Lifespan Considerations
any medication taken can reach the developing fetus, the 1st trimester is the period of greatest risk and the 3rd trimester highest % of drug absorption
What is pregnancy via reproduction?
drug's chemical composition and molecular structure and is not used inna clinical setting
what is chemical drug name?
drugs that are regulated by the FDA and must be prescribed by a healthcare professional because they require periodic monitoring
what are prescription (RX) meds?
established in 1973 by the Controlled Substance Act to regulate drugs that may lead to dependency or abuse
What is DEA?
a genetic polymorphism where the drug is metabolized really fast; codeine is turned into morphine
what is ultra-rapid metabolizer patients?
A vast number of drugs that are lipid soluble, small molecular, non-ionized can enter breast/chest milk. Avoid long-acting drugs and take medications IMMEDIATELY AFTER feeding.
what is breastfeeding via reproduction?
the active ingredient inna drug and mainly used in a clinical setting; this name will NEVER change
what is the generic name?
pre-approved FDA approved meds that are generally safe and don't require periodic monitoring
what are non-prescription/OTC meds?
Classification system used to rank controlled substances (abuse/misuse potential, medical use, and dependency potential)
what are the DEA schedules?
genetic polymorphism where drug is slowly metabolized so it doesn't work and stays in the body
What are poor metabolizer patients?
Medications that pose a great harm to fetus such as Isotretinoin (Accutane)
What is reproductive potential?
Registered trademark by manufacturer (this name varies)
what os brand/trade name?
not regulated by FDA but by 3rd party manufacturers/distributors
what are dietary supplements such as vitamins, herbals, and homeopathic meds?
Requires a DEA license if they want to prescribe a controlled substance
what is prescribing authority?
Decreased gastric acid production and slower emptying time
More blood flow to skin so topical drugs get rapidly absorbed
Have limited binding sites <1 yrs old
Blood Brain barrier not fully developed
Dilute water soluble drugs rapidly due to high body water content
Liver and kidneys are immature
what is neonates pharmacokinetic differences?
drugs that are 80-125% effective
what is bioequivalance?
not available to the public during phase 1-3, only available in phase 4
what is the FDA clinical trial phase?
limited quantities and refills of certain medications; schedule 2 cannot get refills, they require a new prescription for each bottle
What are prescribing limitation?
Polypharmacy is common but is reduced by Medication reconciliation (critical)
decreased dgastric acid production and slower emptying time
Decreased body water and mass but higher fat content; decreased protein binding and liver function
Beers Criteria
What is geriatric pharmacokinetics?
4% difference of a therapeutic drugs efficacy; patients should use the same manufacturer to ensure the product effect stays consistent
what are seizure, thyroid, and transplant meds under the narrow therapeutic index?
benefits outweigh the risks (particularly for certain populations)
Example: Isotretinoin/Accutane which is highly teratogenic so must confirm negative pregnancy test before administration, during therapy, and 1 month after discontinuation
What is the REMS Program?
The study of how genetic differences in a single gene influence variability in drug response
what is pharmacogenetics?