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Lifespan Considerations

Describe the pharmacokinetic changes in oral absorption in the neonate. Oral: absorption increases when drugs are absorbed in the stomach (due to gastric emptying time) while drugs that are absorbed from the intestines are delayed. Absorption of acid-labile drugs increases.
Describe the pharmacokinetic changes in the pediatric. Absorption, distribution and excretion is similar to that of adults. However, between age 1 and 2, metabolizing capacity increases - during this time an increase in dosage or decrease in interval needs to occur.
Describe the pharmacokinetic changes in absoption in the geriatric. Absorption rate slows due to delayed gastric emptying & blood flow. Different levels of gastric acidity may alter absorption of certain drugs, such as drugs that require high acidity to dissolve.
Describe the pharmacokinetic changes in IM and transdermal absorption in the neonate. IM: Absorption is slow & erratic due to low blood flow in the muscle. Transdermal: Absorption is more rapid bc the skin is thin & blood flow is greater in neonates. This = toxicity risk!
Describe the pharmacokinetic changes in distribution in the neonate. Overall, distribution increases. Due to limited protein binding, undeveloped blood-brain barrier and high TBW. Dosages must be reduced.
Describe the pharmacokinetic changes in metabolism in the neonate. Drug-metabolizing capacity is low. Neonates are especially sensitive to drugs metabolized in liver. Dosages must be reduced.
Describe the pharmacokinetic changes in excretion in the neonate. Renal blood flow, glomerular filtration, and active tubular secretion are all low. As a result drugs eliminated primarily by renal excretion must be given in reduced dosage and/or at longer intervals.
Identify the causes of polypharmacy in the elderly and recommendations to decrease the adverse effects of polypharmacy. Increased severity of illness, multiple pathologies and excessive prescribing. Decrease adverse effects through individualization of treatment, patient monitoring to look for any adjustments that should be made to the regimen.
Created by: kdanielah



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