PHARM CH3

Pertaining to a person younger than 1 month of age; newborn infant

Pertaining to a person who is ≥ 65 years of age  (Note: Some sources consider this age to also be ≥55 years of age)

Pertaining to a person who is 12 years of age or younger.

The use of many different drugs at the same time in treating a patient, who often has several health problems.

Exposure of a fetus to drugs is most detrimental during the _____ trimester of pregnancy, and fetuses are at greatest risk for drug-induced developmental defects during the this trimester as well.

Studies indicate no risk to the human fetus

Category of drug when Studies indicate no risk to the animal fetus; information for humans is not available.

Category of drug when Adverse effects reported in the animal fetus; information for humans is not available.

Category of drugs when Possible fetal risk in humans has been reported; however, in selected cases consideration of the potential benefit versus risk may warrant use of these drugs in pregnant women.

Category of drugs when fetal abnormalities have been reported, and positive evidence of fetal risk in humans is available from animal and/or human studies. These drugs are not to be used in pregnant women

In pediatric absorption Gastric emptying is _____ because of irregular peristalsis.

In pediatric absorption First-pass elimination by the liver is _____ because of the immaturity of the liver and reduced levels of microsomal enzymes.

In pediatric absorption gastric pH is ___ acidic until about 1-2 yrs

In pediatric absorption intramuscular absorption is _____ and irregular.

In pediatric distribution Protein binding is _____ because of _____ production of protein by the immature liver.

In pediatric distribution _____ total body water means _____ fat content

To administer medications to pediatrics PT accurately, one must take into account

In pediatric distribution  ____drugs enter the brain because of an immature blood-brain barrier.

In pediatric metabolism Levels of microsomal enzymes are _____ because the immature liver has not yet started producing enough.

Older children may have _____ metabolism and require _____ dosages once hepatic enzymes are produced

In pediatric excretion Glomerular filtration rate and tubular secretion and resorption are all ______ in young patients because of kidney immaturity.

In pediatric excretion Perfusion to the kidneys may be _____ , which results in _____ renal function, concentrating ability, and excretion of drugs

In older adults movement through GI tract is _____ because of the _____ muscle tone & activity

In older adults the absorptive surface of the GI tract is ____?

In older adults metabolism, the levels of microsomal enzymes are _____ because the capacity of the aging liver to produce them is _____.

In older adults there is an ______ fat content.

The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have which of these factors?

A. Increased protein in circulation
B. More muscular body composition
C. Fat composition lower than 0.001%
D. Water composition of approximately 75%

The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (Select all that apply.)

a. Explain to the child in advance about the injection.
b. Provide a brief, concrete explanation about the injection.
c. Encourage participation in the procedure.
d. Make use of magical thinking.
e. Provide comfort measures after the injection

A neonates liver is not fully developed and cannot detoxify many drugs which can lead to ____ _____.

The ______ ___ ______ formula, based on body weight, is the most common method of calculating doses for pediatric patients.

When administering medications to pediatric patients, the nurse understands that the dosage calculations for pediatric patients are different than for adults because pediatric patients

A. have immature liver and kidney function, resulting in impaired drug metabolism and excretion
B. have more stomach acid.
C. have skin that is less permeable.
D. are more likely to develop edema.

______ and _____ often cause confusion, daytime sedation, ataxia, lethargy, forgetfulness, and increased risk for falls in the elderly.

Drug causes Confusion, constipation, urinary retention, nausea, vomiting, respiratory depression, fall in older adults

Drug that causes Edema, nausea, gastric ulceration, bleeding, renal toxicity in older adults

Drug that causes Major and minor bleeding episodes, many drug interactions, dietary interactions in older adults.

Drug that causes  Blurred vision, dry mouth, constipation, confusion, urinary retention, tachycardia in older adults.

Drug that causes  Sedation and strong anticholinergic adverse effects in older adults

Drug that causes  Nausea, hypotension, diarrhea, bradycardia, heart failure, impotence in older adults

Drug that causes Visual disorders, nausea, diarrhea, dysrhythmias, hallucinations, decreased appetite, weight loss in older adults

Drug that causes Sedation, weakness, dry mouth, confusion, urinary retention, ataxia in older adults

Drug that causes  Electrolyte imbalance, rashes, fatigue, leg cramps, dehydration in older adults

The general rule for older PT for medication administration=

The new FDA SAFETY drug categorizing rule requires the use of three subsections in the prescribing information titled?

When teaching a pregnant woman about the use of drugs during pregnancy, which statement will the nurse include? 

A. Pregnant women must never take drugs to control high blood pressure.
B. A fetus is at greatest risk for drug-induced developmental defects during the second trimester of pregnancy
C. Drug transfer to a fetus is most likely to occur during the last trimester of pregnancy.
D. Exposure of the fetus to drugs is most detrimental during the second trimester of pregnancy.

Factors Affecting Pediatric Drug Dosages:

Older Adults Absorption:
Gastric pH is ___acidic
Gastric Emptying is ____
Movement through GI tract is slowed because of ____ muscle tone & activity
Blood flow to GI is _____
Absorptive surface of GI tract is ____

Medication Administration Considerations: Evaluation, what to look for?

The nurse caring for a pediatric patient calculates the safe range for the prescribed medication. Based on the nurses calculations, the dose ordered exceeds the high limit. What is the nurse’s next action?

A. Contact the prescriber immediately.
B. Proceed with administration of the prescribed dose.
C. Contact pharmacy to substitute the prescribed medication with one that will calculate in the safe range.
D. Administer only half the ordered dose.

What does the nurse identify as a pharmacokinetic change that occurs in older adults?

A. Fat content is decreased because of increased lean body mass.
B. There is increased production of proteins by the liver.
C. Gastric pH is more acidic.
D. The number of intact nephrons is decreased.