Week 2 Worksheet (2025)

I Asal Ardalan Worksheet for PHAR 840 (Farris) Spring 2025 Lim Upon completion of this exercise, you will be able to: Ms Pharmacology of Aging Agin ofo ofthe d shortening 1. Describe the effects of Amelia and Phocomelia Amelia: Absence of limbs (upper limbs are most effected) Phocomelia: Paraxial reduction of long bones of limbs (shortening of the limbs) 2. Identify the drug responsible for outbreak of amelia and phocomelia in the 1960s. • The drug was thalidomide Introduced in 1956 as sedative/ hypnotic • Used to ameliorate nausea and vomiting during pregnancy • Some peripheral neuritis in patients with long-term use • NO known serious human toxicities or addictive properties at therapeutic levels 3. Explain why development from the embryo to the adolescent stages of life is referred to as a “Pharmacological Moving Target” • Happens during the first few month • Body composition penal • Renal function metabolis •3 Receptor response • Unique disorders • Organ function Orgent • Extremely small margin of error of the most fragile patients o Errors can be devastating o Individual variance unprintable • Drug metabolizing enzymes o Unique metabolic pathways 4. Name the approximate percentage of approved drugs that have pediatric labelling 20-30% ( 25% this is closer to the correct answer) 5. Describe the level of activity of the majority of CYP450 enzymes during the first 2 or 3 months after birth are Level of activity of CYP450 is low typically compared to neuron Metabolism is low at full term and still low at 1-2 month then it increases with age With 6month to a year, they develop. During the early development, CYP450 are very low 6. Describe how the total body water and extracellular water levels of infants (0 to 6 months) compared to those in adults They are both high goto Total body water: At birth it’s high (80%) drops to 60% around 6 month and continue dropping extra throughout the adulthood Extracellular water: At birth it’s 40% and then drops somewhere from 20-30% at adulthood and continue to drops during development slowderatopogfirst 7. Explain how renal function changes from birth to adolescence Para-aminohipp uric acid: total excretion, active secretion +glomerular filtration Starts slow and develops over the first year to 2 years to approximately adult levels 8. State the age at which gastric acid levels in infants approach those in the adult-3month 9. Explain how the half-lives of CYP450 enzyme substrates change in infants from birth to 6 months of age thalidomide O Papa DDP I Bodom EEitdis a MT Q low Both t D Gaston 4idhrognetabolisestenHghmetabolize Highpoorm Highmat Asal Ardalan Half-lives are high at birth (poorly metabolize) and then drop(become shorter as you age because, of the increase rate of metabolize) 10. Describe how “total body water”, “lean body mass”, “body fat”, and “serum albumin” change in geriatric patients compared to younger adults o o Serum albumin decreases because of decrease rate of synthesis of serum albumin DO NOT worry about a-1 acid glycoprotein 11. Describe how Beta-Adrenergic receptor and baroreceptor activity compare in geriatric patients compared to those in younger adults so odd 12. Describe how the physiological activity of most organ systems in geriatric patients compares to those in younger adults Most organ systems are going to have reduction in the activity. laranytingh gestapo a 21370 13. Name the fraction of elderly adults that are typically on more than 1 drug per day 2/3 use 1 or more drugs daily (70%) 14. Describe how the volume of distribution of water soluble drugs differs between newborns and adults Body water is higher in newborns compare to adults which is higher than geriatrics. As you age, from birth to death have a decrease in total body water 15. Describe how the volume of distribution of water soluble and lipid soluble drugs change as adults age Antipyrine volume of distribution of water soluble is going to decrease with age and volume of distribution of lipid soluble drugs increases (because of the percentage of the body fat increases) 16. Explain why the volume of distribution of water soluble and lipid soluble drugs change as adults age Because of the body water and body lipids contents change. As you age (20-80) body water drops significantly, and you increase significantly your lipid (body fat). Diazepam is indicating increase in body fat. Antipyrine is following the decrease in total body water 17. Identify whether Phase I or Phase II enzyme activity is better preserved as adults age Phase II enzymes are maintained more consistently with age than phase I. phase II enzymes change less than phase I. 18. Name the assumption regarding Creatinine production in the body upon which the validity of the Cockcroft-Gault equation is based as PE Bcofiofbodyfitton 00 D Fi besteadysta werfersowto Antipyrine Lipidtpiore MYBodyfat Asal Ardalan I Rate of creatinine production is the same as rate of creatinine loss. 19. Explain why more drug studies are not conducted in children Ethical problem. Children don’t have control of themselves (Depends on the parent, guardian) 20. Explain how urinary excretion patterns give clues to routes of elimination of drugs(NOT IN THE EXAM)-SKIP 21. Describe how pharmacokinetic parameters change in geriatric patients- They decrease rate of absorption decreases. ADME (typically percent of absorption may not change, same bioavailability but decrease rate. Distribution: depends on water soluble or lipid soluble. But typically, it would change. Metabolism decreases. Excretion: Decreases. Urinary elimination rate would decrease. If metabolically degraded by liver, it would decrease too typically because rate of metabolism decreases. 22. Describe how physiological parameters change with age(SKIP) 23. Identify the fraction of drugs that have specific labeling for pediatric dosing(Same as#4) o o