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Drug Action Across The Life Span > Pharmacology
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Showing 15 questions, Sign in for moreA 16-year-old adolescent is 6 weeks pregnant. The pregnancy has exacerbated her acne. She asks the nurse if she can resume taking her isotretinoin (Accutane) prescription, a category X drug. What is the most appropriate response by the nurse?
To reduce the effect of a prescribed medication on the infant of a breast-feeding mother, how should the nurse teach the mother to take the medication?
An older adult client has arthritis in her hands and takes several prescription drugs. Which statement by this client requires further assessment by the nurse?
A nurse is administering a liquid medication to a 15-month-old child. What is the most appropriate approach to medication administration by the nurse? Select all that apply.
The nurse is preparing to give an oral medication to a 6-month-old infant. How should this drug be administered?
To reduce the chance of duplicate medication order for the older adult returning home after surgery, what actions should the nurse take? Select all that apply.
A client who has been asked to participate in a study asks the nurse what the term placebo means. What would be an appropriate response by the nurse?
Why is it important for the nurse to understand the difference between drug dependence and drug accumulation?
The nurse knows that drug absorption in the elderly is affected by which of these physiologic factors? Select all that apply.
A client was discussing with the nurse the idea that in the future we will be able to determine which drug will be effective depending on a person’s genetic makeup. Which term does this refer to?
The nurse caring for an elderly client understands that when giving medications there are aging factors that affect how the drug will work.
Indicate with an X the factors that influence drug actions related to aging.
Explanation
As individuals age, several physiologic changes impact how drugs are absorbed, distributed, metabolized, and excreted. Factors such as reduced renal function, decreased hepatic metabolism, and lower serum albumin levels can alter a drug’s action in older adults. Recognizing these age-related changes is essential for ensuring safe and effective medication management.
Rationale for correct answer:
Genetics, smoking, diet, gender, other medications and diseases
These factors influence all phases of pharmacokinetics by altering enzyme function, gut health, protein binding, and organ performance. They can affect how drugs are absorbed, distributed, metabolized, or excreted, leading to variability in drug response.
Albumin levels diminish
Older adults often have lower serum albumin, which affects protein binding of drugs. Reduced binding increases the free active drug in circulation, influencing drug distribution and potentially enhancing drug effects or toxicity.
Decreased renal blood flow
Aging reduces renal perfusion and glomerular filtration rate, impairing the kidneys’ ability to excrete drugs. This can lead to drug accumulation and an increased risk of toxicity, especially with renally-excreted medications.
Muscle inactivity and changes in muscle mass
Loss of lean body mass and increased fat content in the elderly alters the volume of distribution. Lipophilic drugs may accumulate in fat stores, while hydrophilic drugs may have less tissue for distribution, affecting both onset and duration of action.
Take-home points:
- Aging reduces renal and hepatic function, increasing the risk of drug accumulation and toxicity.
- Lower albumin levels in older adults can lead to higher active drug levels in the bloodstream.
- Changes in body composition and lifestyle factors significantly impact how drugs are absorbed, distributed, and metabolized in the elderly.
While discussing with a mother the importance of administering furosemide orally to an infant with a cardiac abnormality, the nurse would recognize the need for further explanation if the mother makes which statement?
The nurse recognized there are gender considerations to keep in mind with regard to drug actions.
Choose the most likely options for the information missing from the sentence below by selecting from the lists of options provided.
The gender considerations to keep in mind with regard to drug actions are that
Explanation
Answer:
The gender considerations to keep in mind with regard to drug actions are that women have greater proportion of body fat will affect distribution and that women have slower gastric emptying time will affect absorption, as well as that women have more active cytochrome P450 enzymes will affect metabolism.
Gender differences can significantly influence how drugs are processed in the body. Women generally have a greater proportion of body fat, which can alter drug distribution, especially for fat-soluble medications. Additionally, slower gastric emptying time in women can affect drug absorption, and more active cytochrome P450 enzymes may lead to faster or altered drug metabolism. These differences highlight the importance of considering gender when evaluating drug response and dosing.
Rationale for correct answer:
Women have greater proportion of body fat → distribution
Fat-soluble drugs distribute more widely and persist longer in individuals with higher body fat, which can influence the drug's duration and effectiveness in women.
Women have slower gastric emptying time → absorption
Slower gastric emptying can delay the time it takes for drugs to reach the small intestine, affecting the rate and possibly the extent of drug absorption.
Women have more active cytochrome P450 enzymes → metabolism
Cytochrome P450 enzymes are responsible for drug metabolism. Increased enzyme activity can lead to faster metabolism and potentially reduced efficacy or duration of action of some medications in women.
Take-home points:
- Women’s higher body fat percentage can influence the distribution of fat-soluble drugs.
- Slower gastric emptying in women may delay or alter drug absorption.
- More active cytochrome P450 enzymes in women can change the rate of drug metabolism.
A pregnant woman asked a nurse at the obstetrician’s clinic how she could determine which drug was safe to take during pregnancy. What would be an appropriate response by the nurse?
An expecting mother asks the nurse if it would be okay for her to take some cold medicine. What would be an appropriate response by the nurse?
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