Week 2 PNM300 Exam Study Guide.
Drug therapy during pregnancy - answer-Drugs cross the placenta by diffusion
-Factors affecting safety: drug properties, fetal gestational age, maternal factors
-FDA has implemented pregnancy safety categories
- any changes in the mother physiology can affect the...
Drug therapy during pregnancy - answer✔-Drugs cross the placenta by diffusion
-Factors affecting safety: drug properties, fetal gestational age, maternal factors
-FDA has implemented pregnancy safety categories
- any changes in the mother physiology can affect the amount of drug to which the fetus can be
exposed ( pg 5 of week 2 slides)
Drug Therapy During Breast-Feeding - answer✔Breastfed infants are at risk for exposure to
drugs consumed by the mother
Consider risk-to-benefit ratio (Pg8 of week 2 slides)
neonatal and pediatric considerations: pharmacokinetics/Absorption: - answer✔Absorption:
- Gastric PH less acidic until 1 to 2 years age
- gastric emptying slowed
- First-pass elimination reduced
- reduced bile salt formation decreased bioavailability
- intramuscular absorption faster and irregular
neonatal and pediatric considerations: pharmacokinetics/Distribution: - answer✔Distribution:
- Total body water differences result in increased distribution and dilution of water- soluble
drugs
-Greater total body water means lower fat content
- decreased level of protein binding
- immature blood - brain barrier means more drug enter the brain
neonatal and pediatric considerations: pharmacokinetics/ Metabolism: - answer✔Metabolism:
- liver immature; dose not produce enough microsomal enzymes
- older children may have increased metabolism, requiring higher doses or more frequent
administration than infants
neonatal and pediatric considerations: pharmacokinetics/ Excretion: - answer✔Excretion:
- Kidney immaturity affects glomerular filtration rate and tubular secretion
- decreased perfusion rate of the kidneys may reduce excretion
Factors affecting pediatric drug dosages - answer✔- Skin is thin and permeable.
- Stomach lacks acid to kill bacteria.
- Lungs have weaker mucus barriers.
- Body temperatures are less well regulated, and dehydration occurs easily.
-Liver and kidneys are immature, impairing drug metabolism and excretion.
Methods of dosage calculation for pediatric patients - answer✔1) body surface area method
2) always use weight in kilograms not pounds
3) always use height in centimeters, not inches
4) body weight dosage calculation ( use mg/kg)
Considerations for Older Adults patients - answer✔- older adults : older than age 65 years
- high use of medication
- polypharmacy and prescribing cascade
- nonadherence
- increased incidence of chronic illnesses
- sensory and motor deficits (pg14 on week 2 slides)
Older Adults: Pharmacokinetics: Absorption - answer✔-Gastric pH less acidic
-Gastric emptying slowed
-Movement through GI tract slowed because of decreased muscle tone and activity
-Blood flow to GI tract reduced
-Absorptive surface of GI tract reduced
Older Adults: Pharmacokinetics: Distribution - answer✔Lower total body water percentages
Increased fat content
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