater risk for drug induced developmental defects during? the first trimester
During the last trimester the greatest percentage of maternally absorbed drug gets to the? fetus
Any change that in the mother's physiology that could impact the pharmacokinetic characteristics of drugs can affect? the amount of drug to which the fetus may be exposed
Maternal genotype may also affect how and to what extent certain drugs are? metabolized
Why is drug transfer to the fetus more likely during the last trimester? Because of enhaced blood flow to the fetus, increased fetal surface area, and increased amount of free drug in the mother's circulation
What does thalidomide do? induces birth defects
What is catagoy A of pregnancy safety categories? studies indicate no risk to human fetus
What is catagory B of pregnancy safety categories? Studies indicate no risk to animal fetus, no info for humans
What is catagory C of pregnancy safety categories? AE reported in animal fetus, information for humans is not available
What is catagory D of pregnancy safety categories? Possible fetal risk in humans reported but benifit vs. risk may be better
What is catagory X of pregnancy safety categories? Fetal abnomalities reported and positive evidence of fetal risk in humans available from animal or human studies, shoud not be used during pregnancy
Alot of drugs can also pass through? breast milk
Drug levels in breast milk are usually? lower than those in maternal circulation
Drug exposure from milk usually depends on? volume of milk consumed
The major drug problems in neonates are? immaturing of organs
The sensitivity of recptor sites also? vary with age
Rapidly developing tissues may be? more sensitive to certain drugs
Tetracycline does what? discolors young persons teeth
Corticosteroids may? suppress growth when given systemically
What can quinolone antibiotics do? damage cartilage
What are the charecteristis of pediatric pt's that effect dosage? skin is thinner, stomach lacks acid, lungs have weaker mucous barriers, body temp is less well regulated (dehydration), liver and kidneys are immature
Calculations invole? age, weight, and body surface area
To use the BSA method a nurse needs to know? drug order, info regarding dosage forms, pt's height and weight, BSA nomogram for children and recommended adult dose
A common source of medication error and potential toxicity is? confusiong lbs with kilograms
Elderly pt's have special needs because? of the decline in organ function
elderly today have how many meds? four or five prescription and two OTC
What is life expectancy? 78 yrs
More complicated drug regimine causes increased risk of what? medication errors
Elderly pt's are hospitalized frequently because of? adverse drug reactions
Some drugs may be given to stop AE of? other drugs
What is a prescribing cascade? Where you give another drug to stop AE of another
For elderly drug administration you should? "start low and go slow"
When giving meds to the elderly you should take into consideration? body weight and organ functioning
With emphasis on? (elderly) liver, renal, heart, and CNS
How is kidney function assessed? cratinine and blood urea nitrogen levels
The best way to determine creatinine levels is? collect a pt's urine
Liver function is assessed by? testing the blood for liver enzymes (AST and ALT)
Lab liver values should be done how often for elderly pt's? yearly
In the elderly there is a decrease in absoption of? nutrients and drugs
by the age 65 GI blood supply? decreased by 50%
What is GI motility good for? moving substances out of the stomach and for moving them throughout the GI tract
There is a gradual reduction of _____ _____ _____ with aging? total body water
Elderly pt's may have decreased? protein concentrations
reduced dietary intake and poor GI protein absorption can cause? nutritional deficiencies and reduced blood protein levels
Drugs that are not bound to proteins are? active
What are highly protein bound drugs include? warfarin and phenytoin
metabolism declines with? advancing age
The transformation of active drugs into inactive metabolites is primarily performed by? the liver
With age the liver? loses mass and loses its abiliy to metabolize drugs
There is also a reduction in blood flow to the liver because of? reduced cardiac output and atherosclerosis
reduction in the glomerular filtration rate combined with a reduction in CO leading to reduced renal perfusion can result in? delayed drug excretion and therefore drug accumulation
What drug has a low theraputic index? digoxin
What is the Beers criteria? a system used to identify drugs that may be inappropriatly prescribes, ineffective, or cause adverse drug reactions in elderly
Prescriber's orders should be? checked and rechecked
Dont ever say pediatric pt's are? small adults
What are studies that may be ordered by the prescriber before, after, or during drug therapy? Hepatic and renal functions, red and white blood cell count, and measurement of hemoglobin and hematocrit levels and serum protein levels
What is the brown bag technique? a way of collecting data about meds or drugs being taken by the elderly
What happens when using a brown bag technique? putting all meds in a bag
It is important to remember some elderly pt's may be? confused or poorly informed about meds or health care
Elderly may need the nurse to? speak slow, loud, and clear
A nurse should always assess what? support systems and the pt's ability to take meds safely.
With elderly people should choose _________ approach to reatment first if they can? nonpharmacologic
In younger pt's try to? mix medications with food, but not essential food, do not add drugs to fluids in a cup, document, add small amounts of water to elixers, do not use candy instead of med, keep all meds out of reach of children, always ask how they normally take meds
Elderly pt's should be informed that they should? take meds as directed, and do not double up
The nurse must? ensure that the pt and caregiver understant treatment, and med instructions
The nurse must know? pt's profile and history
Created by: alicia.rennaker
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