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Drug Administration Through Lifespan - Coggle Diagram
Drug Administration Through Lifespan
Pregnancy or Lactation
Excretion
kidney blood flow increases 50%
renal plasma flow
glomerular filtration rate
renal tubular absorption
Distribution and Metabolism
Increased blood/plasma volume
Altered blood flow
increase: uterus, kidney, skin
decrease: skeletal muscles
Changes in lipid levels (think abt breast milk and fat soluble meds)
Placental transfer
Absorption
Progesterone levels
delayed gastric emptying
decreased gastric acidity
increased tidal volume and pulmonary vasodilation
Expanding uterus and blood flow
Protection
Fetal membrane
Placental membrane
Gestational Age and Drug Therapy
Teratogen
Pre-Implantation Period: death of embryo or no effect
Embryonic Period: Max sensitivity (abnormality depends on which organ is forming at time of exposure)
Fetal Period: blood flow to placenta increases and vascular membrane decreases
Pregnancy Lactation labeling rule
Pregnancy Registries
Factors influencing drug secreted into breastmilk
Drug Properties
Water-solubility
Basic Drugs
Timing
Post-breastfeeding
Half-Life of drug
short
long
Protein binding
high
low
Infant's metabolism
Drug destruction in GI system
Pharmacotherapy of Infants
Safety and Accurate Dosing
Infant ingests entire does w/o spitting out
If infant immediately vomits after dose, it may be reordered
Comfort and Positioning
Hold and cuddle infant during positioning
Fluid restrictions = pacifier
Administration Methods
Oral: with dropper towards inner cheek
Rectal Suppositories: hold buttocks together fro 5-10 min
IM Injection: Vastus Lateralis
IV Injection: Veins in feet or scalp
Pharmacotherapy of Toddlers( 1-3)
Safety
keep out of reach and in locked cabinets
medicine looks like candy
toddlers are trying everything and place things in mouth
Medication administration
Administration
short concrete explanation followed by drug administration
physical comfort or verbal praise after drug admin
IM Injection
vastus lateralis muscle
Oral
can mix in jam, syrup, fruit puree in smallest possible amount
avoid mixing healthy foods with bad tasting mefs
IV Injection
feet or scalp vein
longer tubing for more play room
educate parent on safety
Pharmacotherapy of preschoolers (3-5)
Safety
keep out of reach
Medication Administration
Short explanation followed by drug administration
IM Injection
If toddler has walked for over a year, use ventrogluteal for less pain
IV Injection
No more scalp vein, use peripheral
Oral
You can crush or mix with food
Pharmacotherapy of School Age Children (6-12)
Medication Administration
Participation and Choice!
Oral
can take chewable or even swallow
IM Injections
Ventrogluteal
Pharmacotherapy of Adolescents
common needs
skin problems
headaches
menstrual problems
eating disorders
contraception
teaching
sexuality: safe sex, condom
Eating disorders: OTC appetite suppresants, bulimia, anorexia
Alcohol and drug use
confidentiality and privacy
Pharmacotherapy of Adulthood
Young and Middle Aged Adults
drug abuse
sexual activity
excessive stress and surfacing health impairments
Older Adults
polypharmacy
aids
alarmed medication containers
pill organizers
written instructions
physiologic changes affecting pharmacotherapy
absorption
slower absorption: diminished gastric motility and decreased blood flow
increased gastric ph: delays dissolution of oral meds
distribution
increased body fat: can store lipid soluble drugs
decreased body water: increases concentration of water soluble drugs, raising risk of toxicity
reduced albumin production: Lower albumin levels decrease plasma protein-binding, increasing free drug levels and potential drug interactions.
decreased cardiac output: Slower drug distribution due to reduced cardiac output and less efficient blood circulation.
Metabolism
Reduced Hepatic Function: Decreased enzyme production and visceral blood flow in the liver lead to slower drug metabolism, increasing drug half-life and intensifying responses.
Reduced First-Pass Metabolism: This results in higher plasma and tissue drug concentrations, altering dosage and side effect duration.
Excretion: Declined Renal Function: Reduced renal blood flow, glomerular filtration rate, and nephron function decrease drug excretion, increasing serum drug levels and toxicity risk.