Pharmacogenomics and considerations for age

Question 1

What is pharmacogenomics?

Answer 1

Pharmacogenomics is the study of how genetic variations can effect individuals responses to a drug

Question 2

What is the most common genetic variant?

Answer 2

Genetic variants the affect drug metabolism

Question 3

What are some other genetic variants?

Answer 3

Variants that alter drug receptors which can vary drug response and variants that affect the immune system that increase the risk of hypersensitivity

Question 4

When does gastric pH reach adult levels?

Answer 4

20-30 months

Question 5

What is a consideration for absorption with topical administration of medications for children?

Answer 5

They have thinner skin and a large surface area which makes the medication more easily absorbed, will need to decrease doses from adult dosing

Question 6

What is consideration for with PO administration of medications for children?

Answer 6

Kids have an increased intestinal motility thus limiting their absorption, liquids are preferred as they are faster with absorption then breaking down of pills

Question 7

What is a consideration for infants in regards to any drug therapy?

Answer 7

They have lower plasma levels which can increase drug levels in the blood and increase toxicity risk

Question 8

When does renal function reach adults levels in children?

Answer 8

9 months

Question 9

When does liver function reach adult levels in children?

Answer 9

Puberty

Question 10

What affect does the pharmacokinetics of children have in dosing

Answer 10

In general, pedi patients will need lower doses due to the immature body systems that will affect all areas of pharmacokinetics

Question 11

What is the primary issue in regards to drug therapy in the elderly population?

Answer 11

Polypharmacy

Question 12

How is absorption changed in the elderly population?

Answer 12

There is no change in absorption with the elderly population?

Question 13

How is metabolism changed in the elderly population?

Answer 13

Metabolism is slowed in the elderly population and normally requires lower doses due to the increased drug half-life

Question 14

How is distribution changed in the elderly population?

Answer 14

The elderly often have lower serum albumin which can slow the distribution of a drug and create more free drug in the body and promote toxicity

Question 15

How is excretion changed in the elderly population?

Answer 15

Kidney function is generally slowed due to kidney impairment in the elderly and can cause an increased time for drug clearance, drugs many need to be renally dosed due to the renal impairment in the elderly population

Question 16

What is a common pharmacodynamic change that occurs in the elderly population?

Answer 16

They have a decreased homeostatic mechanism that can reduce their likelihood of developing fevers, thus when they do develop fevers, it a severe infection

Question 17

What population is most likely to suffer from adverse effects of medications?

Answer 17

The elderly population (>65 years old)

Question 18

What is a tool to prevent adverse effects in the elderly population?

Answer 18

A complete medication list review at least every 6 months

Question 19

What is a tool that can be utilized in prescribing medications to the elderly?

Answer 19

The BEERs criteria can help weigh the risk/benefit of drugs in the elderly population