Drug Therapy Across the Lifespan: Pediatrics, Geriatrics, and Pharmacogenomics

What is the basis for drug dosing in infants and children?

All drug dosing should be weight-based (mg per kg).

What is the total body water percentage in newborns?

Newborn total body water is about 80%.

How does protein binding in infants compare to adults?

Protein binding is low in infants.

What is a key characteristic of the blood-brain barrier in infants?

The blood-brain barrier is not fully developed.

How does the activity of CYP enzymes in infants differ from adults?

CYP enzymes have lower activity in infants.

What is a significant risk associated with immature kidneys in infants?

Increased risk of drug accumulation.

What changes in drug absorption occur in elderly adults (65+)?

Slower absorption of drugs in the GI tract.

What happens to renal and liver function in elderly adults?

There is a decline in renal and liver function, causing drugs to stay in the body longer.

How does body composition change in elderly adults?

Increased body fat and decreased muscle.

What physiological differences do women have that affect drug therapy?

Women have a higher % of body fat, less muscle tissue, smaller blood volume, and increased hormone fluctuations.

How does renal drug elimination differ between men and women?

Women have a lower rate of renal drug elimination.

What is the impact of CYP3A4 metabolism in women?

Women have faster CYP3A4 metabolism.

What is pharmacogenomics?

The study of genetic variations in drug response.

What is the ideal recommendation for drug use during pregnancy?

Pregnant women should ideally take no drugs.

What factors should be considered if drug therapy is necessary during pregnancy?

Stage of pregnancy, available drug information, risk/benefit analysis, and lowest effective dose for the shortest time.

What type of vaccines should be avoided during pregnancy?

Live vaccines (e.g., MMR).

What is the current recommendation for the COVID vaccine during pregnancy?

The COVID vaccine is currently recommended.

What are physical/chemical incompatibilities in drug therapy?

Some drugs are not compatible with each other and should not be administered simultaneously.

What are black box warnings?

The strongest warning the FDA can give consumers regarding drug safety.

What are the four types of hypersensitivities?

Type 1: Anaphylaxis; Type 2: Autoimmune anemias; Type 3: Examples include Stevens-Johnson Syndrome; Type 4: Examples include contact dermatitis.

What are adverse drug events (ADEs)?

Medication errors that reach the patient, also known as 'near misses.'

What do pregnancy categories A, B, C, D, and X indicate?

A = safe; B = not demonstrated a risk to fetus; C = potential benefits outweigh risks; D = evidence of risk to fetus; X = NOT SAFE.

What are contraindications in drug therapy?

Situations where the risk always outweighs the benefits to the patient.