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Pharmacology > Chapter 3- Drug Action Across The Life Span > Flashcards

Chapter 3- Drug Action Across The Life Span Flashcards

0
Q

Define genetics

A

The study of how living organisms inherit the characteristics or traits of their ancestors

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1
Q

True or False
A person’s genetic composition serves as the basic foundation for all drug responses and their duration of action in the body through out the person’s lifetime

A

True

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2
Q

What are important inheritances from genetics?

A

Metabolic pathways and susceptibility to illness

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3
Q

Define genome

A

The complete package of genetic coding of an organism

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4
Q

How many chromosomes are donated by the biologic mother and father?

A

23 each

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5
Q

A large molecule named Deoxyribonucleic or DNA carries?

A

Genetic information

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6
Q

Genes are

A

Instructions that are contained in segments of DNA

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7
Q

Define polymorphism

A

Naturally occurring variations in the structures of genes and the instructions that they give the organism

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8
Q

The study of how drug response may vary according to Inherited differences is known as

A

Pharmacogenetics

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9
Q

What factors affect ADME?

A

Age, gender, organ function, drug therapy, and drug interactions

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10
Q

Less than 38 weeks of gestation

A

Premature

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11
Q

0 to 1 month

A

Newborn or neonate

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12
Q

One to 24 months

A

Infant or toddler

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13
Q

3 to 5 years

A

Young Child

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14
Q

6 to 12 years

A

Older child

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15
Q

13 to 18 years

A

Adolescents

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16
Q

19 to 54 years

A

Adult

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17
Q

55 to 64 years

A

Older adult

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18
Q

65 to 74 years

A

Elderly

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19
Q

75 to 84 years

A

The aged

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20
Q

85 years or older

A

The very old

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21
Q

True or False

Man and woman do not respond to medications differently

A

False

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22
Q

Gender specific medicine is

A

Science that studies differences in the normal function of man and woman and how people of each gender perceive and experienced disease

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23
Q

How can the absorption of medicines given by IM may be affected?

A

Differences in muscle mass, blood flow to muscles, and muscle activity in patients who are bedridden

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24
Q

Why are topical administration usually more effective in infants

A

The outer layer of skin is not fully developed so this skin is more hydrated and water-soluble drugs are absorbed more readily

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25
Q

Why do babies get diaper rash?

A

Plastic acts as an occlusive dressing that increase hydration of the skin. Water soluble drugs are absorbed more readily in hydrated skin

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26
Q

True or False

Inflammation increases the amount of drug absorbed

A

True

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27
Q

True or False?
Time release tablets, enteric-coated tablet, and sublingual tablets should not be crushed because it will increase absorption and potential for toxicity

A

True

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28
Q

Chewable tablets should not be given to everyone even children who

A

Have loose teeth

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29
Q

What factors influenced GI absorption?

A

Gastric pH, gastric emptying time, motility of the G.I. tract, enzymatic activity, blood flow of the mucous lining of the stomach and intestines, permeability and maturation of mucosal membranes and concurrent disease process

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30
Q

What is the pH for a premature infant?

A

A pH of 6 to 8

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31
Q

What is the pH of Full stomach

A

Five

32
Q

True or False

A woman’s stomach empty more slowly than a man

A

True

33
Q

What is the total body water content of a preterm infant?

A

83%

34
Q

What is the total body water content Of an adult man?

A

60%

35
Q

What is the total body water content of an older adult person?

A

50%

36
Q

Complete the sentence

As we age, lean body mass and total body water..

A

Decrease

37
Q

Complete this sentence

As we age, total fat content…

A

Increases

38
Q

What are some drugs that are highly fat soluble?

A

Antidepressants, phenothiazines, benzodiazepines, and calcium channel blockers

39
Q

Complete the sentence

Drugs that are highly fat-soluble….

A

Require a longer onset of action and accumulate in tissue, prolonging their action and increasing the potential for toxicity

40
Q

Give two examples of water-soluble drugs

A

Ethanol and aminoglycoside antibiotics

41
Q

Why must highly fat-soluble medicines be given in smaller dosage to low birth weight infants?

A

Because there is less fat tissue to bind the drug, leaving more drug to be active at receptor sites

42
Q

What disease states can lower albumin levels?

A

Reno failure, malnutrition, and cirrhosis

43
Q

Define drug metabolism

A

The process whereby the body and activates medicine

44
Q

What are the major pathways to drug metabolism

A

Enzyme systems that is found primarily in the liver

45
Q

How does age affect the liver?

