Week 1: Drug Receptors-Geriatrics & Pediatrics

older adults are more sensitive to

adverse effects of drug therapy

adverse drug reactions can

impede progress and ability to participate in reactions

reasons for increased incidence of adverse effects

pattern of drug use, altered response to drugs

polypharmacy

excessive or inappropriate use of meds

those over 65% use what percent of drugs and are what percent of population

15% of population, use 30% of prescription drugs

-also use more OTC and CAMs

characteristics of polypharmacy in older adults

for no reason, duplicates, have interacting meds, use contraindicated meds, inappropriate dose, treat adverse effects, patients improve when meds are removed

medication cascade

increased illness, need drugs, increased side effects, treat side effects, more drugs, repeat

altered gastrointestinal/absorption function is due to

low gastric acid, stomach emptying, absorbing area, motility

distribution is altered due to

low h20, lean body mass, plasma proteins, and high body fat

hepatic metabolism is altered due to

low liver mass, liver blood flow, and enzyme activity

renal excretion is altered due to

low kidney mass, kidney blood flow, tubular function in nephron

other factors that increase risk of ADR in adults

many diseases, lack of testing, lack of regulation, adherance, education, diet, OTC use

BEERS criteria

expert panel developed a list of meds that post an especially high risk for ADR in older adults

most drugs can cross the ____ in pregnant women

placenta

crossing the placenta can

expose embryo and fetus to pharmacologic and teratogenic effects

factors affecting placental drug transfer

physiochemical properties of drug, rate of crossing, duration of exposure, characteristics of tissues, stage of development, effects of drugs in combo

when should you time lactation with medical ingestion

take med 30-60 min after nursing and 3-4 hours before next feeding

during the first year of life whats the challenge

drug dosing

does drug absorption for infants/children follow the same principles as adults

yes

the distribution of drug volumes changes as

body comp changes, have more body weight from water

what activity is lower in neonates

metabolising activity of liver

lower metabolizing activity causes

slow clearance and prolonged half life

in infants/kids what function is impaired

excretion, gfr is lower

elixirs

alcoholic solutions in which drug molecules are dissolved and evenly distributed

-no shaking, doses are same

suspensions

contain undissolved particles of drugs

-shake bottle, uneven if not done correctly

pediatric drug adherence

hard, need both kid and parent to adhere

dosing of kids is based on

child weight, tend to be underestimated

are most drugs approved for kids

no, too expensive

since they often underestimate dosage, they can use

surface area to be adequate