NR565 | NR 565 Advanced Pharmacology Midterm Exam Latest 2024 | Chamberlain
When prescribing medication we must understand that liver function declines with age due to what cause?
- enlarged liver
- decreased blood flow to liver
- increased activity of the hepatic enzymes - ANSWER✔✔decreased blood flow to
- decreased liver mass
- decrease in enzyme activity
- high drug dosages
- lack of monitoring medications
- decreased renal excretion
- overprescribing/polypharmacy - ANSWER✔✔decreased renal excretion
- decreased hormones
- increased body fat
- decreased lean mass
- decreased albumin - ANSWER✔✔2, 3, 4 1 / 4
liver
What is the most important cause of adverse drug reactions? (older age)
Distribution of medication can be affected in the elderly in what ways? SATA
changes in body composition associated with age due to an increase in body fat percentage and decrease in lean muscle mass. There is also a decrease in total body water. Distribution can also be impacted by decreased total body water and decreased cardiac output. Absorption can be impacted by increase gastric pH, decreased absorption surface area decreased G.I. motility and decrease gastric emptying.Metabolism can be impacted by de Cristo paddock blood flow, paddock mask, and activity of hepatic enzymes. Excretion can be impacted by decreased renal blood flow, decrease GFR, decrees to both secretion, and decrease number of nephrons An 82 year old male visits the clinic complaining that his pain medications "take forever" to work after he takes his pill. What are possible reasons you can explain to him?
1.Perhaps we need to increase your dosage.
2.Sometimes as you get older, absorption may be slower resulting in a delayed response.
3.As we get older the gastric acid decreases and may slow absorption. - ANSWER✔✔ 2&3 How does renal and hepatic function impact medication levels in body? - ANSWER✔✔ Patients with renal or hepatic insufficiency can experience greater peak effect and longer duration of action for medications, thereby reducing the dose at which respiratory depression and overdose may occur. Similarly, for patients ages 65 years and older, reduced renal function and medication clearance due to age can result in a smaller therapeutic window between safe dosages and dosages associated with respiratory depression and overdose.How do elderly metabolize differently than younger people? - ANSWER✔✔Older adults metabolize opioids slowly and therefore require lower doses than younger adults.When should naloxone be prescribed? - ANSWER✔✔with every opioid prescription 2 / 4
What is the typical dose of naloxone and how is it administered? - ANSWER✔✔4 mg, nasal spray- one spray to one nostril If no response, additional doses can be given every 2 to 3 minutes until emergency services arrive In regards to dosage, why do we need to be cautious when giving naloxone? - ANSWER✔✔Dosage must be titrated carefully bc if too much is given the patient will swing from a state of intoxication to withdrawal What is the half-life of naloxone? - ANSWER✔✔Short- naloxone must be administered every few hours until opioid concentrations have dropped to nontoxic levels US Drug Enforcement Administration description of the scheduled drugs - ANSWER✔ ✔The DEA enacted the Controlled Substances Act (CSA) in 1970 to regulate drugs and other substances based on their potential for abuse and dependency. Five schedules of controlled substances were created that are updated annually. Classes of scheduled substances include narcotics, depressants, stimulants, hallucinogens, and anabolic steroids. The DEA issues eligible providers with a registration number to write prescriptions for controlled substances.Schedule I - ANSWER✔✔high potential for abuse and no current accepted medical use example of schedule I - ANSWER✔✔Heroin, Lysergic Acid Diethylamide (LSD), Marijuana (cannabis), 3,4-Methylenedioxymethamphetamine (ecstasy), Methaqualone, and Peyote Schedule II - ANSWER✔✔substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence 3 / 4
Examples of schedule II - ANSWER✔✔Combination products with less than 15 milligrams of Hydrocodone per dosage unit (Vicodin), Cocaine, Methamphetamine, Methadone, Hydromorphone (Dilaudid), Meperidine (Demerol), Oxycodone (OxyContin), Fentanyl, Dexedrine, Adderall, and Ritalin Schedule III - ANSWER✔✔substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Abuse potential is less than schedule I and II drugs, but more than schedule IV examples of schedule III - ANSWER✔✔Products containing less than 90 milligrams of Codeine per dosage unit (Tylenol with codeine), Ketamine, Anabolic steroids, Testosterone Schedule IV - ANSWER✔✔substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence example schedule IV - ANSWER✔✔Xanax, Soma, Darvon, Valium, Ativan, Talwin, Ambien, Tramadol Schedule V - ANSWER✔✔substances or chemicals are defined as drugs with lower potential for abuse than schedule IV and consist of preparations containing limited quantities of certain narcotics. Are generally used for antidiarrheal, antitussive, and analgesic purposes example schedule V drugs - ANSWER✔✔Cough preparations with less than 200 milligrams of Codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin What type of analgesic for mild to moderate pain? - ANSWER✔✔tylenol, NSAID (Advil/motrin), COX2 inhibitors (like NSAIDS) What type of analgesic for moderate to severe pain? - ANSWER✔✔opioids
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