Principles in Geriatric and Pediatric Pharmacology Flashcards

1
Q

In a patient with decreased clearance of a drug, the loading dose ____________ and the maintenance dose ________________.

A

stays the same; decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The fluoroquinolones are excreted ____________.

A

renally (after being metabolized by the liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The macrolides are metabolized _______________.

A

by the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In general, the volume of distribution ___________ with age.

A

decreases for hydrophilic molecules (because the lipid portion of the body increases) and increases for hydrophobic molecules (same)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which enzyme converts acetaminophen to its toxic metabolite?

A

2E1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Discuss how the ability to conjugate drugs changes from birth to adulthood.

A
  • Birth: able to sulfate and glycine conjugate drugs at birth
  • Acetylation and glucuronide conjugation develop by 2-3 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In general, ____________ clearance is less variable in children and is more rapid than in adults.

A

renal

In fact, some drugs needed to be given at increased doses in children because of renal clearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Because of Reye syndrome, ____________ is not offered in liquid solution.

A

aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In a kid younger than 12, give _____________ for atypical pneumonia.

A

azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Absorption is generally only different for those younger than _____________.

A

one year, especially during the first 30 days of life

The decreases in absorption in the elderly are not usually of clinical significance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Explain how the changes in body composition change the volume of distribution over age.

A

In general, the volume of distribution is not altered by changes in body composition; thus, loading dose should remain roughly the same.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why does chloramphenicol lead to gray baby syndrome?

A

It cannot be effectively cleared by the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe how pharmacokinetics changes with age.

A

In general, the effects of drugs at receptors changes very little and the serum concentration needed to have an effect does not change either.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is body area measured?

A

In general, only when the dose of a drug needs to be extremely controlled (such as with chemotherapy).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is mixing liquid medicines into formula not recommended for babies?

A

Babies might not consume the entire bottle, so the dose will be incomplete.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Corticosteroids can suppress ______________.

A

growth via inhibition of growth hormone release at the pituitary

17
Q

As we age, our stomachs tend to be ____________.

A

less acidic (this leads to increased absorption of basic drugs and decreased absorption of acidic drugs) and have less motility

18
Q

Phase _______ metabolism decreases with age.

A

I (phase II metabolism is usually unaffected)

Note: this is why oxazepam and lorazepam are preferred over chlordiazepoxide and diazepam –O and L are metabolized by phase II reactions!

19
Q

Some phase I metabolic enzymes are not at adult levels until _____________.

A

the teens

20
Q

If a drug has a higher volume of distribution in the elderly –like, for instance, diazepam –then you may need to adjust the ____________.

A

loading dose upward (because increased Ld is required for increased Vd)