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70 Cards in this Set

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Pregnancy Category A
no risk to fetus at any stage of pregnancy
Pregnancy Category B
No risk in animal studies, but no adequate studies in pregant women, or
risk shown in animal studies, but adequate studies have shown no risk to fetus
Pregnancy Category C
Animal studies show risk but no adequate studies in humans; benefits may be worth risk to pregnant woman, or
no animal, no human studies
Pregnancy Category D
evidence of human fetal risk; benefits may outweigh risks in pregnant women
Pregnancy Category X
studies show fetal abnormalities. The risks outweight any benefits to pregnant woman.
in pregnancy, reduced tone & motility of GI tract would effect what pharmacokinetc property of the mother...
Absorption
in pregnancy, altered secretion of HCl would effect what pharmacokinetc property of the mother...
Absoption
in pregnancy, weight gain would effect what pharmacokinetc property of the mother...
Distribution
in pregnancy, increase in intra/extra cell volume would effect what pharmacokinetc property of the mother...
Distribution
in pregnancy, increase in blood volume --> increase in kidney blood supply would effect what pharmacokinetc property of the mother...
Distribution, Excretion
in pregnancy, increase in plasma protein production would effect what pharmacokinetc property of the mother...
Distribution
in pregnancy, increase in competition for protein binding sites would effect what pharmacokinetc property of the mother...
Distribution
in a mother during pregnancy, changes in pharmacodynamic properties would effect....
effective dose-response
in a fetus, changes in placental metabolism and integrity would effect what fetal pharmacokinetic property?
Absorption, Distribution, Biotransformation
in a fetus, changes in umbilical blood flow would effect what fetal pharmacokinetic property?
Distribution
in a fetus, changes in an immature BBB would effect what fetal pharmacokinetic property?
Distribution
in a fetus, changes in an immature renal and hepatic system would effect what fetal pharmacokinetic property?
Biotransformation, Excretion
in a fetus, reduced plasma binding sites would effect what fetal pharmacokinetic property?
Distribution
in a fetus, the higher water-body mass ratio would effect what fetal pharmacokinetic property?
Distribution
Drugs may harm a fetus and the effects are different based on the stage of development. What are the stages?
a.ovum cell multiplication – fertilization to implant
b.embryonic period 2 to 8 weeks (cell differentiation and organogenesis)
c. fetal period 8 weeks to birth
Drug effects on neonates (newborns) from in utero exposure:
1.low birth weight
2.fetal alcohol syndrom (FAS)
3.cocaine exposure
4.teratogenesis
5. developmental problems (become evident as child gets older)
teratogenesis
damage to a developing detus induced by a chemical
What pregnancy category?
Prenatal Vitamins
Pregnancy Category A
What pregnancy category?
Penicillin, Cephalosporin
Pregnancy Category B
What pregnancy category?
Antivirals, Laxatives, Cardiac drugs
Pregnancy Category C
What pregnancy category?
Tetracyclines, Progesterones, Many Diruetics
Pregnancy Category D
What pregnancy category?
Estrogens, Vaccines for reubella, smallpox, measles, mumps
Pregnancy Category X

*Flu vaccine is okay
What percentage of drug passes from mother to infant during breast-feeding?
1-2% concetration
(compare to 50-100% conc. found in placenta/fetus)
These chemicals/drugs are usually excluded - do not cross the milk barrier:
ionized, non-lipid soluble, protein bound.
When breastfeeding, mammary epithelial metabolism would effect what pharmacokinetc property of the infant...
Biotransformation
When breastfeeding, mammary blood flow would effect what pharmacokinetc property of the infant...
Distribution, Excretion
When breastfeeding, level of drug in the mother's body would effect what property of the infant...
pharmacodynamics
When breastfeeding, immature digestive system of newborn would effect what pharmacokinetc property of the infant...
Absorption
When breastfeeding, immature renal and hepatic system of newborn would effect what pharmacokinetc property of the infant...
Excretion, Biotransformation
When breastfeeding, immature enzyme activity of newborn would effect what pharmacokinetc property of the infant...
Biotransformation
When breastfeeding, the low number of plasma proteins in a newborn would effect what pharmacokinetc property of the infant...
Distribution
When breastfeeding, the amount of fat/water in a newborn would effect what pharmacokinetc property of the infant...
Distribution
When breastfeeding, the type of feeding of a newborn would effect what pharmacokinetc property of the infant...
