Pharmacology Chapter 3
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| A neonate is how old? | person younger than 1 month of age; new born infant
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| What is diffusion? | the passive movement of a substnace between different tissues from areas of higher concentration to areas of lower concentration.
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| What is active transport? | the active (energy-requiring) movement of a substance between different tissues va biomolecular pumping mechanisms contained with cell membranes.
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| What is the difference between diffusion and active transport? | active transport requires energy where as diffusion is a passive process.
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| What are the 4 main lifespan considerations? | 1)pregnancy 2)breast-feeding 3)neotatal and pediatric 4) elderly
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| Which trimester is the peroid of greatest danger for drug-induced developmental defects? | First trimester
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| How do drugs cross the placenta? | diffusion
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| During what trimester does the greatest percentage of maternally absorbed drug get to the fetus? | 3rd trimester
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| What are the pregnancy saftey categories? | Category A,B,C,D,X
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| Category__________ studies indicate no risk to human fetus. | category A
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| Category_________ has possible fetal risk in humans reported; however, consideration of potential benefit vs risk may warrent use of these drugs in pregnany women. | category D
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| Category _____ studies indicate no risk to animal fetus; info for humans not available. | category B
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| Category_____ adverse effects reported to animal fetus, information for humans is not available. | category C
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| Category_____ has fetal amnormalities reported and positive evidence of fetal risk in humans available from animal and human studies. These drugs should not be given to pregnant women. | category X
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| Breast-fed infants are at risk for exposure to drugs consumed by the mother. True or False? | True
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| For what age is the word child/pediatric used? | 1 years to 12 years of age
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| What does a nomogram do? | a graphic tool for estimating drug dosages using various body measurements.
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| Polypharmacy is? | the use of many different drugs concurrently in treating a patient, who ofter has several health problems.
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| What age is a person who is elderly? | 65 or older
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| What is the risk-to-benefit ratio used for? | breast-feeding; the risks of transfer of maternal medication to the infant in relation to the benefits of continuing breastfeeding and the therapeutic benefits to the mother.
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| What are the pharmacokinetic changes in the neonate and pediatric pt. for absorbtion? | gastric pH less acidic, gastric emptying slowed, intramuscular absorbtion faster and irregular.
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| What are the pharmacokinetic changes in the neonate and pediatric pt. for distribution? | the younger the person, the greater the % of total body water which means lower fat content, decrease in protein binding, immature blood-brain barrier (more drugs enter the brain)
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| What are the pharmacokinetic changes in the neonate and pediatric pt. for metabolism? | liver immature, older children may have increased metabolism requiring higher doses than infants.
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| What are the pharmacokinetic changes in the neonate and pediatric pt. for excretion? | kidney immaturity affects glomerular filtration rate and tubular secretion, decreased perfusion rate of the kidneys many reduce excretion of drugs
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| What are some factors affecting pediatric drug dosages? | skin is thin and permeable, stomach lacks acid to kill bacteria, lungs have weaker mucus barriers, body temps less, hydration levels low, liver and kidneys are immature
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| what is the formula for the West monogram? | (height/weight) BSA of adult/BSA of child * adult dose= esimated child's dose
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| Weight should be set in kg or lbs for pediatric patients? | kg kilograms
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| What are the physiologic changes in the elderly patient? | cardiovascular, gastrointestinal,hepatic, renal
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| What are the pharmacokinetic changes in the elderly pt. for absorbtion? | gastric pH less acidic, gastric emptying slowed, movement through GI tract slowed, blood flow to GI tract reduced, use of laxatives accelerate GI mobility
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| What are the pharmacokinetic changes in the elderly pt. for distribution? | lower total body water %, increased fat content, decreased productio of proteins by the liver/results in decreased protein binding to drugs and increased circulation of free drugs
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| What are the pharmacokinetic changes in the elderly pt. for metabolism? | aging liver produces fewer microsomal enzymes, affecting drug metabolism, reduced blood flow to the liver
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| What are the pharmacokinetic changes in the elderly pt. for excretion? | decreased glomerular filtration rate, decreased # of intact nephrons
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| What are the problematic medication for the ELderly? | analgesics (NSAIDS and opoids), anticoagulants, anticholinergics, antidepressants, antihyertensives,cardiac glycosides,sedatives, thiazide diuretics
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| What is the predicted % of the population over 65 in 2020? | 20%
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| What type of medication has the symptoms of "I get dizzy when I stand up and I nearly fainted when I stood"(also her systolic BP dropped 15 pts when she stood)? | antihypertensives
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| What is one of the main differences in pediatric vs adult that a nurse should watch out for before giving a drug to the patient? | Infants have water composition of approx 75% (which means less fat)
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