Chapter 3

herbal medicines

Pregnant women should avoid:

Monoclonal antibodies

medicines that were synthesized to attack certain types of cancers

Carcinogenicity

Ability of a drug to induce living cells to mutate and become cancerous

Teratogenic

Androgenic and estrogenic hormones ACE inhibitors, ethanol, tetracycline Thalidomide, vitamin A, warfarin Angiotensin II receptor antagonists Anticonvulsants, antimanic agents, antithyroid Chemotherapy, statins, cocaine These are drugs known to be:

Reyes's syndrome

Aspirin use is linked to:

Nocebo effect

Effect where patient's negative expectations can result in a less-than-optimal outcome

Genome

Complete package of genetic coding of an organism

Cumulative Effect

Drug accumulation occurs when the next dose is given before the previously given drug has been metabolized or excreted May result in drug toxicity

Teratogens

Drugs that cause abnormal development of fetal tissues

B Rationale: Drugs that are relatively insoluble are transported in the bloodstream bound to plasma proteins (albumin and globulins). There is a decreased affinity for binding in infants, especially preterm infants. These drugs are then distributed over a wider area of the neonate's body. They will therefore require a higher dosage of these medications in order to achieve a therapeutic effect.

Due to the decreased protein-binding capacity in preterm infants, what adjustment in dosage of protein-binding drugs would need to made? a- The dosage should be decreased. b- The dosage should be increased. c- The dosage should be kept at the same level. d- Protein-binding drugs are not administered to infants.

c: Drugs are therapeutic when maintained within the normal range for the drug. In this example, the level is below that indicated for the drug, or subtherapeutic. A subtherapeutic level would require increasing the dose for the patient to achieve the maximum benefit of the drug.

It is important to maintain therapeutic levels of drugs to avoid the complications of being over- or undermedicated. If a drug level of 0.5 to 2 ng/mL is considered therapeutic, a drug level of 0.45 ng/mL is considered to be what? a- Toxic b- Therapeutic c- Subtherapeutic d- Tolerant

Polypharmacy

Multidrug therapy

Drug Tolerance

Occurs when a person begins to require a higher dosage of a medication to produce the same effects that a lower dosage once provided. Can be caused by psychological dependence

Drug Dependence

Person is unable to control his/her ingestion of drugs -Physiologic: Person develops withdrawal symptoms if drug is withdrawn -Psychological: Person is emotionally attached to a drug

Pharmacogenetics

Study of how drug response may vary according to inherited differences

Genetics

Study of how living organisms inherit the traits of their ancestors, including function of metabolic pathways

Geriatric patients

Total body water content decreases in:

d

Which form of medication is more easily administered for a toddler who requires a course of antibiotics? a- Enteric b- Capsules c- Tablets d- Liquid

Women. A woman's stomach empties solids more slowly than a man's does

Which gender has increased absorption rates?

Placebo effect

effect where patient's positive expectation can positively affect the outcome.

C

Pregnancy categories: a,b,c,d, or x? Animal studies have shown an adverse effect, and there are no adequate and well-controlled studies in pregnant women OR no animal studies have been conducted, and there are no adequate and well-controlled studies in pregnant women

x

Pregnancy categories: a,b,c,d, or x? Studies are adequate, well-controlled, or observational; in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. The use of the product is contraindicated in women who are or who may become pregnant

D

Pregnancy categories: a,b,c,d, or x? Studies are adequate, well-controlled, or observational; in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risk

A

Pregnancy categories: a,b,c,d, or x? Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities

B

Pregnancy categories: a,b,c,d, or x? Animal studies have revealed no evidence of harm to the fetus; however, there are no adequate and well-controlled studies in pregnant women OR animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus

c : 74%

Which patient has the greatest percentage of body water? a- Older adult b- Middle-aged person c- Infant d- Toddler

b

Which type of topical drug is more readily absorbed by infants? a- Fat-soluble b- Water-soluble c- Emollient d- Protective