Factors Modifying Drug Activity Flashcards Preview

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Flashcards in Factors Modifying Drug Activity Deck (22):
1

What are the factors in modifying drug activity?

Age
Weight
Sex
Pharmacogenetic
Drug Interactions
Effect of disease

2

What are some factors that specifically effect the elderly?

May absorb drugs less completely or more slowly because of dec splanchnic blood flow or delayed gastric emptying
Reduced gastic acidity
Hypoalbuminemia
Reduction in muscle mass
Qualitative changes in drug-binding sites
Reduced renal blood flow
Dec cardiac output

3

Which drug responses change with aging?

Changes in receptors
Changes in postreceptor signaling mechanism
Changes in homeostatic control
Disease-induced changes

4

What are some impaired homeostatic mechanism in the elderly?

Dec activity of arotic/carotid chemoreceptors
Reduced baroreceptor reflex
Impaired thermoregulation
Inappropriate response to blood glucose and insulin
Altered neurological control of bowel and bladder

5

What are some drug dispositions in peds?

Preterm infants
Term infants in 1 mo of life
1 mo to 2 yrs
2 ys to 12yrs
12 yrs to 18 yrs

6

What are limited in preterms that have drug issues?

Gfr's 1/10 of newborn
Limitation on tubular reabsoption
Glucuronidation pathway limited
Gastric acids not found or limited
Metabolism and elimination not active
Skin not totally protective
Dec plasma albumin and total plasma protein conc
Dec drug binding ability

7

Issue with drugs for term infants to 1 mo

Inc body water, dec body fat
Dec exocrine pancreatic function
Dec albumin conc and binding
CYP450 slow functioning
Phase 1 oxidation rxn reduced
High sulfate conjugation

8

Issues with drugs for 1 mo to 2 yrs

Rapid growth, things work pretty well

9

Issues with drugs for 2 yrs to 12 yrs

Drug clearance inc and exceeds adult levels
Shorter half-lives and dosing requirements are frequently greater

10

Issues with drugs for 12 yrs t 18 yrs

Sex changes
Dec drug absorption and elimination in female
Females less gastric acidity and inc gastric emptying
Estrogen dec CYP450 - dec phase I pathway

11

What should be done for children with chronic illness for drugs?

Possible inc of drug dosages like is CF who have inc hepatic metabolism (inc drug clearance)

12

Are most drugs given the peds used for the same things as adults?

Yes

13

What is example of a drug used for adults that is different for children?

Caffeine - used to treat apnea

14

What does tetracycline do in children it doesn't do in adults?

Discolors teeth

15

What are the factors used to calculate pediatric dose?

Age, weight, surface area
Should never exceed adult dose

16

What is the standard for therapeutic dose in humans?

70 kg adult

17

How does sex influence drug administration?

Hormonal difference
No real significant differences

18

Pharmacogenetics

Abnormal biotransformation or reaction to a drug due to a genetic difference (not defect)

19

Concomitant of drug therapy

Effect of one drug may be altered significantly by the administration of another drug
Can enhance or reduce therapeutic effects or toxicity

20

What is most likely the effects of time administration?

Inc enzyme activity during the day probably

21

What are some reason the pt does not comply?

Self-conscious
Reminded of disease
Does not feel sick
Adverse drug reactions (ADRs)

22

How can you inc compliance to take drugs?

What they are taking
Why its prescribed
Which ADRs might develop
What will occur if drugs aren't taken