220 likes | 387 Views
Pharmacology in the Lifecycle. Mike Ori. Compare fat, muscle, body water, renal clearance, hepatic clearance, and skin qualities across the lifecycle. Comparisons to adult. Discuss the various methods of drug delivery across the lifecycle.
E N D
Pharmacology in the Lifecycle Mike Ori
Compare fat, muscle, body water, renal clearance, hepatic clearance, and skin qualities across the lifecycle
Discuss the various methods of drug delivery across the lifecycle
Explain why off-label use of pharmaceuticals is high in pediatrics
Safety and efficacy studies are typically carried out in healthy young adults therefore evidence based dosing regimens are not available for children. Case studies, expert opinion, and other less rigorous methodologies are commonly relied on.
Discuss in general terms the pediatric applicability of cockroft-gault, traub-johnson, and the schwartz equation
Cockroft-gault is for use in adults age 18 and older. • Schwartz and traub-johnson are both suitable for use in pediatrics
Describe the status of the blood brain barrier in geriatric patients and relate this to the beers list
The BBB is not as tight in geriatric patients which results in increase CNS effects of drugs targeted to the CNS and to drugs with CNS side effect.
Describe the importance of the Beer list in geriatric patients
Because of diminished eyesight and cognition changes, many geriatric patients prefer choosing beers from a picture list. • Alternatively, it’s a list of drugs, created by consensus of expert opinion, that should be avoided or used with caution in older adults.
They have lower total body water, impaired baroreceptors, impaired renal concentration capability all of which combined with social factors to limit hydration. As a result, many geriatric patients are hypovolemic, hyponatremic, and hyperkalemic.
Cognitively impaired, dependent female living alone • Vulnerable adult living with others, physically or financially dependent • Family history of domestic abuse • Caregiver with mental illness or substance abuse • Caregiver forced by circumstance to care for the elder
Prolonged interval between trauma or illness and presentation • Suspicious hx of unexplained injuries • Irregular follow-up, lack of adherence • Elder not given opportunity to speak for themselves • Vulnerable adult: Fearful or withdrawn behavior • Caregiver: indifferent or angry