NR 565 - advanced pharmacology midterm -
Chamberlain
1. What is BEERS criteria?: Recommendations of medications inappropriate for elderly (65
and older), prescriber ultimately decides
2. What is the CYP450 (cytochrome P450): liver enzyme system where medications are
metabolized, can either be inducers or inhibitors and create drug-drug interactions
3. CYP450 inducers: Speed up metabolism of drugs (drug is cleared faster), drug has lesser
ettect (decrease blood levels of drug), elevate CYP450 enzymes
4. CYP450 inducer drug names: Barbituates, St John wort, Carbamazepine, rifampin, alcohol,
phenytoin, griseofulvin, phenobarbital, sulfonylureas
5. CYP450 inhibitors: inhibit metabolism, increase blood levels of medications
6. CYP450 pneumonic: "VISA credit card debt INHIBITS spending on designers like CK to look
GQ"
7. CYP450 inhibitors drug names: Valproate, isoniazid, sulfonamides, amiodarone,
chloramphenicol, ketoconazole, grapefruit juice, quinidine
8. How is absorption of intramuscular medications different in
neonates?: slow and erratic due to low blood flow in muscles first few days of life
9. Why is absorption of medication in the stomach increased in
infancy?: delayed gastric emptying
10. Some medications that should be avoided in the pediatric
patient?: glucocorti- coids, discoloration of developing teeth with tetracyclines, and kernicterus
with sulfonamides, levofloxacin (antibiotics) aspirin (Severe intoxication from acute overdose)
11. what should be included in medication administration patient
education?: -
dosage size and timing
route and technique of
administration duration of treatment
drug storage
nature and time course of desired
responses nature and time course of
adverse responses finish taking
antibiotic
12. What are some things that put the elderly patient at higher risk
for adverse
drug reactions?: reduced renal function
, NR 565 - advanced pharmacology midterm -
Chamberlain
polypharmacy (the use of five or more medications
daily) greater severity of illness
presence of comorbidities
, NR 565 - advanced pharmacology midterm -
Chamberlain
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered
pharmacokinetics inadequate supervision of long-term therapy
poor patient adherence
13. How can healthcare providers decrease likelihood of an elderly
patient expe- riencing an adverse drug reaction?: obtaining a thorough drug history
that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to
age monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic
illness periodically reviewing the need for continued
drug therapy encouraging the patient to dispose of
old medications
taking steps to promote adherence and to avoid drugs on the Beers list
14. How can we promote medication adherence with elderly
patients?: simplifying drug regimens
providing clear and concise verbal and written
instructions using an appropriate dosage form
clearly labeling and dispensing easy-to-open
containers developing daily reminders
monitoring
frequently
attordability of
drugs support
systems
15. Why do nitrates need to be taken no later than 4 PM?: Need nitrate free
interval so
tolerance doesn't develop
16. Nine factors that impact outcome of medication?:
Gender and race Genetics and pharmacogenomics
Variability in
, NR 565 - advanced pharmacology midterm -
Chamberlain
absorption placebo
ettect Tolerance
patho
Chamberlain
1. What is BEERS criteria?: Recommendations of medications inappropriate for elderly (65
and older), prescriber ultimately decides
2. What is the CYP450 (cytochrome P450): liver enzyme system where medications are
metabolized, can either be inducers or inhibitors and create drug-drug interactions
3. CYP450 inducers: Speed up metabolism of drugs (drug is cleared faster), drug has lesser
ettect (decrease blood levels of drug), elevate CYP450 enzymes
4. CYP450 inducer drug names: Barbituates, St John wort, Carbamazepine, rifampin, alcohol,
phenytoin, griseofulvin, phenobarbital, sulfonylureas
5. CYP450 inhibitors: inhibit metabolism, increase blood levels of medications
6. CYP450 pneumonic: "VISA credit card debt INHIBITS spending on designers like CK to look
GQ"
7. CYP450 inhibitors drug names: Valproate, isoniazid, sulfonamides, amiodarone,
chloramphenicol, ketoconazole, grapefruit juice, quinidine
8. How is absorption of intramuscular medications different in
neonates?: slow and erratic due to low blood flow in muscles first few days of life
9. Why is absorption of medication in the stomach increased in
infancy?: delayed gastric emptying
10. Some medications that should be avoided in the pediatric
patient?: glucocorti- coids, discoloration of developing teeth with tetracyclines, and kernicterus
with sulfonamides, levofloxacin (antibiotics) aspirin (Severe intoxication from acute overdose)
11. what should be included in medication administration patient
education?: -
dosage size and timing
route and technique of
administration duration of treatment
drug storage
nature and time course of desired
responses nature and time course of
adverse responses finish taking
antibiotic
12. What are some things that put the elderly patient at higher risk
for adverse
drug reactions?: reduced renal function
, NR 565 - advanced pharmacology midterm -
Chamberlain
polypharmacy (the use of five or more medications
daily) greater severity of illness
presence of comorbidities
, NR 565 - advanced pharmacology midterm -
Chamberlain
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered
pharmacokinetics inadequate supervision of long-term therapy
poor patient adherence
13. How can healthcare providers decrease likelihood of an elderly
patient expe- riencing an adverse drug reaction?: obtaining a thorough drug history
that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to
age monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic
illness periodically reviewing the need for continued
drug therapy encouraging the patient to dispose of
old medications
taking steps to promote adherence and to avoid drugs on the Beers list
14. How can we promote medication adherence with elderly
patients?: simplifying drug regimens
providing clear and concise verbal and written
instructions using an appropriate dosage form
clearly labeling and dispensing easy-to-open
containers developing daily reminders
monitoring
frequently
attordability of
drugs support
systems
15. Why do nitrates need to be taken no later than 4 PM?: Need nitrate free
interval so
tolerance doesn't develop
16. Nine factors that impact outcome of medication?:
Gender and race Genetics and pharmacogenomics
Variability in
, NR 565 - advanced pharmacology midterm -
Chamberlain
absorption placebo
ettect Tolerance
patho
