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Questions and Answers
How does the total body water content in infants compare to that in adults?
What is a significant difference in gastric acid output between neonates and adults?
How does the blood-brain barrier (BBB) differ in neonates compared to adults?
What characterizes the hepatic enzyme activity in neonates?
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What age range is associated with adult glomerular filtration rate attainment?
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How does aging affect drug metabolism?
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What is a common challenge faced by elderly patients regarding medication compliance?
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What impact does polypharmacy have on elderly patients?
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How does aging affect the distribution of lipid-soluble drugs?
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What factor contributes to reduced drug absorption in elderly patients?
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Study Notes
Infants and Children Drug Response
- Infants and children differ in their drug responses compared to adults due to various physiological factors.
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Body Build:
- Infants have a higher percentage of total body water, predominantly extracellular.
- Body fat content is lower in children.
- Thin skin increases percutaneous absorption.
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Gastrointestinal Function:
- Gastric acid output is lower in newborns compared to adults.
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Plasma Protein Binding:
- Reduced in neonates due to lower albumin concentration.
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Blood-Brain Barrier (BBB):
- More permeable in newborns.
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Hepatic Enzyme Activity:
- Low in newborns, leading to slower drug metabolism.
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Renal Clearance:
- Less efficient in infants and children, with adult glomerular filtration rate achieved around 3-5 months and adult secretory and reabsorptive capacity attained after 7 months.
- Drugs eliminated primarily by the kidneys (e.g., aminoglycosides) are cleared slowly in the first weeks of life.
Geriatric Drug Response
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Effects of Aging:
- Aging affects both pharmacokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body).
Pharmacokinetics in Geriatrics
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Drug Absorption:
- Reduced blood flow, absorptive surface area in the intestines, and gastric secretions.
- Delayed gastric emptying leads to slowed absorption and drug action.
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Drug Distribution:
- Decreased muscle and water content, with an increased fat content.
- Lipid-soluble drugs have slower elimination, longer half-lives, and longer duration of action.
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Drug Metabolism:
- Rate of drug metabolism decreases with age due to reduced production of liver enzymes.
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Drug Excretion by Kidney:
- Decreased elimination results in increased half-life and duration of action.
Pharmacodynamics in Geriatrics
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Altered Response:
- Drug response in the elderly may differ from adults due to altered receptor sensitivity and impaired physiological adaptive mechanisms.
Challenges with Elderly Compliance
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Complicated Regimens and Polypharmacy:
- Complex dosing regimens and multiple medications can contribute to non-compliance.
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Confusion:
- Age-related memory loss, underlying conditions like Alzheimer's disease, and living alone can increase confusion, leading to medication errors.
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Unpleasant Side Effects:
- Side effects can discourage adherence to drug regimens.
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Drug Form:
- Difficulty swallowing large capsules or other particular medication forms can make adherence difficult.
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Containers:
- Difficulty opening or reading and understanding medication bottle labels can lead to errors in administration.
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Description
Explore how infants and children respond differently to drugs compared to adults. This quiz covers physiological factors such as body composition, gastrointestinal function, plasma protein binding, and metabolic activity that influence drug efficacy and safety in young patients.