Lifespan Considerations
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| 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.
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| 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.
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| 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.
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| 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!
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| 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.
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| 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.
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| 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.
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| 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.
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