Drug Response in Infants and Children
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Questions and Answers

What factor contributes to a slower clearance of aminoglycosides in neonates?

  • Reduced renal clearance (correct)
  • Higher total body fat percentage
  • Lower gastric acid output
  • Increased hepatic enzyme activity

    • Which age-related change affects drug absorption in the elderly?

  • Reduced blood flow to the intestines (correct)
  • Increased absorptive surface area
  • Faster gastric emptying
  • Enhanced gastric secretions

    • Why is plasma protein binding reduced in neonates?

  • Higher levels of albumin
  • Decreased body water
  • Lower albumin concentration (correct)
  • Greater fat content

    • What is a consequence of decreased muscle and water content in elderly patients?

    <p>Lengthened duration of action for lipid-soluble drugs</p> Signup and view all the answers

    What physiological change in neonates increases drug permeability across the blood-brain barrier?

    <p>Less developed blood-brain barrier</p> Signup and view all the answers

    Which of the following factors does NOT complicate medication compliance in the elderly?

    <p>Absence of side effects</p> Signup and view all the answers

    How does aging affect drug metabolism?

    <p>Decreased rate of drug metabolism</p> Signup and view all the answers

    What characteristic of the renal system in neonates affects drug excretion?

    <p>Inefficient renal clearance</p> Signup and view all the answers

    What aspect of drug distribution is affected by aging?

    <p>Increased fat content leading to altered drug half-life</p> Signup and view all the answers

    How does renal function in neonates affect drug elimination?

    <p>Renal clearance is less efficient, leading to slower drug elimination</p> Signup and view all the answers

    Which factor contributes to altered drug response in elderly patients?

    <p>Alteration of drug receptors with age</p> Signup and view all the answers

    What is a common issue that complicates medication adherence in elderly patients?

    <p>Complex dosing regimens and polypharmacy</p> Signup and view all the answers

    What happens to drug metabolism as a person ages?

    <p>Decreased rate of drug metabolism</p> Signup and view all the answers

    How does the permeability of the blood-brain barrier change in neonates compared to adults?

    <p>It is more permeable, allowing easier drug passage</p> Signup and view all the answers

    Why is plasma protein binding reduced in neonates?

    <p>Lower concentration of albumin in neonates</p> Signup and view all the answers

    What is an impact of delayed gastric emptying in elderly individuals?

    <p>Slowed rate of drug absorption</p> Signup and view all the answers

    Study Notes

    Drug Response in Infants and Children

    • Infants and children have different drug responses compared to adults due to their unique physiological characteristics.
    • Body Composition: Infants have higher total body water than adults, primarily extracellular. Their fat content is lower, and their skin is thinner, leading to increased percutaneous absorption.
    • Gastrointestinal Function: Gastric acid output is lower in neonates than in adults.
    • Plasma Protein Binding: Plasma protein binding is reduced in neonates due to lower albumin concentration.
    • Blood Brain Barrier: The blood-brain barrier (BBB) is more permeable in neonates, allowing for faster drug entry into the brain.
    • Hepatic Enzyme Activity: Hepatic enzyme activity is low in neonates, affecting drug metabolism.
    • Renal Clearance: Renal clearance is less efficient in neonates, with adult glomerular filtration rate attained after 3-5 months and adult secretory and reabsorptive capacity achieved after 7 months.
    • Drug Elimination: Drugs that rely on renal elimination, such as aminoglycosides, are cleared slowly during the first few weeks of life.

    Drug Response in Geriatrics

    • Pharmacokinetics:

      • Absorption: Aging affects drug absorption due to reduced blood flow, intestinal surface area, gastric secretions, and delayed gastric emptying. This can lead to slower absorption and onset of drug action.
      • Distribution: Reduced water content and increased fat content in the elderly affect drug distribution. Lipid-soluble drugs have slower elimination, longer half-lives, and longer durations of action.
      • Metabolism: The rate of drug metabolism decreases with age due to reduced liver enzyme production.
      • Excretion: Decreased renal elimination leads to increased half-lives and durations of drug action.

