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Blueprint for Quiz including modules 1 thru 3, and study questions Updated 2023 A+
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Blueprint for Quiz including modules 1 thru 3, and study questionsBLUEPRINT FOR QUIZ INCLUDING MODULES 1 THRU 3,
AND STUDY QUESTIONS.
Quiz 1 3/9 Wed 8 pm to 3/12 Sat 8m WE WILL BE TESTED ON MATERIAL FROM OUR READINGS (required) AND LECTURES.
Module Objectives
-Apply pharmacology principles when writing prescriptions for patients; Apply prescribing basics and the BON requirements for prescriptive
authority and apply this knowledge as it relates to NP practice by writing prescriptions that fulfill the legal requirements for legal practice
Study Questions of Module 1 are already in first part of Blueprint (BP). Mod 2/Mod3 are very long, so are at end of BP.
This shows movement of drugs following a GI absorption.
What is the first-pass effect? Sibo
● refers to rapid hepatic inactivation of certain oral
drugs.
● When the drugs are absorbed from the GI tract,
● carried directly to the liver through hepatic portal
vein before entering systemic circulation.
How does this affect the distribution of the drug?Sibo
● If capacity of liver to metabolize drug is
extremely high,
● this drug can be completely inactivated on its
first-pass through the liver.
● Need to increase dosage for 1st dose.
, Blueprint for Quiz including modules 1 thru 3, and study questions
How do the pharmacokinetics and pharmacodynamics compare for special populations such as the elderly, the
pregnant female, and children? Sibo (All answers from Drugs across Lifespan)
● The aging process can affect all phases of pharmacokinetics.
● From early adulthood on, there is a gradual, progressive decline in organ function.
● not enough studies have been done on pregnant woman, the young
● so we must balance the risk of the unknown with the benefits
● for the young/pregnant clients, less prescriptions are better.
Drug sensitivity varies with age.
● Infants and older adults are especially sensitive to drugs.
● In the very young, heightened drug sensitivity is the result of organ immaturity.
● In older adults it is due to decline of organ function
● Older adults also have more severe illnesses, multiple illnesses, and treatment with multiple drugs.
● the plasma drug levels are higher in the infants than in adults.
Pharmacokinetic factors (first remember before dosing:)
● determine the concentration of a drug at its sites of action
● hence determine the intensity and duration of responses.
● If drug levels are elevated, responses will be more intense.
● If drug elimination is delayed, responses will be prolonged.
Neonates and Infants Children one year and older
Pharmacokinetics in Neonates and Infants: SIMILAR TO ADULTS pharmacokinetically
● immature organ systems that regulate drug levels ● pharm+acokinetic parameters are similar to
● so they are at risk for both drug effects adults.
● that are unusually intense and prolonged. ● drug sensitivity more similar to adults than for
children less than one year.
Our role for safe, effective therapy ● absorption metabolism, distribution
● By accounting for pharmacokinetic differences in the very metabolism, and elimination, similar to
young, adults.
● we increase the chances that drug treatment will be effective DIFFERENCE pharmacokinetically
, Blueprint for Quiz including modules 1 thru 3, and study questions
and safe ● metabolize drugs faster than adults.
● Drug-metabolizing capacity is markedly
elevated til age 2 years; then gradually
declines.
The drug-metabolizing
● capacity of newborns is low. ● Complete maturation of the liver develops by
● As a result, neonates are especially sensitive to drugs that 1 year.
are eliminated primarily by hepatic metabolism.
● When these drugs are used, dosages must be reduced.
● The capacity of the liver to metabolize many drugs increases
rapidly about 1 month after birth
● and approaches adult levels a few months later.
The increased drug sensitivity of infants is due largely to:
the immature state of five pharmacokinetic processes:
(1) drug absorption,
(2) protein binding of drugs,
(3) exclusion of drugs from the central nervous system
(CNS) by the blood-brain barrier,
(4) hepatic drug metabolism, and
(5) renal drug excretion.
Gastrointestinal physiology in the infant
● is very different from that in the adult.
● So drug absorption may be enhanced or impeded,
● depending on the physicochemical properties of the drug
involved.
● Gastric emptying time is both prolonged and irregular in early
infancy,
● then gradually reaches adult values by 6 to 8 months.
, Blueprint for Quiz including modules 1 thru 3, and study questions
Renal drug excretion ● Adult levels of renal function are achieved by
● is significantly reduced at birth. 1 year.
● Renal blood flow, glomerular filtration, and active tubular
secretion are all low during infancy.
● drug-excreting capacity of infants is limited,
● drugs that are eliminated primarily by renal excretion
-must be given in reduced dosage
-or at longer dosing intervals, or both.
Drug sensitivity varies with age.
● Infants and older adults are especially sensitive to drugs.
● In the very young, heightened drug sensitivity is the result of
organ immaturity.
ADVERSE REACTIONS (all pedi ages)
● Like adults, pediatric patients are subject to adverse reactions when drug levels rise too high.
● vulnerable to unique adverse effects related to organ system immaturity & growth and development.
● Among these age-related effects are growth suppression (caused by glucocorticoids),
● discoloration of developing teeth (caused by tetracyclines)
● kernicterus (caused by sulfonamides).
The blood–brain barrier is not fully developed at birth.
● As a result, drugs and other chemicals have relatively easy access
to the CNS,
● making the infant especially sensitive to drugs that affect CNS
function.
● Accordingly, all medicines employed for CNS effects
morphine, phenobarbital give in reduced dosage.
● Reduce dosage for actions outside the CNS if those drugs are
capable of producing CNS toxicity as a side effect.
Neonates and Infants Children one year and older
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