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55 Cards in this Set
- Front
- Back
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4 phases of pharmokinetics |
Absorption Distribution Metabolism Excretion |
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The _______ trimester of pregnancy is the period of greatest danger of drug-induced developmental defects highest risk for developmental defects secondary to drug and toxin exposure. |
first |
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Transfer of both drugs and nutrients to the fetus occurs primarily by _______ across the placenta (The passive movement of a substance between different tissues from areas of higher concentration to areas of lower concentration) |
Diffusion |
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The active (energy requiring) movement of a substance between different tissues via pumping mechanisms contained within cell membranes |
active transport |
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The factors that contribute to the safety or potential harm of drug therapy during pregnancy can be broadly broken down into three areas: |
Drug properties Fetal gestational age Maternal factors |
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Drug properties that impact drug transfer to the fetus include: |
The drug's chemistry Dosage Concurrently administered drugs |
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The primary drug characteristics that increase the likelihood of drug transfer via breastfeeding include: |
Fat solubility Low molecular weight High concentration |
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Younger than 38 weeks gestation |
Premature or preterm |
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Younger than one month |
Neonate or newborn |
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One month up to a year |
Infant |
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1 year up to 12 years |
child |
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Some drugs may be given specifically to counteract the adverse effects of other drugs Ex. Potassium supplement to counteract the potassium loss caused by certain diuretic medications |
Prescribing cascade |
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largest percentage of drugs/toxins that the mom absorbs will reach the fetus in what semester? |
Last (3rd) |
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3rd trimester has largest percentage of drugs/toxins that the mom absorbs will reach the fetus because why? |
-Enhanced blood flow to the fetus -Fetal surface area -Increased permeability of the placenta |
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Diffusion with water |
osmosis |
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the amount of blood expressed in liters that can travel around the body in one minute |
cardiac output |
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How many mL of urine we make per minute |
GFR- glomerial filtration rate |
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Mother at risk for: |
increased renal perfusion Increased lung profusion Increased urine output Blood volume and CO increase GI motility increase GFR increase Albumin decrease |
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If pH increases is it more or less acidic? |
Less |
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When pH goes up it is more _______ |
alkaline (pH greater than 7) |
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What stage of pharmacokinetics does maternal changes in gastric pH affect most? |
absorption |
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If GI motility decreases what is mother at risk for? |
constipation |
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sanitation of the cell? What is it called in the placenta? |
P Glycoprotein P/P Glycoprotein |
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P/P Glycoprotein job is to what? |
Protect fetus against toxins, constantly searching the cells |
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Kidneys do no like excreting _____ soluble things |
fat |
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______ soluble substances cross the placenta more easily |
fat |
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Pregnancy risk categories: Category A: |
no documented risk to fetus |
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Pregnancy risk categories: Category B |
no documented risk to animals in study,no information on humans |
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Pregnancy risk categories: Category C |
adverse effects to animals in study, no information on humans documented |
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Pregnancy risk categories: Category D |
risk to humans documented, must weigh risk and benefits |
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Pregnancy risk categories: Category X |
fetal abnormalities reported – this drug is not used during pregnancy. Considered a teratogen. |
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Pregnant mother should not? |
-not use OTC drugs, herbal, supplements -not consider drug interactions like antacids -try to avoid newly registered drugs -potential teratogens -use lowest dosage and shortest half life, shortest treatment duration |
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Factors increasing the risk of a drug crossing into the breast milk are: The _____ of the mom’s medication(s) Drugs given in _____ doses or concentrations, increased frequency, longer duration of therapy Longer______ medications |
route high half-life |
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Teaching: take med ____ to ____ minutes after, and then ______ before next feeding |
30 to 60 3 hours |
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Worst time to nurse the baby is ______ minutes after she takes the medication |
30 |
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Contraindications while breast feeding? |
radiation chemo drinking |
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what phase in pediatric pharmacokinetics? Slower gastric emptying – slows down rate of absorption Reduced first pass effect- enteric med. Wont be destroyed I.M.– unreliable and irregular- possibility of damaging Musc. tissue |
Absorption |
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what phase in pediatric pharmacokinetics? Total body water is higher 80% preemie, 70% full term) Fat content is lower- fat soluble will be different
Protein binding decreased BBB easier to cross (blood brain barrier) (opioids) |
Distribution |
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what phase in pediatric pharmacokinetics? Irregular– at adult level by adolescence Reduced first pass effect Special caution Dilantin, barbiturates, analgesics, and cardiac |
Metabolism |
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what phase in pediatric pharmacokinetics? Renal functions and blood perfusion decreased |
Excretion |
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If dose is by weight we only use ____ |
kg |
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Children feel safer and less fearful when ______ rather than laying down for injections and maintain head ______ |
seated up |
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when giving medicine don’t want to instill down center of tongue, let it slowly drip down side of ______. |
mouth |
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Age appropriate explanation for toddlers: |
short and to point, do not use terms like “It won’t hurt”, etc. |
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Age appropriate explanation for preschoolers: |
short and to point, consider the developmental level of child |
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Age appropriate explanation for school aged: |
Begin teaching techniques |
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Age appropriate explanation for adolescents: |
Prepare pt. in advance, and encourage self-expression, and privacy. Participation if possible and appropriate |
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Older adult rule of thumb: |
every body cell and every organ is affected by aging. |
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What are intrinsic factors that can / will influence how the aging patient’s physiology/hemodynamics change |
disease processes polypharmacy |
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What are extrinsic factors that can / will influence how the aging patient’s physiology/hemodynamics change |
healthy lifestyle active |
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Pharmacokinetics and aging Gastrointestinal-- Pepsin and HCl decreased production, Peristalsis decreased, Enzyme production decreased Which phase of pharmacokinetics does this affect? |
metabolism |
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Pharmacokinetics and aging Psychosocial: Related to losses Decreased ability to cope with stressors What does this affect ? |
compliance |
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rate by which urine produces decreases pertaining to aging is called |
Glomerular function |
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No appetite and not eating |
anorexic |
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Initially tells you a lot If a person in hospital gains a pound a day we think it is fluid retention, we might not catch why, if not for what? |
Baseline assessment |
