Variations in Drug responses
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What can be done to excrete a drug faster?
- alter pH of blood and urine
- alter electrolytes
What is pharmacodynamic tolerance?
receptor sites are always occupied so you need a higher amt to produce same effect
- Tolerance resulting from accelerated drug metabolism.
- This form of tolerance is brought about by the ability of certain drugs (eg, barbiturates) to induce synthesis of hepatic drug-metabolizing enzymes, thereby causing rates of drug metabolism to increase.
- Because of increased metabolism, dosage must be increased to maintain therapeutic drug levels.
tolerance that can be defined as a reduction in drug responsiveness brought on by repeated dosing over a short time.
more intense effects and possible toxicity could be a result of malnutrition because
- Lower amounts of plasma proteins (albumin) causing levels of free drug to rise
- Decreased oxidative metabolism & decreased glomerular filtration rate
is the study of genetically inherited conditions that affect the way drugs act on the body and modify the way the body acts on drugs
Based on research for risks posed to the fetus, what are the categories?
- Category A and B (remote risk)
- Category C (if benefit outweighs the risk) Mom may fall ill if not given to her. Monitor mom and baby closley
- Category D and X (proven risk)
What is the difference in absorption in children when it comes to parenteral, enteral, and topical?
- Enteral: absorption rate goes up
- Parenteral : muscles arent as large so we must use smaller volume
- Topical: absorb faster cuz skin is thinner and higher water.
What are the differences in distribution when it comes to children?
- Higher water concentration, lower fat
- Immature blood brain barrier
- Limited protein binding capacity
Who is at risk for the most intense adverse affects?
- Neonates (1st 4 weeks of life)
- Infants (week 5-52 of life)
In the older adult, distribution decreases, medications don't dissolve as well, and medications are stored in fat cells. Why?
- Decreased CO = distribution decreases
- Decreased body water= meds don’t dissolve well
- Increase body fat= resevior for meds
How can we avoid adverse effects?
- Obtain a solid baseline assessment
- Benefit:Risk ratio
- Strategies to help unintentional noncompliance
Because the degree of renal impairment among the elderly varies, what test should be done for pts that are about to take a drug excreted by the kidneys?
creatinine clearance test to test how well kidneys function
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