Patient Specific Factors

Question 1

Neonate

Answer 1

0-28 days

Question 2

Infant

Answer 2

1 month - 1 year

Question 3

Child

Answer 3

1 year - 12 years

Question 4

Adolescent

Answer 4

12-18 years

Question 5

Elderly

Answer 5

> 65 years

Question 6

Very elderly

Answer 6

> 80 years

Question 7

Young old

Answer 7

65-74

Question 8

Old

Answer 8

75-84

Question 9

Old Old

Answer 9

85-94

Question 10

Oldest Old

Answer 10

> 95

Question 11

Pediatrics Gastric pH

Answer 11

Decreased acidity (increased pH) 
More drugs make it to the intestine intacts

Question 12

Pediatric Gastric emptying time

Answer 12

Delayed in newborns

Question 13

Geriatrics pH

Answer 13

Increased pH (decreased acidity)

Question 14

Geriatrics GI emptying time

Answer 14

Delayed

Question 15

Geriatrics absorption changes

Answer 15

Tmax is increased
AUC is unchanged
Decreased F
Same exposure, peak just won’t occur as quickly

Question 16

Pediatrics Distribution

Answer 16

Newborn = less body water –> give less fat soluble drugs and more water soluble drugs

Question 17

Neonate Protein, albumin, plasma globulin and alpha-1 acid glycoprotein are

Answer 17

Decreased

Question 18

Neonate unconjugated bilirubin and FFA are

Answer 18

Increased

Question 19

Neonate + High protein binding =

Answer 19

Lower dose bc more free drug

Question 20

Geriatric Distribution

Answer 20

Decreased total body water (decreased Vd of water drugs)
Increased fat content (increased Vd of fat drugs)
Decreased albumin and alpha-1 acid

Question 21

Pediatric Phase 1 Metabolism

Answer 21

3A4 50 %
2D6 25%
2C9/19
Rapid maturity of liver enzymes so the doses are changing in peds

Question 22

Glucuronidation adn acetylation in Peds

Answer 22

G: not matured
S: makes up for that

Question 23

Geriatrics Metabolism

Answer 23

Decreased liver size and BF
Decreased Phase I
Decreased clearance
Increased half-life

Question 24

Peds Elimination

Answer 24

Immature kidneys at birth

GFR is 10-20% when born but increases rapidly

Question 25

Geriatrics Elimination

Answer 25

Decreased kidney mass, GFR, renal BF | Increased half-life and increased exposure to toxic metabolites

Question 26

Acid production is greater in

Answer 26

men

Question 27

GI transit time is half that of ____ in ____

Answer 27

Half of women's in men

Question 28

Blood volume is greater in

Answer 28

Men | Hydrophilic Vd is higher`

Question 29

Fat % is greater in

Answer 29

women

Question 30

Phase I + Women

Answer 30

3A4 = more efficient | 1A2, 2E1 = less efficient

Question 31

Opiate sensitivity increased in

Answer 31

women

Question 32

Peds Dose Estimations based on

Answer 32

age, weight and BSA

Question 33

Adult/Ger Dose Estimations based on

Answer 33

age, kidney function and weight

Question 34

Males IBW

Answer 34

50 kg + 2.3 kg X inch > 5 ft

Question 35

Females IBW

Answer 35

45.5 kg + 2.3 kg X inch > 5 ft (-2.3 kg X inch > 5 ft)

Question 36

Adjusted body weight

Answer 36

IBW + 0.4 * (TBW-IBW)

Question 37

BSA

Answer 37

Square root of cm*kg/3600

Question 38

1 Pound = ___ kg

Answer 38

2.2

Question 39

1 inch = ____ cm

Answer 39

2.54