    • Pharmacodynamics: Drug responses in the elderly differ from adults because of alterations in receptor function and impaired physiological adaptive mechanisms associated with aging.

    Challenges with Elderly Compliance

    • Complicated Dosing Regimens and Polypharmacy: Elderly individuals may have difficulty adhering to complex dosing regimens and managing multiple medications (polypharmacy).
    • Confusion: Age-related memory loss, cognitive impairments like Alzheimer's disease, or living alone can contribute to confusion and reduce compliance.
    • Unpleasant Side Effects: Unpleasant side effects can discourage the use of medication.
    • Drug Form: Difficulties swallowing large capsules or other forms of medication can affect compliance.
    • Drug Container: Containers that are difficult to open or understand can also present challenges.

    Drug Response in Infants & Children

    • Body Built Differences:

      • Infants and children have a higher percentage of total body water compared to adults, with a larger proportion being extracellular.
      • Fat content in children is lower than adults.
      • Due to thinner skin, infants and children have an increased rate of percutaneous absorption.

    • Gastrointestinal Function:

      • Neonates have lower gastric acid output compared to adults.

    • Plasma Protein Binding:

      • Plasma protein binding is reduced in newborns due to a lower concentration of albumin.

    • Blood Brain Barrier (BBB):

      • The BBB is more permeable in neonates.

    • Hepatic Enzyme Activity:

      • Hepatic enzyme activity is low in the neonatal stage.

    • Renal Clearance:

      • Renal clearance is less efficient in infants and children compared to adults.
      • Adult glomerular filtration rate is achieved after 3-5 months.
      • Adult secretory and reabsorptive capacity is reached after 7 months.
      • Drugs reliant on renal elimination, like aminoglycosides, are cleared very slowly in the first weeks of life.

    Drug Response in Geriatrics

    • Aging Effects on Pharmacokinetics and Dynamics:
      • Both pharmacokinetics and dynamics of drugs are affected by aging.

    Pharmacokinetics:

    • Drug Absorption:

      • Reduced blood flow, absorptive surface area in the intestine, gastric secretions, and delayed gastric emptying occur with age.
      • This results in slower drug absorption and slower drug action.

    • Drug Distribution:

      • Older individuals experience a decrease in muscle and water content, while fat content increases.
      • Lipid-soluble drugs exhibit slower elimination, a longer half-life, and a longer duration of action in older adults.

    • Drug Metabolism:

      • The rate of drug metabolism declines with age due to decreased production of liver enzymes.

    • Drug Excretion by Kidney:

      • Decreased elimination leads to increased half-life and duration of action.

    Pharmacodynamics:

    • Drug Responses in the Elderly:
      • Drug responses in older adults differ from those in younger adults due to alterations in receptors and age-related impairment of physiological adaptive mechanisms.

    Challenges with Elderly Compliance:

    • Complicated Dosing Regimens and Polypharmacy:

      • Complicated drug regimens and polypharmacy can make it challenging for elderly individuals to adhere to their medication schedules.

    • Confusion:

      • Age-related memory loss, Alzheimer's disease, and living alone can contribute to medication confusion.
      • This confusion tends to be directly proportional to the number of medications taken.

    • Unpleasant Side Effects:

      • Unpleasant side effects associated with medications may discourage use in older adults.

    • Form of Medication:

      • Elderly patients may have difficulty swallowing large capsules or other specific medication forms.

    • Container Difficulty:

      • Difficulty opening or reading and understanding medication containers can present a challenge.

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    Related Documents

    Drug Response In Infants & Children & Geriatrics PDF

    Description

    This quiz explores the unique physiological characteristics of infants and children that influence their drug responses. Participants will learn about factors such as body composition, gastrointestinal function, plasma protein binding, and the blood-brain barrier. Understanding these differences is crucial for effective pediatric pharmacotherapy.

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