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NUR 2060 (Pharmacology)- Biopsychosocial lect - EXAM 1 CONTENT (2)
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NUR 2060 (Pharmacology)- Biopsychosocial lect - EXAM 1 CONTENT (2)
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NUR 2060 (Pharmacology)- Biopsychosocial lect -EXAM 1 CONTENT
ADRs during pregnancy - ANS--Teratogenesis/birth defects
-uterine stimulation (prostaglandins)
-uterine suppression (aspirin late)
-drug-dependent infant (wean)
-respiratory neonate suppression (CNS meds)
By what age are most organs approximate to maturity of adults? - ANS-1 year old
Causes of Complications in Older Adults - ANS--multiple meds
-complex regimines
-noncompliance
-OTC drug interactions (herbals too)
-multiple prescribers
-expense
-cognitive alterations (dementia - forgot)
Describe effects to blood brain barrier with giving drugs to neonate/infants... - ANS-immature
CNS which increases susceptibility to drugs that affect the CNS
Describe fat soluble and water soluble drug distribution in geriatric patients... - ANS--fat soluble
drugs= distributed widely & long residual effects
-water soluble drugs= higher concentration due to low total body water
Describe metabolism and excretion of drugs in neonate/infants... - ANS-metabolism and
excretion is low so dosages are lower
-hepatic drug metabolism: liver immature
-renal drug excretion: kidneys immature
Describe protein binding with giving drugs to neonate/infants... - ANS-1. albumin levels are
lower in neonates/infants
2. endogenous compounds (i.e. fatty acids, bilirubin) compete with drugs for available binding
sites
(increased free drugs in blood)
Describe transdermal absorption in neonates/infants... - ANS-Transdermal is rapid and
complete (toxicity risk)
, Discuss GI absorption in neonates/infants... - ANS--may be increased or decreased
-Gastric emptying prolonged and gastric ph is very low which leads to increased absorption of
some (stomach, acid labile) -decreased of others (intestine)
-absorption is erratic (unpredictable)
Embryonic period (week 3-week 8) - ANS-Stage of fetal development where:
-increased risk for gross malformation
FDA early attempts at Risk Management - ANS-earlier attempts included:
-use of patient package inserts
-med guides
-restricted access programs
-classification of drugs as controlled substances
Fetal period (week 9-term) - ANS-Stage of fetal development where:
-increased risk for behavioral & developmental effects
Food and Drug Administration Amendments Act (2007) - ANS-gave the FDA authority to subject
drugs to new risk identification and communication strategies, called Risk Evaluation and
Mitigation Strategies (REMS), in the postmarketing period
In geriatric patients, most drug sensitivity is related to... - ANS-organ system degeneration
Patient/Family Teaching - ANS--Drug name(s) & therapeutic category
-Dose
-Schedule (chart may help)
-Route & technique of administration
-Expected therapeutic response & when it should develop
-Nondrug measures to enhance therapeutic effect
Patient/Family Teaching (con't) - ANS--Duration of Tx
-Method of drug storage
-Symptoms of major ADRs & measures to minimize discomfort & harm
-Major drug-drug & drug-food interactions
-Who to contact when: therapeutic failure, severe ADRs, severe adverse interactions
Pediatric drug-metabolizing capacity is markedly elevated during what age? How do you fix the
doses in this population? - ANS--ages 1-2, (then gradually declines)
-increase dose, or decrease interval (aka increase frequency)
Risk Minimization Action Plans (RiskMAPS) in 2005 - ANS-FDA only had the authority to
mandate postmarketing "commitments" from drug manufacturers before the drug was approves;
"could not be enforced" after the drug was approved
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