Question

1. Discuss the pharmacokinetics of children 1 year old or older.
2. Discuss reasons pediatric patients are subject to adverse drug reactions when drug levels rise too high.
3. Discuss dosage determination, noting that pediatric doses have been established for some drugs but not for others and, therefore, for drugs that do not have established pediatric doses, the doses can be extrapolated from adult doses.
4. Discuss the appropriate steps in determining exposure to teratogens.
5. Discuss drug therapy during breast-feeding and the potential risks to the breast-feeding neonate or infant of a mother who is taking drugs. Consider the health and well-being of both the mother and the fetus.
6. Distinguish among the categories established by the U.S. Food and Drug Administration to classify potential drug risks to the fetus (A, B, C, D, X). Comment on the meaning of each category with regard to potential fetal risks, the reasons medications are categorized as they are, and the evidence upon which each drug is assigned to a classification.
7. Discuss the significance of body weight and composition, focusing on the effect of weight and the requirement for larger doses of a drug to obtain a therapeutic effect because of an increase in tissues to perfuse (percentage of body fat) and an increase in receptor sites in some reactive tissue.
8. Discuss bioavailability and other causes of variable absorption. Explain why differences in bioavailability a significant concern with drugs are that have a narrow therapeutic index.
9. Discuss common mechanisms by which genetic differences modify drug responses (e.g., altered drug-metabolizing enzymes, altered drug targets).
10. Discuss three gender-related differences that can occur in response to administration of the same drug.
11. Discuss two primary determinants of race-related drug responses.
12. Discuss factors that may result in the patient’s failure to take medications as prescribed.
13. Discuss drug interaction as a source of variability.
14. Discuss the effects of diet on drug responses.
15. Discuss types of medication errors, causes of medication errors, ways to reduce medication errors, and ways to report medication errors.
16. Discuss organ-specific toxicity. Focus on the liver as a drug-metabolizing system and explain why it is such a crucial participant in organ-specific toxicity with drugs.
17. Discuss how and why adverse drug reactions occur, given that for a prescription drug to be approved for use, it must have demonstrated and been documented for safety, and also given the explicit printed information provided about such facts as doses, routes, interactions, and so on.
18. Discuss adverse reactions to new drugs and the importance of being alert for unusual responses when giving new drugs. Also point out the importance of informing other nurses where to report unknown adverse effects of a new drug and of accessing a website where information on adverse effects can be reported.
19. Give examples of inhibitory interaction of drugs that can produce dangerous effects and those that are beneficial.
20. Discuss the mechanisms and clinical consequences of drug–herb interactions and drug–food interactions. Focus on ways to minimize adverse drug–drug interactions and drug–food interactions. Include in the discussion the effect of food on drug absorption and metabolism, drug toxicity, drug action, and the timing of drug administration with respect to meals.
21. Identify electronic resources available for determining action, side effects, therapeutic index, and anticipated effects of drugs.
22. Discuss dose-response relationships (e.g., basic features of the dose-response relationships, maximal efficacy, and relative potency), the effects drugs can produce, and the amount of drug needed to elicit an effect.
23. Discuss properties of drug-receptor interactions (e.g., drug receptors, four primary receptor families, receptors and selectivity for drug action, theories of drug-receptor interaction, agonists, antagonists, partial agonists, and regulation of receptor sensitivity).
24. Describe how receptors function in the responses to many drugs and physiologic processes, such as the activity of the respiratory and gastrointestinal systems.
25. List the four primary families of receptors.
26. Discuss “receptor less drugs” (e.g., antacids, antiseptics, saline laxatives, chelating agents, and so on).
27. Discuss interpatient variability in drug responses and describe how to measure variability.
28. Implement effective communication tools to advocate for patients in the clinical setting.
29. Identify electronic resources available for determining action, side effects, therapeutic index, and anticipated effects of drugs.
30. Discuss the concept of a drug’s therapeutic index and its application and benefits to clinical practice, such as the relationships between the doses of a drug and whether its effects are subtherapeutic (inadequate response), therapeutic (desired response), or toxic (adverse effects related to excessive dosage).

Answer 1

Q. No 1. Answer :

Pharmacokinetics means absorption , metabolism, distribution, and excretion, these are different in children comparing to an adults.

* due to low maturity of organs like gastrointestinal gut, liver and kidneys, there is a less absorption, metabolism and distribution .

* Due to decreased glomerular filteration rate decreased capacity of excretion of medication, will see in one year old children.

Q. No 2. Answer :

Reasons pediatric clients are subjective to adverse drug reactions when drug levels rise too high :

* children are more sensitive to the drugs.

* Due to activation of immune system, when we will give over dose which may effect on own body functions like it may effect on antibodies which are produces on children body.

* so own body cells also destroys, and reactions may arises due to over dosage.

Q. No 13. Answer :

Drug interaction as a source of variability :

Drug interaction means when the two are more drugs administer together there is a interact with each drug, which may leads to some other side effects.

Due to this drug interaction there may be a increases or decreased responses of drugs on the organ receptors which may leads to low uses for the diseases.

So it is one of the source of variability.

Q. No 25. Answer :

Four primary families of receptors :

1. Ligand gated ion channels.

2. G- protein coupled receptors.

3. Kinase linked receptors.

4. Nuclear receptors.

These are the four primary families of receptors.