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Pharmacology > Peds > Flashcards

Peds Flashcards

1
Q

What percentage of drugs are not FDA approved for children (and even fewer for infants)?

A

60%

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2
Q

What percentage of drugs lack dosing, efficacy, and safety data for children?

A

75%

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3
Q

How much can we round up dosese to avoid decimals?

A

limit round up to 10% of dose

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4
Q

What are some issues with IM administration of drugs in children?

A

not well tolerated

variable muscle mass in infants & young children

variable blood flow to muscle, SQ tissue

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5
Q

What are elixirs?

A

drug dissolved & evenly distributed in alcohol

caution with evaporation

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6
Q

What are some suspending agents for crushed tablets?

A

apple sauce

pudding

chocolate syrup

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7
Q

What age can we start giving capsules/tablets?

A

~ age 6

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8
Q

What age can we use a nebulizer?

A

age 3

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9
Q

What age can we start using MDIs?

A

age 5

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10
Q

What percentage of dosing errors occur in children?

A

~ 70%

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11
Q

What is the best source for drug dosing in children but frequently not available?

A

manufacturer’s package insert information

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12
Q

What is the GI system like in neonates?

A

high gastric pH

irregular peristalsis

low levels pancreatic enzymes

bile acids can alter absorption

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13
Q

Why is topical absorption higher in neonates/infants?

A

thin stratum corneum

increase cutaneous perfusion

higher surface to weight ratio

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14
Q

Do neonates have less P450 activity?

A

yes; 50-70% adult levels

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15
Q

What is metabolism & renal elimination like in toddlers?

A

more rapid metabolism & renal elimination than adults

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16
Q

At what age can we start using the Cockroft-Gault Formula?

A

age 18

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17
Q

What is the BBB like in neonates and young children?

What does this impact?

A

BBB is less effective

greater opioid impact

bilirubin passes through also

18
Q

In children who are teething, what drug to we need to be cautious with because of systemic absorption?

A

Lidocaine

19
Q

What should we use to treat teething pain in children?

A

7.5% benzocaine gel without alcohol

20
Q

What should we use to treat mild, non-candidal diaper rash?

A

zinc oxide cream, drying

21
Q

What should we use to treat candial diaper rashes?

A

Clotrimazole 1% cream

nystatin ointment resistance issues

22
Q

How should we treat mild diarrhea in children?

A

regular diet

absorb significant protein, fat, CHO

BRAT diet is less effective

23
Q

What are otic suspensions?

A

acid pH to replicate normal ear canal environment

24
Q

What happens when you give otic suspensions to children with vent tubes or recent perforation?

A

painful!

25
Q

What should we give instead of otic suspensions for kids with otitis externa with vent tubes?

A

ophthalmic suspensions

26
Q

What is the issue with antipsychotics and children/adolescents?

A

more susceptible to extrapyramidal symptoms, espiecally dystonias

more weight gain

27
Q

What is the usual dosing for Acetaminopen?

What is the max dosing?

A

10-15 mg/kg/dose

max: 65 mg/kg/day

28
Q

What is the regular dose of Amoxicillin?

High dose of Amoxicillin?

Maximum child dose?

A

regular: 40-45 mg/kg/day
high: 80-90 mg/kg/day

max child dose is adult dose

29
Q

Should we use Aspirin in children?

A

no, especially febrile children

30
Q

What can happen if we give Aspirin to children?

A

Reye’s Syndrome

fatty liver degeneration, encephalopathy, liver failure

31
Q

Why is benzocaine preferred over lidocaine in children?

A

benzocaine is poorly soluble in water & very slowly absorbed so don’t get toxic levels as easily as lidocaine

32
Q

What are some cautions with antidepressants in children?

A

suicide ideation

impulsivity

agitation

33
Q

What are some cautions with antipsychotics in children?

A

more susceptible to extrapyramidal symptoms

tardive dyskinesia

34
Q

What is Phenobarbitol used for?

A

generalized motor seizures in infants

35
Q

Who should we avoid using Tetracyclines in?

A

avoid in PG

&

children < 8yrs (dental staining)

36
Q

What is a Vitamin A analogue that is teratogenic?

A

Isotretinoin

increases risk of malformed fetus 25x

I-PLEDGE program

2 forms contraception (one either surgical or hormonal)

37
Q

What can we use as a barrier protection for diaper irriation?

(either in infants or nursing homes)

A

zinc oxide cream

38
Q

What is Ethosuximide used to treat?

A

petit mal or absence seizures in children

39
Q

When is the highest risk for suicide after starting a new anti-depressant?

A

within 2 weeks

so want to follow up within that time period

40
Q

Can the location of medicine in the rectal vault influence rates of absorption?

A

yes

Pharmacology (16 decks)

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