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N125 SCC Pediatric/Geriatric_Pharmacology
Quiz questions based on power points from class
18
Pharmacology
Not Applicable
01/28/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Name three limitations of Pediatric Pharmacology
Definition
  • Research
  • Off-label instructions
  • Expert opinions
  • Small clinical trials
  • Lack of knowledge of effects, uses and doses of pediatric medications
  • Practitioners personal experience with the medication
Term
What is the Pediatric Research and Equity Act?
Definition
Act that requires drug manufacturers to study pediatric medication use and offers incentives for pediatric pharmacology research.
Term
Why is the Pharmocokinetics phase different for pediatric pharmacology?
Definition

Becuase of differences in body composition and organ maturity


with differences being more pronounced in neonates and younger infants

Term
How is absorption different for Neonates and infants?
Definition
  1. Lack of maturation of the GI tract
  2. Gastric pH is less
  3. Gastric emptying is prolonged
  4. Feeding methods differ
  5. Altered perfusion affects IM/Subq absorption
  6. Topical: skin is thin and porous
  7. GI Surface area higher than in adults, may get systemic effects

 

Term
How is absorption different for Adolescents?
Definition

As children grow and develop the absorption of medications generally becomes more effective therefore absorption in infants and neonates must be considered in dosing and administration.

 

A contradiction to this occurs during the adolescent years, during which poor nutritional habits, changes in physical maturity & hormonal differences may cause a slowing of medication absorption

Term
How is Distribution different for pediatric phbarmacology?
Definition
  • Body fluid composition
    • Greater volume of fluid, decreased concentration of the drug therefore neonates to about age two require higher concentration of water soluable drugs
  • Body tissue composition
    • neonates and young infants tent to have Less fat in body composition which means they require less fat-soluble medication
  • Protein-binding capability
    • Less albumin, fewer protein receptor sites, means we decrease the dosage
    • High bilirubin in neonates binding with the receptors meant for drug =  more free drug
  • Effectiveness of barriers
    • - Skin more absorptive, BBB immature
  •  

Term

How is the Metabolism in pediatric pharmacology different?

 

Definition
  • Decreased level of hepatic enzymes results in slower metabolism of drugs until about age 2
  • Child >2 = higher metabolic rate so dosage adjusted
  • First-pass effect high, this is why we will sometimes use the rectal route to avoid the first pass effect with children.
Term
How is Excretion different in Ped Pharmacology
Definition

Less than 9 months of age

 

  1. Decreased renal blood flow
  2. Decreased glomerular filtration rate
  3. Reduced renal tubular function
  4. Medications excreted more slowly
  5. Dehydration
Term
Which tests are used to monitor kidney function?
Definition
creatinine, BUN, Creatinine clearance
Term
Which tests are used to monitor liver function?
Definition
Monitor liver function by the following tests: ALT, AST, GGT, bilirubin
Term
How would you change your Medication Administration approach with a Toddler vs a Preschooler?
Definition

With the Toddler you will want simple explainations, a firm approach and enlist their imagination and play for sucessful administration

 

With a preschooler use age appropriate explainations, and allow some level of choice and control to sucessfully administer medication

Term
/How would you change your medication administration approach for a school aged child vs an older child or adolecent?
Definition

Though cooperative school aged children may fear bodily injury and need even more control, involvement in the process, and information. age appropriate fears related to pain, changes in body image and injury are prevalent among older school age and adolescent clients.

 

The nurse should establish a positive rapport with the client. contract with the adolescent related to the plan of care, and ensure privacy in all aspects of medication admin

Term
Where should IM injections not be given on children who have not be walking for at least a year?
Definition

Gluteal

 

the ventrogluteal or vastus lateralist is the preferred site

Term
what is Atraumatic Care?
Definition
The delivery of therapeutic care through the implementation of interventions that eliminate or minimize the psychologic and physical distress experienced by children and their families.
Term
What are the Physiologic Changes in older adults?
Definition
  • Slower absorption of oral medications
  • Impaired circulation can delay transportation of drugs to the tissues
  • Drugs metabolized more slowly & less completely
  • Drugs excreted less completely
Term
How will absorption be effected in the older adult?
Definition
  • Slow
  • Increase alkaline GI secretions
  • Decrease motility
  • Distribution
  • Loss of protein binding sites
  • Loss of body water
  • Increase in body fat
Term
How is the metabolism different in older adults?
Definition

Metabolism

  • Decrease hepatic blood flow
  • Decrease enzyme function
  • Drug clearance by the liver is reduced
  • Excretion
  • Decreased blood flow to liver & kidneys
  • CLcr normally 80-130 mL/min
  • Half-life of drug prolonged = toxicity
Term
Describe what kind of Patient Teaching you would do for an older adult
Definition
  • Reason, route, dose, side effects and when to notify the HCP
  • Adherence to drug regimen
  • Keep record of drugs and when they are taken
  • Diet considerations
  • Supportive and available to answer questions
  • One pharmacy, discuss OTC with pharmacist
  • Easy open cap if needed
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