Safe Administration of Drugs throughout the Life Cycle

Question 1

What are the 4 phases of lifespan changes that have dramatic pharmacokinetic changes?

Answer 1

Pregnancy
Newborn
Pediatric
Older Adult

Question 2

Drugs cross the placenta by

Answer 2

diffusion

Question 3

What are factors affecting safety with drug therapy during pregnancy?

Answer 3

Drug Properties (chemistry, dosage, concurrently administered drugs)
Fetal gestational age
Maternal Factors

Question 4

In the first trimester, the fetus is at the greatest risk for

Answer 4

drug-induced developmental defects

Question 5

In the first trimester, what is developing at their most rapid rate?

Answer 5

Skeleton, muscle, limbs, and visceral organs

Question 6

What should you NOT do during drug therapy in your first trimester of pregnancy?

Answer 6

Self treatment of illness

Question 7

In the third trimester of pregnancy, what is a concern during drug therapy?

Answer 7

The greatest percentage of maternally absorbed drug gets to the fetus

Question 8

Any change in the mom’s physiology can

Answer 8

affect the amount of drug to which the fetus may be exposed to.

Example: Changes in liver and kidney functions

Question 9

The FDA does not have safety categories. INSTEAD, drug manufactures must

Answer 9

identify specific risks in PREGNANCY and BREASTFEEDING.

Question 10

What are the three subsections in the prescribing phase for pregnancy labeling information?

Answer 10

Pregnancy
Lactation
Female and Males of reproductive potential

Question 11

Breastfed infants are at risk for

Answer 11

exposure to drugs consumed by the mother

Question 12

Drug levels in breast milk are usually

Answer 12

lower than those in the maternal circulation

Question 13

What should you consider regarding drug therapy while breastfeeding?

Answer 13

Risk-to-benefit ratio

Question 14

Infants and children generally require

Answer 14

lower doses than adults. (Duh, they are smaller)

Question 15

Pediatric patients handle drugs much differently because

Answer 15

of the immaturity of their vital organs.

Question 16

What category is between BIRTH and 1 MONTH of age?

Answer 16

Neonate

Question 17

What category is between 1 MONTH and 12 MONTHS of age?

Answer 17

Infant

Question 18

What category is between 1 and 12 YEARS of age?

Answer 18

Child

Question 19

In pediatrics, altered maturity of organs can

Answer 19

affect drug dosage

Question 20

In pediatrics, Tetracycline may

Answer 20

permanently discolor teeth

Question 21

In pediatrics, system steroids may

Answer 21

suppress growth

(think of smol peepee)

Question 22

In pediatrics, Gastric pH is less acidic until

Answer 22

1 to 2 years of age

Question 23

In pediatrics, Gastric emptying slowed can affect

Answer 23

absorption in neonate and pediatric patients

Question 24

In pediatrics, What route of drug administration is faster and irregular?

Answer 24

Intramuscular

Question 25

In pediatrics, Greater total body water means

Answer 25

lower fat content (when talking about dosing lower because of distribution)

Question 26

What alters metabolism and excretion of drugs in pediatrics?

Answer 26

Immature liver and kidneys

Question 27

In pediatrics, what causes more drugs to enter the brain which then alters metabolism and excretion?

Answer 27

Immature blood brain barrier

Question 28

Factors Affecting Pediatric Drug Dosages: Skin is

Answer 28

thin and permeable

Question 29

Factors Affecting Pediatric Drug Dosages: Stomach

Answer 29

lacks acid to kill bacteria

Question 30

Factors Affecting Pediatric Drug Dosages: Body temperatures

Answer 30

less well regulated and dehydration occurs easily

Question 31

Factors Affecting Pediatric Drug Dosages: Liver and kidneys are

Answer 31

immature, impairing drug metabolism and excretion

Question 32

In pediatrics: ALWAYS CONSIDER

Answer 32

organ maturity

Question 33

What are 4 methods of dosage calculations in pediatric patients?

