Flashcards in Lifespan Deck (45)
What are ways to reduce drug risks for people who are breastfeeding?
-Refer to Narrative Summary of benefits and risks of medication for use during pregnancy and lactation
-Decrease # of meds mom is on
-Utilize smallest dose possible
-Try to stick to meds safe for baby (otherwise pump and dump)
What categories determine the risk of a drug to a pregnant women and the baby?
Categories A,B, C, D and X
What are category A drugs?
Human trials have shown no risk to fetal development (don’t use much as drug trials don’t occur in pregnant women)
What are category B drugs?
In animals, drug showed no negative effects to developing fetus
What are category C drugs?
Show some risk to fetus, but benefits outweigh risk
What are category D drugs?
Should only be used in life-threatening situations due to possible significant consequences to fetus and the pregnancy in general
What are category X drugs?
Do pediatric patients respond differently to drugs than the rest of the population?
Are pediatric patients more sensitive to drugs?
Do pediatric patients show a great need for individualization?
What are pediatrics drug sensitivity mostly due to?
Are pediatric patients at a greater risk for ADRs?
Pediatric relationships with drugs changes as what?
They grow and develop
Are drug trials done on pediatric patients?
What is different in oral absorption of drugs with pediatrics?
Delayed gastric emptying for several months
What is different with absorption of intramuscular drugs and pediatrics?
It is delayed in first few days of life then faster in infants
What is different about percutaneous absorption in pediatrics?
Increased in infants
What is different in the distribution related to protein binding in pediatric patients?
A decrease in albumin levels due to immature liver = less binding site availability?
What is different in distribution related to the BBB of pediatrics?
Not fully developed= easy access for drugs causing an increase in CNS effects
What is different in metabolism of drug in pediatric patients?
-The drug metabolizing capacity of newborn is low
-Neonates =especially sensitive to drugs primarily eliminated by hepatic metabolism
When does the ability to metabolize drugs by hepatic metabolism occur in pediatric patients?
When do infants have complete liver maturation? (Plays a role in metabolism of drugs)
By 1 year
Is the ability to excrete drugs significantly reduced at birth?
Why is the ability to excrete drugs significantly reduced at birth?
-low renal blood flow
-low glomerular filtration
-low active tubular secretion
For pediatric patients drugs eliminated primarily by renal exception must be given how?
In reduced dosage and/or at longer dosing intervals
When are adult levels of renal function in pediatric patients achieved?
By 1 year
What is significant about the blood brain barrier (BBB) in pediatric patients?
Not fully developed, making it easier for drugs to effect CNS
(More risk for ADRs and toxicity)
What are changes in absorption related to geriatric patients?
-% of oral dose that is absorbed doe not change with age
-rate of absorption may slow
-delayed gastric emptying
Why does having an increased % of body fat and decreased % of lean body mass change the distribution of drugs in geriatric patients?
Body fat is a storage depot for lipid-soluble drugs