Clinical trial in special population final
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The document discusses guidelines for clinical drug trials involving pediatric populations. It outlines important considerations for trials involving different pediatric age groups, including preterm and term newborns, infants, children, adolescents, and issues related to informed consent. Key factors discussed include appropriate dosing based on developmental differences, minimizing blood draws and pain/distress, informed consent processes, and protecting patient well-being.
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This document discusses polypharmacy in the elderly population. It defines polypharmacy as taking more medications than are clinically necessary. The elderly are at high risk for polypharmacy due to increased prevalence of illnesses and use of multiple providers. Polypharmacy can lead to adverse drug reactions, decreased adherence, poor outcomes and quality of life. Primary care physicians play an important role in managing polypharmacy through annual medication reviews called "brown bag reviews" where patients bring all medications. This helps optimize treatment by discontinuing unnecessary medications and simplifying dosing regimens.
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Polypharmacy and medication errors
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Polypharmacy
This document discusses polypharmacy, which is defined as the administration of many drugs simultaneously or an excessive number of drugs. Polypharmacy is common in elderly patients with multiple chronic conditions. It can be appropriate if all drugs achieve therapeutic objectives and minimize adverse effects, but is often inappropriate if drugs are unnecessary or cause harm. Tools like Beers Criteria, STOPP, and START can help identify inappropriate polypharmacy and guide deprescribing. The document outlines factors contributing to polypharmacy and consequences like adverse drug reactions, providing strategies to assess medication benefit-harm and safely discontinue unnecessary drugs.
Prescribing medication for the elderly
1. The document discusses guidelines for prescribing medication to elderly patients, noting that diseases often present atypically in older adults and multiple conditions usually occur simultaneously.
2. Key considerations include patient compliance, which decreases with more complex regimens, and polypharmacy, as the elderly often receive drugs from multiple sources.
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Editor's Notes
- patent ductus arteriosus - Patent ductus arteriosus, or PDA, is a heart condition that is normal but reverses soon after birth. In a persistent PDA, there is an irregular transmission of blood between two of the most important arteries in close proximity to the heart, the aorta and the pulmonary artery Necrotizing enterocolitis (NEC) is a medical condition primarily seen in premature infants , [1] where portions of the bowel undergo necrosis (tissue death).
- , many of the physiologic and pharmacologic principles discussed above also apply to term infants.
- The UDP-glucuronyl transferase enzyme system of infants, especially premature infants, is immature and incapable of metabolizing the excessive drug load. Insufficient renal excretion of the unconjugated drug.
- 1.Most pathways of drug clearance (hepatic and renal) are mature, with clearance often exceeding adult values. Changes in clearance of a drug may be dependent on maturation of specific metabolic pathways.
- CYP1A2
- The total volume of blood is estimated at 80 to 90 ml/kg body weight; 3% is 2.4 ml blood per kg body weight.
- Dose calculation errors occur in measuring height n weight