A

Liver weight, the number of functioning hepatic cells and hepatic bloodflow decreases with age

46
Q

True or False

There are specific laboratory tests that are available for measuring liver function

A

False

47
Q

Erythromycin, prednisolone, verapamil, and diazepam metabolize faster in

A

Women

48
Q

What are the primary routes of drug excretion?

A

The renal tubes into the urine and the G.I. tract into the feces

49
Q

Define drug excretion

A

When the metabolites of drug and sometimes the active drug itself are eventually excreted from the body

50
Q

List other minor routes of excretion

A

Evaporation through the skin, exhalation from the lungs, and secretion into the saliva and breastmilk

51
Q

What happens to the kidneys as the body ages?

A

Decreased renal bloodflow caused by arteriosclerosis and reduced cardiac output, a loss of glomeruli, and decreased tubular function and concentrating ability

52
Q

Define therapeutic drug monitoring

A

The measurement of a drugs concentration and biological fluids to correlate the dosage administered and the level of medicine in the body with the pharmacologic response

53
Q

Which assay is commonly used for drug concentration?

A

Blood serum samples

54
Q

Why is therapeutic drug monitoring and essential in neonates, infants and children?

A

To ensure that the drugs are within an appropriate therapeutic range

55
Q

What must be adjusted to ensure therapeutic serum concentration

A

Dosage and frequency of administration

56
Q

List all the conditions that therapeutic drug monitoring is routine

A

Epilepsy, dysrhythmias, heart failure, and antimicrobal therapy

To prevent toxicities and ensure that dosages are adequate to provide appropriate therapeutic levels

57
Q

When would blood levels of drugs be measured?

A

If toxicity is suspected

58
Q

How does one test the blood level of a drug for therapeutic monitoring?

A

One sample is drawn immediately before the next dose is to be administered to obtain the trough. Another is drawn 20 minutes after the medicine has been administered via IV or 60 minutes after the medicine have been administered orally to obtain the peak

59
Q

List examples of parameters

A

Expected therapeutic actions, expected side effects, reportable adverse effects, probable drug interactions, laboratory results, vital signs

60
Q

What is the nurse expected to do when a peak and trough for an medication has been ordered

A

The nurse must check the laboratory results in a timely manner and make sure that the prescriber is notified of the laboratory results

61
Q

Children are susceptible to dehydration from

A

Fever vomiting and diarrhea

62
Q

Why is it difficult to assess the therapeutic response to medicines administered to neonates, infants and young children?

A

These patients are often nonverbal or cannot tell us where it hurts

63
Q

Define polypharmacy

A

Multi drug therapy

64
Q

Explain trough and peak

A

Trough is before the next dose peak is after the med is given

65
Q

List the six rights

A

1) Right dose
2) Right drug
3) Right person
4) Right documentation
5) Right time
6) Right route

66
Q

Two medications that have a narrow therapeutic window

A

Digoxin and gentamycin

67
Q

What are the parameters for warfarin

A

Must know PT and INR

68
Q

What is the INR for warfarin

A

2 to 3

69
Q

What is the parameter for Heparin?

A

PTT

70
Q

What is the PTT for heparin?

A

1 1/2 to 2 1/2 times control

71
Q

Examples of renal function tests

A

BUN, Creatinine, and GFR

72
Q

What are the parameters for Lovenox

A

Platelets. Hold if less than 100,000

73
Q

If gastric emptying time increases what happens to the speed of absorption of a drug

A

The faster the empty time the less time the drug has to be absorbed therefore drug absorption is decreased

74
Q

List accurate methods of measuring oral liquid medication

A

Medicine cups, droppers provided with a specific medication, or oral syringes to measure liquid forms of oral medications accurately

75
Q

Fill in the blank

The younger the individual the ____ the percentage of the total body water

A

Higher

76
Q

Fill in the blank

Off label use of medication is____?

A

Legal

77
Q

Fill in the blank

Lipid soluble drugs have an affinity for fat tissue in the body and will often have a ___ half-life

A

Longer

78
Q

What is the safest method of initiating newly prescribed medications to a geriatric patient?

A

Drug dose should be initiated at 1/3 to 1/2 the normal adult dose. Therapeutic drug monitoring should be completed

Pharmacology (11 decks)

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