General Pediatrics Flashcards
(52 cards)
Which vitals are generally higher in infancy and decrease with time?
Heart rate and respiratory rate
Which vital sign is generally lower in infancy and increases with time?
Blood pressure
T/F: Infected/septic newborns may present with HYPOthermia instead of a fever
TRUE
Which eGFR formula should be used in pediatrics (do not memorize)?
Bedside Schwartz
CrCl (mL/min/1.73m^2) = (0.413*height)/SCr
What are limitations to off-label drug use?
- Denied insurance coverage possible
- Liability for adverse effects
- Limited experience in specific conditions or age groups
- Limited available dosage formulations
Which substance is in many preparations and should be avoided in pediatrics?
Propylene glycol
What is the BUD for a water-containing formulation prepared from solid ingredients and refrigerated?
14 days
When can injectable solutions be given orally?
If both (IV and PO) solutions contain the same salt form with similar bioavailability
What do you need to ask for when dosing something in pediatrics?
BODY WEIGHT
If there is no provided dosing resources, what is usually the maximum pediatric dose of a given medication?
The usual adult dose
What is normal urine output?
1 mL/kg/hour
What are we worried about when urine output falls below 1 mL/kg/hour?
AKI - are they on any nephrotoxic agents?
When does the ability to detect bitter/sour/salty tastes develop?
2 years
When will a child likely respond to odors in medications?
5-7 years
T/F: Gastric pH is lower in early life
FALSE, pH is higher
What are acid labile drugs that may be broken down more in older children as opposed to neonates?
Beta-lactams and macrolide antibiotics
What leads to a decreased rate of drug absorption in neonates?
Low rate of gastric emptying + poor intestinal contractility (until about 6-8 months)
Why should the rectal route be avoided in infants?
Higher amplitude pulsatile contractions -> decreased absorption/bioavailability
Pediatrics have (greater/lesser) absorption through the percutaneous route than adults
GREATER (SA, hydration, perfusion rate, permeability)
Why do young children have better IM bioavailability than older children?
Greater capillary density -> more drug reaching bloodstream
A neonate needs to take phenobarbital, a weak acid drug. Should their dose be higher or lower than an adult dose?
HIGHER - more drug is ionized due to the basic environment and will be trapped in the digestive tract -> less absorbed
Why might neonates need higher doses of hydrophilic drugs?
A greater percentage of total body water leads to higher Vd of these drugs, and less drug available in the blood stream
Why might neonates need lower doses of lipophilic drugs?
Less muscle/fat than adults means a lower Vd for these drugs, and more drug available in the blood stream
Are aminoglycosides hydrophilic or lipophilic?
HYDROphilic
