Drug Therapy in Pediatric Patients

Question 1

Pediatric patients are more sensitive to drugs than adults, they show ____

Answer 1

greater individual variation

Question 2

Drug sensitivity in the very young results from

Answer 2

organ system immaturity

Question 3

Because of heightened drug sensitivity, they are at increased risk for

Answer 3

adverse drug reactions

Question 4

Increased sensitivity in infants is due too the immature state of 5 pharmacokinetic processes:

Answer 4

drug absorption
protein binding of drugs
exclusion of drugs from CNS by BBB
hepatic drug metabolism
renal drug excretion

Question 5

IV administration: infant levels _____ than adults. As a result, drug concentration in infants is higher

Answer 5

decline more slowly

Question 6

SubQ administration: infant levels remain_______ causing effects to be more intense and prolonged

Answer 6

higher for longer

Question 7

Gastric emptying is _________ in early infancy. Then reaches adult values by _______

Answer 7

prolonged and irregular

6-8 months

Question 8

For drugs that are absorbed in the stomach, delayed gastric emptying ____ absorption

Answer 8

enhances

Question 9

For drugs that are absorbed in the intestine absorption is _____

Answer 9

delayed

Question 10

Gastric acidity is very low for _____ after birth and does not reach adult values for ______

Answer 10

24 hours

2 years

Question 11

Drug absorption after IM injection in the neonate is ______ due to low blood flow through muscle during the first days of postnatal life

Answer 11

slow and erratic

Question 12

By early infancy, absorption of IM drugs becomes

Answer 12

more rapid

Question 13

Drug absorption through skin is ____ in infants than in older children and adults

Answer 13

more rapid and complete

Question 14

Due to infants skin being very thin and enhanced absorption, infants are at risk for

Answer 14

toxicity from topical drugs

Question 15

In infants, amount of serum albumin is ____ and endogenous compounds compete with drugs for available binding sites

Answer 15

low

Question 16

Concentrations of ____ of drugs are high in the infant and intensify effects

Answer 16

free levels

Question 17

Protein binding capacity reaches adult values within

Answer 17

10-12 months

Question 18

Medicines like morphine and phenobarbitol should be given in ___ dosage

Answer 18

reduced

Question 19

Drug metabolizing capacity of newborns is ____ and dosages must be ____

Answer 19

low

reduced

Question 20

Complete maturation of the liver develops by

Answer 20

1 year

Question 21

Renal blood flow, GFR, and active tubular secretion are all ____ during infancy

Answer 21

low

Question 22

Adult renal function is achieved by

Answer 22

1 year

Question 23

Most pharmacokinetic parameters in children are similar to adults by

Answer 23

1 year

Question 24

How do children differ pharmacokinetically from adults?

Answer 24

they metabolize drugs faster

Question 25

drug metabolizing capacity is elevated until age ___ then declines

Answer 25

2

Question 26

Age related adverse effects include:

Answer 26

growth suppression by glucocorticoids
discoloration of teeth by tetracyclines
kernicterus by sulfonamides

Question 27

Method of conversion most commonly based on

Answer 27

BSA

Question 28

Pedi dosage

Answer 28

childs BSA x adult dose/1.73m2

Question 29

Monitor pediatric patients for _______as a component of optimizing dosage

Answer 29

therapeutic and adverse responses

Question 30

________ should be provided to reinforce verbal instructions

Answer 30

written instructions

Question 31

If a child spits out med

Answer 31

parents should estimate the amount lost and readminister that amount