NR 565 Advanced Pharmacology Midterm Exam 2024

During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long term consequences? - 1st trimester (fetus most at risk d/t rapid growth) What is BEERS criteria? - Recommendations of medications inappropriate for elderly (65 and older), prescriber ultimately decides What is the CYP450 (cytochrome P450) - liver enzyme system where medications are metabolized, can either be inducers or inhibitors and create drug-drug interactions CYP450 inducers - Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes CYP450 inducers pneumonic - "Bullshit Crap GPS INDUCES rage" CYP450 inducer drug names - Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas CYP450 inhibitors - inhibit metabolism, increase blood levels of medications CYP450 pneumonic - "VISA credit card debt INHIBITS spending on designers like CK to look GQ" CYP450 inhibitors drug names - Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic properties of drugs? - increase glomerular filtration rate leads to increase durg excretion increase hepatic metabolism decrease tone and motility of bowel increase drug absorption Examples of medications that can be teratogenic - Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES). How is absorption of intramuscular medications different in neonates? - slow and erratic due to low blood flow in muscles first few days of life Why is absorption of medication in the stomach increased in infancy? - delayed gastric emptying Some medications that should be avoided in the pediatric patient? - glucocorticoids,