Lec 13- Medicines for children Flashcards

Question

Taste testing in children

Answer 1

* Taste-testing with medicines (sensory analysis study) requires a clinical protocol * Increasing demand from regulators * No defined standards of acceptability * eTounge techniques * Adult taste panels * Easier to do in adults than children- ethics, adherence, result interpretations * However, Children are different: taste buds and olfactory receptors are well developed in infants and the number then decreases with age. * Tendency to prefer sweeter tastes; less tolerance of bitter & salty tastes

Answer 2

* Airway anatomy differs in adults and children * Mostly fixed doses or combined doses * Metered Dose Inhaler * Requires coordination during use which limits utility in young children. Spacers can be used, but they are bulky and inconvenient for mobile use, and different spacer models can lead to different exposures * Dry powder Inhalers (DPI) * Can be efficient devices for some children but beware inspirational force differences in younger children. Also, children under six do not generally have enough inspirational force * Nebulisers with air compressors * Provide an alternative relatively passive men of delivery inhaled drugs but can also be bulky, inconvenient and heavy * Can result in imprecise dosing although some flexibility possible * There may be constraints in terms of total dose possible

Answer 3

* Liquid formulations such as solutions, syrups, suspensions often considered the most appropriate for younger children who are unable to swallow capsules or tablets * Taste can be an issue for liquid formulations * Dose-volume is important * The flexibility of dose e.g. using oral dosing syringe to accurately measure the prescribed dose * Stability can be a challenge e.g. preserved v unpreserved * Oral powders, effervescent tablets, orodispersible, chewable tablets, mini-tablets and films may be suitable for young children

Answer 4

* Tablets and capsules offer advantages such as stability, accuracy, portability, a greater opportunity of MR but are typically not widely prescribed for younger children

Answer 5

* Tablets made for scoring (delivery half the dose)- breaking of tablets = inaccurate dose delivered into patients * Orodispersible minitablets- 2mm in diameter, these can use an increasing number of tablets to give certain dose * Dissolve in mouth within minutes * In paediatrics we often dissolve tablets in liquids (in a syringe) to deliver to patient this can have poor homogenity * With ODMT we get 100 dissolution

Answer 6

* This shows that ODMT can dissolve rapidly in many different types of liquid * Offers a range of taste masking for children (in milk one day than juice in another)- individual preferencing

Answer 7

* Mixed powdered/granulated formulations into or sprinkling them onto food is a viable option for paediatric delivery of drugs but beware * Food can change the bioavailability of a drug by * Causing instability of the drug e.g. acidic citrus foods causing degradation * Delaying gastric emptying * Changing GI pH * Stimulating bile flow * Increasing splanchnic blood flow * Physical or chemical interactions with dosage form or API * Different diets (e.g. cultural/elective) introduce another variable

Answer 8

* Condition * Status epilepticus is seizure activity that lasts too long * It happens when a seizure doesn't stop in the usual time or when someone has seizures one after another without recovering in between * Status epilepticus can happen with any type of seizures * Treatment * Rectal Diazepam licensed indication * Rescue administration any time, any place * Required more socially acceptable administration of BZs

Answer 9

* Chronic pathological drooling is common in children with cerebral palsy (10-40%) of which 15% is severe * Frequent in individuals who are also developmentally disabled * Common in children with epilepsy and/or learning difficulties * Other rarer and often more debilitating neurological disorders can be associated with sialorrhoea * Reason for variability in drooling in children with neurological disorders is unclear * Degree of drooling is not constant over time

Answer 10

* Negative consequences for health and QoL: its effects should not be underestimated * Chronically irritated and macerated facial skin * Dehydration is a consequence of chronic fluid and nutrient loss * Persistent drooling into school-age leads to social isolation which can be both practically and socially devastating * A constant source of frustration for parents/caregivers, negatively affecting the relationship with a child

Answer 11

* Symptomatic treatment of severe sialorrhoea in children aged 3 years and older, with chronic neurological disorders * Sialanar first product, containing any active ingredient, to be authorised in Europe to treatment drooling in any patient population- PUMA * Clinical evidence-based dosing, easily titrated for individual patient needs, to balance efficacy and tolerability * Minimal excipients, all suitable for children * Sodium Benzoate * Raspberry flavouring * Sucralose * Citric acid * Purified water

Answer 12

* Therapeutics are directly delivered into breast milk as it exits the mother's breast and is consumed by the infant

Lec 13- Medicines for children Flashcards

(39 cards)