12 - Pedi Pharm

Question 1

problems from using chloramphenicol and TMP/SMX in babies

Answer 1

chloramphenicol - grey baby syndrome

TMP/SMX - kernicterus

Question 2

problems w/ babies and oral med absorption

Answer 2

“relative achlorhydria” - stomach ph >4 in neonates
irregular motility / gastric emptying time
fragile intestinal mucosa - can get destroyed by high osmolality

Question 3

where is preferred site for IM drugs in babies?

Answer 3

anterolateral thigh

Question 4

relative difference in body volume compartments in babies and how it affects dosing

Answer 4

babies have way more total body water and much less fat

need larger doses of hydrophilic drugs and lower doses or lipophilic drugs

Question 5

drug-protein binding in neonates

Answer 5

dec > inc free drug conc, need to reduce dose accordingly

Question 6

neonatal gasping syndrome was caused by what?

Answer 6

benzyl alcohol (additive in soln of several drugs)

Question 7

what drug metab/excretion process really increases in capacity in the first week of life?

Answer 7

renal clearance

Question 8

how are these factors different in a baby compared to an adult (pharm context)?
volume of distribution
protein binding
hepatic metabolism
renal clearance

Answer 8

inc volume
dec protein binding
dec hepatic
dec renal