09.11.1 Drug Metabolism

Front 1

Teratogens:
definition
examples

Back 1

Definition:
- things that will cause problem to embryonic stage in 1st trimester (1-7 weeks)
Examples:
- Thalidomide
- retinoic acid
- warfarin
- ethanol

Front 2

Toxic:
definition
examples

Back 2

definition
- causes problems in fetal stage in 8-38 weeks
examples
- morphine-> causes CNS depression
- atropine - > causes tachycardia

Front 3

drugs that pass in large amounts in breast milk

Back 3

- Tetracycline
- Barbiturates
- booze
- lithium
- radioiodine (chemo)

Front 4

Lethal:
definition
examples

Back 4

definition
- causes problems in pre-embrionic stage in 2 weeks
examples
- methotrexate (inhibits DNA synth)

Front 5

Grey baby syndrome:
symptoms
causes

Back 5

symptoms
- abdominal distension
- vomiting
- cyanosis (blue or purple skin from no oxygen)
- cardiovascular collapse
- irregular respiration
- death
causes
- immature UGTs (UDP-glucuronosyltransferase) in babies means they can't metabolize Chloramphenicol, which is toxic when built up

Front 6

baby's have:
water
fat
gastric pH
bile
integument

Back 6

more water (water soluble drugs get diluted)
less fat (lipophilic drugs get concentrated)
more gastric pH (more absorption of acid labile drugs)
lower bile (less absorption of lipophilic things)
immature integument (slower absorption rate)

Front 7

<2 month old child:
enzyme development
drug dose =

Back 7

enzyme development
- immature enzyme
drug dose =
- low dose based on response and monitoring

Front 8

2-6 month old child:
enzyme development
drug dose =

Back 8

enzyme development
- immature enzymes with significant activity
drug dose =
- adult dose*(infant weight/adult weight)

Front 9

>6 month old child:
enzyme development
drug dose =

Back 9

enzyme development
- mostly mature enzymes
for UGT or CYP2D6 drugs:
- drug dose = adult dose*(infant weight/adult weight)
for other drugs:
- drug dose = adult dose*(infant body surface area/adult body surface area)

Front 10

geriatrics patients process drug differently b/c:

Back 10

- decline in liver blood flow
- renal decline
- ageing doesn't affect clearance of phase I and II reactions

Front 11

pregnant patients process drug differently b/c:

Back 11

- higher blood volume, body mass, fat content
- higher renal output
- more liver blood flow

Front 12

drugs that get past placenta

Back 12

- most drugs unless they are big (>1000 daltons like antibiotics) or lipophobic
- placental absorption affected by things that alter blood flow (like beta-blockers/ tobacco)