Absorption
When breastfeeding, concentration of drug in milk would effect what pharmacokinetc property of the infant...
Absorption
When breastfeeding, duration of feeding of newborn would effect what pharmacokinetc property of the infant...
Absorption
When breastfeeding, volume of milk ingested by a newborn would effect what pharmacokinetc property of the infant...
Absorption, concentration of drug in the infant
When breastfeeding, timing of feeding in relation to drug dosing schedule of newborn would effect what pharmacokinetc property of the infant...
concentration of drug in the infant
The factors affecting drug pharmacokinetics and pharmacodynamics in children in relation to ABSORPTION - ORAL ROUTE:
-less acidic gastric pH
-prolonged gastric emptying time
-irregular peristalsis
-low enzyme activity
The factors affecting drug pharmacokinetics and pharmacodynamics in children in relation to ABSORPTION - PARENTERAL ROUTE:
-variable blood flow
-decreased skeletal muscle mass
The factors affecting drug pharmacokinetics and pharmacodynamics in children in relation to ABSORPTION - TOPICAL ROUTE:
-thinness of skin
-hydration of skin increased
The factors affecting drug pharmacokinetics and pharmacodynamics in children in relation to DISTRIBUTION:
-effect of body fluid on concentration & perfusion
-decreased binding of drugs to serum protein
-immature blood brain barrier
-varied distribution of lipid soluble drugs based on proportion of body fat (size of body)
The factors affecting drug pharmacokinetics and pharmacodynamics in children in relation to BIOTRANSFORMATION:
-immature enzyme systems
-reduced metabolism of drugs
-variable rates of metabolism
The factors affecting drug pharmacokinetics and pharmacodynamics in children in relation to EXCRETION:
-immature renal function prolongs drug elimination
-immature hepatic fcn prolongs drug elimination
How do the characteristics of pharmacokinetics - A,D,B,E - influence the next level of interaction (the next level - D,B,E)?
Determines the # of plasma drug molecules that go to the next level.
Primary factors that may affect drug pK's and pD's in adults...
1.INDIRECT - a result of the variable and sometimes unkown effects of stress on the physiology
2. DIRECT - due to lifestyle habits of nutrition and physical fitness
3. DIRECT - due to destructive lifestyle habits of smoking, alcohol, substance abuse, sedentary lifestyle
In the elderly, increase in gastric pH would effect what pharmacokinetic property...
Absorption
In the elderly, decrease in absorptive surface area would effect what pharmacokinetic property...
Absorption
In the elderly, decrease in splanchic blood flow would effect what pharmacokinetic property...
Absorption
In the elderly, decrease in GI motility would effect what pharmacokinetic property...
Absorption
In the elderly, decrease in rate of gastric emptying would effect what pharmacokinetic property...
Absorption
In the elderly, increase in body fat would effect what pharmacokinetic property...
Distribution
In the elderly, decrease in lean body mass would effect what pharmacokinetic property...
Distribution
In the elderly, decrease in body water would effect what pharmacokinetic property...
Distribution
In the elderly, decrease in serum albumin would effect what pharmacokinetic property...
Distribution
In the elderly, decrease in cardiac output would effect what pharmacokinetic property...
Distribution
In the elderly, decrease in hepatic blood flow would affect what pharmocokinetic process...
Biotransformation
In the elderly, decrease in hepatic mass would affect what pharmocokinetic process...
Biotransformation
In the elderly, decrease in hepatic enzyme activity would affect what pharmocokinetic process...
Biotransformation
In the elderly, decrease in renal blood flow would affect what pharmocokinetic process...
Excretion
In the elderly, decrease in glomerulaar filtration rate would affect what pharmocokinetic process...
Excretion
In the elderly, decrease in tubular secretion would affect what pharmocokinetic process...
Excretion
In the elderly, decrease in # of nephrons would affect what pharmocokinetic process...
Excretion
Factors that affect the pharmaceutic phase in the elderly...
manual dexterity
vision
cognitive
What are some resulting problems related to drug use in the elderly?
compliance
toxicity
drug-drug interactions
polypharmacy
adverse drug rxns
drug-nutrient interactions
patient “knows better”
What are factors that contribute to poor compliance in the elderly?
multiple chronic disorders
multiple prescriptions
multiple dosing for each med
multiple prescribers
change in regimen
cognitive/physical impairment
living alone
recent discharge from hospital
low literacy
inability to pay for drugs
personal conviction drug is uneeded/dosage is too high
presence of side effects