Flashcards in Chapter 10 - Drug Therapy in Pediatric Patients Deck (15):
Drug sensitivity in the very young results largely from
organ system immaturity
Because of heightened drug sensitivity, pediatrics are at increased risk of
adverse drug reactions
What two laws where designed to promote drug research in children
Best Pharmaceuticals for Children Act (BPCA), passed in 2002, and the Pediatric Research Equity Act (PREA) of 2003.
The increased sensitivity of infants is due largely to the immature state of what five pharmacokinetic processes:
(1) drug absorption,
(2) protein binding of drugs,
(3) exclusion of drugs from the central nervous system (CNS) by the blood-brain barrier,
(4) hepatic drug metabolism, and
(5) renal drug excretion.
Gastric emptying time is both ______and______ in early infancy, and then gradually reaches adult values by _____
prolonged ; irregular
6 to 8 months
For drugs that are absorbed primarily from the stomach, delayed gastric emptying
for drugs that are absorbed primarily from the intestine, absorption is ______.
Drug absorption following IM injection in the neonate is _____
slow and erratic - due in part o low blood flow through muscles during the first days of postnatal life.
Drug absorption through the skin is more ___ and_____ in infants than in older children and adults
rapid ; complete -- The stratum corneum of the infant's skin is very thin, and blood flow to the skin is greater in infants than in older patients. This can cause toxicity from topical drugs.
Binding of drugs to albumin and other plasma proteins is limited in the infant, because
(1) the amount of serum albumin is relatively low and (2) endogenous compounds (eg, fatty acids, bilirubin) compete with drugs for available binding sites
This causes the concentration of free levels of such drugs to be high
The drug-metabolizing capacity of newborns is
Renal drug excretion is significantly ______at birth
By what age are most pharmacokinetic parameters in children are similar to those in adults
Complete maturation of the liver develops by