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PNM300 Week 3 Study Set Exam
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PNM300 Week 3 StudySet Exam
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
- other factors: liver enzymes production, genetic differences, and substances to which
the mother may have been exposed during pregnancy
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
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