Midterm Exam

Question 1

Chloramphenicol caused

Answer 1

gray baby syndrome

Question 2

thalidomide caused

Answer 2

phocomelia

Question 3

sulfonamides caused

Answer 3

kernicterus

Question 4

Geriatric PK considerations

Answer 4

Decreased muscle mass and increased total body fat increasing distribution of lipophilic drugs

Question 5

Fried’s rule infant < 2

Answer 5

month/150 x adult dose

Question 6

Modified weight rule infant > 2

Answer 6

wt(kg)/50 kg x adult dose

Question 7

Young’s rule infant > 2

Answer 7

[age/(age +12)] x adult dose

Question 8

Body weight dosing

Answer 8

Most commonly used calculation

Question 9

Body surface area dosing

Answer 9

Most accurate calculation

Question 10

Neonatal gastric emptying

Answer 10

peristalsis may be absent up to 1st four days of life

Question 11

Neonatal gastric emptying rate factors

Answer 11

Decreased: CHD, GERD, high caloric feeds, RDS
Increased: Human milk

Question 12

Infant gastric pH

Answer 12

Neutral at birth
Acidic (pH 1-3) in 24 h
Neutral (pH 6-8) in 1 wk
Acidic through childhood

Question 13

Why is IM not preferred for infants?

Answer 13

Less muscle mass, erratic peripheral perfusion, decreased muscular contraction

Question 14

What vitamin is given IM at birth?

Answer 14

Vitamin K

Question 15

Why is topical route not preferred for infants?

Answer 15

Increased skin absorption because of undeveloped epidermal layer

Question 16

Premature infant total body h20

Answer 16

85%

Question 17

Full-term infant total body h20

Answer 17

75%

Question 18

Albumin level for infants

Answer 18

Low. Chance of displaced bilirubin from highly protein-bound drugs

Question 19

Displaced bilirubin can cause

Answer 19

jaundice and kernicterus

Question 20

Benzyl alcohol (preservative) effect in infants

Answer 20

Hippuric acid - “benzyl alc gasping syndrome”, severe metabolic acidosis and multiple organ failure

Question 21

Modified/Bedside Schwartz

Answer 21

CrCl = 0.413 x Ht (cm)/Scr

Question 22

Pedi oral abs gastric pH

Answer 22

Increased

Question 23

Pedic gastric emptying time

Answer 23

Increased

Question 24

Pedi intestinal CYP3A4

Answer 24

Decreased

Question 25

Pedi percutaneous abs hydration of the epidermis

Answer 25

Increased

Question 26

Pedi body water : fat ratio

Answer 26

Increased

Question 27

Pedi protein binding

Answer 27

Decreased

Question 28

Pedi GFR

Answer 28

Decreased

Question 29

Pedi cardiac output depends on

Answer 29

Heart Rate

Question 30

Adult cardiac output depends on

Answer 30

Stroke Volume

Question 31

What scale is not useful in predicting outcomes in young children

Answer 31

Glascow coma

Question 32

When do cranial sutures fuse for infants

Answer 32

16-18 months

Question 33

Pediatric metabolic differences

Answer 33

Poor ability to thermoregulate - cannot shiver
FEVERS MATTER!

Question 34

Pediatric age-related idiosyncrasies

Answer 34

Phenobarbital and diphenhydramine may cause hyperactivity

Question 35

Half of older adults over what age have hearing loss?

Answer 35

85

Question 36

What is the 4th leading cause of death

Answer 36

Medication-related problems & adverse drug reactions

Question 37

MTM goals (3)

Answer 37

Improve quality of care
Improve health outcomes
Reduce costs

Question 38

Five core elements of MTM

Answer 38

Medication therapy reviews: comprehensive, targeted
Personal Medication Record
Medication-related action plan
Intervention and/or referral
Documentation and follow-up

Question 39

Targeted intervention programs (MTM)

Answer 39

Focuses on pharmacist’s activity on specific medication issues:
gaps in care
non-adherence
high-risk medications
cost-saving opportunities