Drug Therapy Across The Lifespan - Vocabulary Flashcards

A comprehensive set of vocabulary flashcards covering pharmacokinetics/pharmacodynamics, lifespan considerations, pharmacogenomics, pregnancy, safety concepts, hypersensitivity, monitoring, and nursing considerations.

Pharmacokinetics (PK)

The study of how drugs move through the body (absorption, distribution, metabolism, excretion).

Pharmacodynamics (PD)

The study of the effects of drugs on the body and their mechanisms of action.

Routes of administration

Methods by which drugs are given (oral, IV, etc.) and their pros/cons affecting drug delivery.

Weight-based dosing (mg/kg)

Dosing calculated according to body weight (milligrams per kilogram).

Total body water in newborns (~80%)

Newborns have a high total body water content, affecting drug distribution.

Protein binding in infants

Lower protein binding in infants leading to more free (active) drug.

CYP enzyme activity in infants

Lower hepatic enzyme activity, reducing drug metabolism in infants.

Blood-brain barrier development

In newborns, the barrier is not fully developed, affecting CNS drug exposure.

Renal immaturity

Immature kidneys increase risk of drug accumulation in infants.

Beers Criteria

Guidelines for safer prescribing in older adults to avoid high-risk meds.

Age-related pharmacokinetic changes

In elderly: slower absorption, reduced renal/liver function, longer drug half-life.

Increased body fat in elderly

More body fat and less muscle alter drug distribution and storage.

Gender differences in pharmacokinetics

Women often have higher body fat, lower muscle, smaller blood volume, and hormonal fluctuations affecting drug response.

Lower renal drug elimination in women

Women may eliminate drugs via the kidneys at a slower rate.

Pharmacogenomics

Study of how genetic variations affect drug response.

CYP2C19 poor metabolizers (Asian)

15–30% of Asian patients poorly metabolize drugs via CYP2C19.

CYP2D6 poor metabolizers (Caucasian)

About 7% of Caucasian patients poorly metabolize drugs via CYP2D6.

Ultrarapid metabolizers

Individuals who metabolize certain enzymes very quickly, affecting drug levels.

ACE inhibitors less effective in African Americans

Pharmacogenomic variability can reduce effectiveness in this population.

Pregnancy and drug therapy principles

Aim to avoid drugs if possible; if needed, weigh risks, use lowest effective dose for shortest time; consider stage of pregnancy.

Live vaccines contraindicated in pregnancy

Live vaccines (e.g., MMR) should be avoided during pregnancy.

COVID vaccine in pregnancy

COVID-19 vaccine is currently recommended during pregnancy.

Decreased renal function (elderly)

Age-related decline in kidney function affecting drug clearance.

Aging physiological changes affecting drug therapy

General elderly changes including slower absorption and longer drug action.

Higher body fat in women vs men

Women typically have a higher percentage of body fat, influencing drug distribution.

Lower rate of renal drug elimination in women

Renal clearance can be reduced in women for certain drugs.

Pharmacogenomics (definition)

The study of how genetic differences influence individual drug responses.

CYP2C19 poor metabolizers (Asian)

A subset of patients with reduced metabolism via CYP2C19.

CYP2D6 poor metabolizers (Caucasian)

A subset of patients with reduced metabolism via CYP2D6.

Ultrarapid metabolizers (pharmacogenomics)

People who metabolize specific drugs unusually fast, altering efficacy.

ACE inhibitors less effective in some populations (pharmacogenomics)

Genetic factors can reduce ACE inhibitor effectiveness in certain groups.

Pregnancy CATEGORIES (A–X)

Classification of fetal risk: A, B, C, D, X with increasing risk and guidance.

Pregnancy Category D drugs (examples)

Drugs with evidence of fetal risk but potential life-saving benefits (e.g., ACE inhibitors, ARBs, certain antiepileptics, benzodiazepines, etc.).

Pregnancy Category X drugs (examples)

Drugs with fetal abnormalities or risk that outweighs any benefit (e.g., warfarin, methotrexate, isotretinoin, certain hormones).

Contraindication

A condition or factor that prevents use of a drug because risks outweigh benefits.

Black Box Warning (BBW)

The FDA’s strongest warning; must appear on packaging/labeling and is crucial for monitoring.

Physical/chemical incompatibilities

Some drug combinations are harmful or react when mixed; verify compatibility.

IV compatibility

Check that IV drugs can be given together without precipitation or harm.

Precipitate in IV line

Formation of solid material in IV fluids indicating incompatibility.

Adverse Drug Event (ADE)

A medication error that reaches the patient; not all errors reach patients, but those that do are ADEs.

Hypersensitivity reactions (types I–IV)

Allergic or immune-mediated drug reactions categorized as I–IV.

Type I hypersensitivity

IgE-mediated reactions such as anaphylaxis; mild to severe symptoms.

Type II hypersensitivity

Autoimmune reactions (e.g., autoimmune hemolytic anemia).

Type III hypersensitivity

SJS, lupus, serum sickness; immune complex–mediated.

Type IV hypersensitivity

Delayed-type reactions (e.g., contact dermatitis).

Anaphylaxis symptoms

Severe hypersensitivity: hives, swelling, wheezing, hypotension, loss of consciousness.

Type I Hypersensitivity treatment

Treatment includes antihistamines, corticosteroids, and epinephrine for anaphylaxis.

Adverse Drug Event (ADE) and near miss

ADE: error reaches patient; a near miss is caught before reaching the patient.

Therapeutic range/window

Plasma drug concentration range with desired effect and minimal toxicity.

Minimum Effective Concentration (MEC)

The lowest concentration needed to achieve a therapeutic effect.

Peak level

Highest serum drug level; typically checked soon after dosing (e.g., 15–30 minutes).

Trough level

Lowest serum drug level; typically checked before the next dose (e.g., 15–30 minutes prior).

Nursing considerations in drug therapy

No drug is completely safe; tailor care to each patient; monitor for adverse effects; review allergies/history.

Swiss cheese model of error

Concept that multiple defensive layers must fail for an error to reach the patient.