20.6k Factors Altering Medication Response

liver and kidney functions

The (?) of infants are not yet fully developed, so their response to medications can be altered.

deteriorate

Likewise, as we age, the functions of these organs begin to (?).

infants and elderly people

As a result, (?) are most susceptible to having an altered response to a medication.

body mass

The more (?) a person has, the more fluid is potentially available to dilute a medication.

higher concentration

A given amount of medication causes a (?) in a person with little body mass than in a much larger person.

body mass

Thus, most medication dosages are stated in terms of (?).

1.0 mcg/kg

For example, the standard dose of fentanyl for a patient in pain is (?).

100 mcg

A 100-kg patient receives (?) of fentanyl whereas a 50-kg patient receives only 50 mcg.

sex

Most differences in medication response due to (?) result from the relative body masses of men and women.

body fat

The different distribution and amounts of (?) also affect the amounts of medication available at any given time.

stimuli

Various (?) in a patient’s environment affect the response to a given medication.

mood or behavior

This is most clearly seen with medications affecting (?).

diazepam

The same dose of an antianxiety medication such as (?) (Valium) has different effects depending on the patient’s mood or surroundings.

afraid of heights

For example, if the patient were (?), the usual dose of diazepam would not likely help the patient remain calm while rappelling from the top of a tall building.

Surrounding conditions

(?) can also affect the distribution or elimination of a medication.

Heat

(?), for example, causes vasodilation and increases perspiration, both of which can alter the rate at which the body distributes and eliminates a medication.

absorption

If a patient takes a medication immediately after eating, its (?) is different than if the same medication is taken before breakfast in the morning.

nausea

Some medications can cause (?) if taken on an empty stomach and must therefore be taken only after eating.

disease states

Several (?) alter the medication-response relationship.

renal and hepatic dysfunctions

Most notable are (?), both of which can lead to excess accumulation of a medication in the body.

Renal failure

(?) is likely to decrease elimination of medications whereas hepatic failure can decrease or inhibit their metabolism, prolonging their duration of action.

Acid–base disturbances

(?) can alter a medication’s solubility or the extent to which it ionizes, thus changing its absorption rate.

Genetic traits

(?) such as the lack of specific enzymes or lowered basal metabolic rate alter medication absorption or biotransformation and thus modify the patient’s response.

mental state

A patient’s (?) can also affect their response to a medication.

placebo effect

The best-known example of this is the (?).

believes that a medication will have a given effect

Essentially, a patient who (?) is much more likely to perceive that the effect has occurred.

Medication–medication interactions

(?) occur when two or more medications are available in the same patient.

increase

The interaction can (?), decrease, or have no effect on their combined actions.

other types of interactions

In addition to medication-medication interactions, (?) are possible.

rate of absorption of food and nutrients

They include a medication’s effects on the (?), alteration of enzymes, and food-initiated alteration of medication excretion.

Alcohol consumption and smoking

(?) can also cause interactions with medications.

incompatible

Finally, some medications are (?) with each other.

catecholamines

As an example, (?) such as epinephrine precipitate in an alkaline solution such as sodium bicarbonate.