Answer 33

Body surface area method Always use weight in KILOGRAMS Always use CENTIMETERS Body weight dosage calculations

Question 34

What is the most commonly used body weight dosage calculation in pediatrics?

Answer 34

mg/kg Example: 30mg/kg, patient weighs 20kg They would get 600mg

Question 35

What occurs with advancing age?

Answer 35

Decline an organ function

Question 36

Drug therapy in OLDER adults is most likely to result in

Answer 36

Adverse effects and toxicity

Question 37

Who is considered an older adult?

Answer 37

Age 65 years and older

Question 38

What percentage of older adults is on at least one medication?

Answer 38

87%

Question 39

What percentage of older adults is on at least five medication's

Answer 39

36%

Question 40

With older adults, taking multiple medication's can

Answer 40

Increase the risk of drug interactions

Question 41

What is the term used for simultaneous use of multiple medications?

Answer 41

Polypharmacy

Question 42

What is important to educate the patient or caregiver when dealing with poly pharmacy?

Answer 42

The dangers of multiple drug use

Question 43

More complicated medication regimens with older adults can

Answer 43

Predispose the patient to self medication errors

Question 44

Older adults gastric pH is

Answer 44

Less acidic and gastric emptying slowed

Question 45

In older adults, blood flow to the

Answer 45

G.I. tract reduced and absorptive surface reduced (which results in decreased absorption and distribution)

Question 46

In older adults, what can affect medication distribution in the body?

Answer 46

Lower total body water percentages and increase fat content.

Question 47

Older adults, decrease in total body, water leads to

Answer 47

Decrease distribution of some drugs, as antibiotics may lead to risk of toxicity

Question 48

In older adults, decreased production of proteins by the liver results in

Answer 48

Decreased protein binding of drugs, which increases circulation of free drugs

Question 49

Older adults, microsomal enzymes are decreased due to

Answer 49

Decrease production by the aging liver

Question 50

Older adults, liver blood flow is reduced, which decreases

Answer 50

Hepatic metabolism

Question 51

An older adults, decreased metabolism, leads to

Answer 51

Potential for drug toxicity

Question 52

In older adults, glomerular filtration is decreased by

Answer 52

40 to 50% (which affects excretion of drugs)

Question 53

An older adult is difficult for drugs to be excreted due to

Answer 53

Decrease blood flow and number of intact nephrons are decreased

Question 54

An older adults drugs are cleared less effectively because of

Answer 54

Decreased excretion

Question 55

What is an important indicator of renal function?

Answer 55

Creatinine clearance

Question 56

An older adults, if creatinine clearance is abnormal

Answer 56

Drug dosages may need to be adjusted

Question 57

What are two pediatric considerations for safe medication administration?

Answer 57

Mixing medication's to disguise, the taste and age-appropriate terminologies for the child

Question 58

What are five safety considerations with pediatric patients and medications?

Answer 58

Avoid oral aspiration, injury with injections, teach parents about the medication, alert, parents for any side effects, and keep all medication's out of the reach of children

Question 59

What are four steps to take if there's a poisoning in the home?

Answer 59

Poison prevention, education is essential, do not induce vomiting, do not use home activated, charcoal, and if poisoning occurs, call the poison control center or 911

Question 60

What are older adult considerations for safe administration of medication's?

Answer 60

Take as directed, do not double up doses, or discontinue without guidance from a prescriber

Question 61

What did you take into consideration prior to teaching an elderly patient about medication's?

Answer 61

1. Appropriate time – not in pain & not tired 2. Prepare the patient before teaching  Glasses  Hearing aid 3. Private, comfortable & quiet, well-lit environment 4. Keep lesson clear & brief 5. Allow for questions, feedback & return demo 6. Provide handouts to reinforce information

Question 62

To promote compliance when teaching an elderly patient, you should

Answer 62

Assess knowledge deficit, assess any confusion, concerning drugs, financial concerns, or how they can pay for meds