[2] Developmental Pharmacology

Question 1

What are some of the most disastrous therapeutric misadventures in pediatrics?

Answer 1

Thalidomide 1957
Chloramphenicol 1959
Diethylstilbestrol 1971

Question 2

What is the Harris Drug Amendment of 1962?

Answer 2

Required demonstrated efficacy and safety for FDA Approval and USA marketing

Question 3

Are children small adults?

Answer 3

No, unless they’re midgets.

Question 4

Weight doubles by?

Answer 4

5 months

Question 5

Weight triples by?

Answer 5

1 year

Question 6

Body surface area doubles by?

Answer 6

1 year

Question 7

Caloric expenditure increases 3-4 fold by?

Answer 7

1 year

Question 8

Define: Adolescence

Answer 8

Transition to adulthood

Question 9

Dosing depends on?

Answer 9

Size of the child
Pharmacokinetics: ADME
Need for special formulations

Question 10

[T/F] FOR DJ VILLEZA

For the MOST FRAGILE of patients you are allowed to have EXTREMELY LARGE MARGINS OF ERROR.

Answer 10

Gee I don’t know DJ what do you think

For other people please email DJ at jesusvilleza.jr@gmail.com for the answer

Question 11

2 Main Factors of Drug Absorption

Answer 11

Characteristic of the Drug/Active Ingredient

Host Factors

Question 12

When do humans start developing CYP1A1?

Answer 12

3 months of age

Question 13

When do humans start developing Intestinal Glutathione Conjugation?

Answer 13

1-3 years of age

Question 14

At birth what is the gastric pH?

Answer 14

Alkaline (pH 6-8)

Falls to pH 1-3 after 24 hours

Rises again during the next 9-12 days

Question 15

Compare gastric emptying time of neonates and adults

Answer 15

Infants: 6-8 Hours
Adults: 2 Hours

Question 16

Why is Paracetamol not given to neonates?

Answer 16

They are poorly absorbed because weakly acidic, non-ionized drugs are better absorbed by infants

Question 17

Compare blood flow in intestinal smooth muscles of neonates as compared to infants and children and adults

Answer 17

Neonates < Infants and Children > Adults

Question 18

Compare Percutaneous Absorption in neonates, children, and adults

Answer 18

Neonates > Children > Adults

Question 19

Histamine is not present in neonates until?

Why is this important?

Answer 19

3rd week of life

No need to perform allergy skin tests because results will not yield any useful information

(Very important, make sure to memorize)

Question 20

What is the earliest age that inhalational devices can be effective for children?

Answer 20

6 months

Question 21

Compare Total Body Water of infants as compared to Adults?

Answer 21

Infants: 80% > Adults: 55-60%

Question 22

Which has a higher TBW content? Preterm or Full Term Infants?

Answer 22

Preterm Infants

Question 23

Presence of Fetal Albumin in Newborns, Infants, and Children

Answer 23

N: Present
I: Absent
C: Absent

Question 24

Acidic drugs bind to?

Answer 24

Albumin

Question 25

Basic drugs bind to?

Answer 25

Alpha-Glycoprotein

Question 26

Neonatal proteins have increased binding capacity with?

Answer 26

Bilirubin

Question 27

Define: Kernicterus

Answer 27

Highly protein bound drugs can displace bilirubin from albumin binding sites

Question 28

Most abundant hepatic P450 Enzyme

Answer 28

CYP3A4

Question 29

Cytochrome P450 Enzymes Present in the Fetus

Answer 29

CYP3A7* CYP1A1 CYP3A5 *Most abundant

Question 30

How long does it take for neonates to reach adult levels of GFR?

Answer 30

1 year of age

Question 31

GFR of neonates is what % of adult value?

Answer 31

30-40%

Question 32

How does Edema affect drug absorption?

Answer 32

Low albumin levels would affect protein binding drugs

Question 33

Reaction of Children to Tetracycline

Answer 33

Discolored Teeth

Question 34

Reaction of Children to Phenobarbital

Answer 34

Hyperactivity | Impaired Intelligence

Question 35

Reaction of Children to Chloramphenicol

Answer 35

Gray Baby Syndrome

Question 36

Reaction of Children to Phenytoin (Dilantin)

Answer 36

Thickened Skull | Coarse Features

Question 37

Reaction of Children to Valproic Acid (Depakene)

Answer 37

Hepatotoxicity

Question 38

Reaction of Children to Aspirin

Answer 38

Reye's Syndrome in patients with Chickenpox or Infleunza

Question 39

What drug causes rapid closure of patent ductus arteriosus?

Answer 39

Indomethacin

Question 40

What drug causes the ductus to remain open?

Answer 40

Prostaglandin E1