Chapter 3- Drug Action Across The Life Span Flashcards Preview

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Flashcards in Chapter 3- Drug Action Across The Life Span Deck (79):
0

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

True

1

Define genetics

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

2

What are important inheritances from genetics?

Metabolic pathways and susceptibility to illness

3

Define genome

The complete package of genetic coding of an organism

4

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

23 each

5

A large molecule named Deoxyribonucleic or DNA carries?

Genetic information

6

Genes are

Instructions that are contained in segments of DNA

7

Define polymorphism

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

8

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

Pharmacogenetics

9

What factors affect ADME?

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

10

Less than 38 weeks of gestation

Premature

11

0 to 1 month

Newborn or neonate

12

One to 24 months

Infant or toddler

13

3 to 5 years

Young Child

14

6 to 12 years

Older child

15

13 to 18 years

Adolescents

16

19 to 54 years

Adult

17

55 to 64 years

Older adult

18

65 to 74 years

Elderly

19

75 to 84 years

The aged

20

85 years or older

The very old

21

True or False
Man and woman do not respond to medications differently

False

22

Gender specific medicine is

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

23

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

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

24

Why are topical administration usually more effective in infants

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

25

Why do babies get diaper rash?

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

26

True or False
Inflammation increases the amount of drug absorbed

True

27

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

True

28

Chewable tablets should not be given to everyone even children who

Have loose teeth

29

What factors influenced GI absorption?

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

30

What is the pH for a premature infant?

A pH of 6 to 8

31

What is the pH of Full stomach

Five

32

True or False
A woman's stomach empty more slowly than a man

True

33

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

83%

34

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

60%

35

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

50%

36

Complete the sentence
As we age, lean body mass and total body water..

Decrease

37

Complete this sentence
As we age, total fat content...

Increases

38

What are some drugs that are highly fat soluble?

Antidepressants, phenothiazines, benzodiazepines, and calcium channel blockers

39

Complete the sentence
Drugs that are highly fat-soluble....

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

40

Give two examples of water-soluble drugs

Ethanol and aminoglycoside antibiotics

41

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

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

42

What disease states can lower albumin levels?

Reno failure, malnutrition, and cirrhosis

43

Define drug metabolism

The process whereby the body and activates medicine

44

What are the major pathways to drug metabolism

Enzyme systems that is found primarily in the liver

45

How does age affect the liver?

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

46

True or False
There are specific laboratory tests that are available for measuring liver function

False

47

Erythromycin, prednisolone, verapamil, and diazepam metabolize faster in

Women

48

What are the primary routes of drug excretion?

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

49

Define drug excretion

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

50

List other minor routes of excretion

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

51

What happens to the kidneys as the body ages?

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

52

Define therapeutic drug monitoring

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

Which assay is commonly used for drug concentration?

Blood serum samples

54

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

To ensure that the drugs are within an appropriate therapeutic range

55

What must be adjusted to ensure therapeutic serum concentration

Dosage and frequency of administration

56

List all the conditions that therapeutic drug monitoring is routine

Epilepsy, dysrhythmias, heart failure, and antimicrobal therapy

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

57

When would blood levels of drugs be measured?

If toxicity is suspected

58

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

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

List examples of parameters

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

60

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

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

61

Children are susceptible to dehydration from

Fever vomiting and diarrhea

62

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

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

63

Define polypharmacy

Multi drug therapy

64

Explain trough and peak

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

65

List the six rights

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

66

Two medications that have a narrow therapeutic window

Digoxin and gentamycin

67

What are the parameters for warfarin

Must know PT and INR

68

What is the INR for warfarin

2 to 3

69

What is the parameter for Heparin?

PTT

70

What is the PTT for heparin?

1 1/2 to 2 1/2 times control

71

Examples of renal function tests

BUN, Creatinine, and GFR

72

What are the parameters for Lovenox

Platelets. Hold if less than 100,000

73

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

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

74

List accurate methods of measuring oral liquid medication

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

75

Fill in the blank
The younger the individual the ____ the percentage of the total body water

Higher

76

Fill in the blank
Off label use of medication is____?

Legal

77

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

Longer

78

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

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