neonatal prescribing

Question 1

What is the neonatal period?

Answer 1

The first 28 days of life

This period is critical for development and health monitoring.

Question 2

What defines a preterm baby?

Answer 2

Born before 37 weeks gestation

Term babies are born before 40 completed weeks.

Question 3

What is considered a low birth weight baby?

Answer 3

< 2.5 kg

Very low birth weight is < 1.5 kg, and extremely low birth weight is < 1 kg.

Question 4

What percentage of neonatal prescriptions are off-label or unlicensed?

Answer 4

80%

This highlights the challenges in neonatal pharmacy.

Question 5

What are some common neonatal problems?

Answer 5

• Respiratory
• Sepsis
• Gastro-intestinal
• Cardiac
• Renal
• Metabolic
• Other

These problems require careful consideration in prescribing.

Question 6

True or False: Neonates are considered mini adults when it comes to pharmacotherapy.

Answer 6

False

Neonates have unique physiological differences that affect drug handling.

Question 7

What does ADME stand for in pharmacokinetics?

Answer 7

• Absorption
• Distribution
• Metabolism
• Excretion

Understanding these processes is vital for safe prescribing.

Question 8

What is the typical gastric pH at birth for term neonates?

Answer 8

6-8

It falls to 1.5-3 within hours and rises to 4-5 over 10 days.

Question 9

Fill in the blank: The total body water (TBW) percentage in preterm neonates is ______.

Answer 9

85%

This contrasts with adults, who have a TBW of around 60%.

Question 10

What is a critical risk when prescribing gentamicin to neonates?

Answer 10

Nephrotoxicity

This is due to immature renal function in neonates.

Question 11

What is the function of the blood-brain barrier in neonates?

Answer 11

Functionally incomplete

Many drugs can penetrate into the cerebrospinal fluid (CSF).

Question 12

What is a common first-line antibiotic for neonates?

Answer 12

Benzylpenicillin

Gentamicin is also commonly used as a first-line antibiotic.

Question 13

What is the purpose of administering caffeine citrate in neonates?

Answer 13

To prevent apnoea of prematurity

This is critical for ventilated babies.

Question 14

What are the main reasons for NICU admission?

Answer 14

• Respiratory Conditions - 25%
• Infections - 18%
• Jaundice - 6%
• Asphyxia & Birth trauma - 2.5%
• Cardiac disorders
• Other

Understanding these reasons helps in preparing for neonatal care.

Question 15

What is a common treatment for patent ductus arteriosus (PDA) in neonates?

Answer 15

Ibuprofen

It is used to close the PDA, while prostaglandin E2 is used to keep it open.

Question 16

What is the role of Vitamin K in neonates?

Answer 16

To prevent haemorrhagic disease of the newborn

All babies are routinely given Vitamin K.

Question 17

Fill in the blank: The common drug for treating neonatal seizures is ______.

Answer 17

Phenobarbital

Other anticonvulsants may also be used depending on the situation.

Question 18

What is the impact of maternal steroids given during preterm labor?

Answer 18

Mature fetal lungs

Dexamethasone or betamethasone are commonly used.

Question 19

What is the significance of the PAR register?

Answer 19

For at-risk mothers with antenatal specialist medical team

This helps monitor and manage potential risks to the fetus and neonate.

Question 20

Why was Baby S given Curosurf?

Answer 20

To treat surfactant deficiency

Surfactant is crucial for lung function in premature infants.

Question 21

What are the common drugs used for viral infections in neonates?

Answer 21

• Acyclovir
• Ganciclovir
• Zidovudine

These are critical for managing infections in the NICU.

Question 22

What is the definition of a neonate?

Answer 22

1-28 days of life

Question 23

What is the definition of a preterm baby?

Answer 23

<37 weeks

Question 24

What age range defines adolescents?

Answer 24

10-19 years

Question 25

How many children under 18 years live in the UK?

Answer 25

14 million

Question 26

How many children under 5 years live in the UK?

Answer 26

3.47 million

Question 27

What is the annual birth number in the UK?

Answer 27

700,000

Question 28

What percentage of births result in defects?

Answer 28

2-3%

Question 29

How many serious pediatric illnesses are mentioned?

Answer 29

10

Question 30

What is the obesity rate among children in 2022/2023?

Answer 30

9.2%

Question 31

What is the prevalence of epilepsy in children?

Answer 31

1 in 220 children

Question 32

What percentage of children aged 6 to 17 experience a seizure?

Answer 32

0.7%

Question 33

What is the prevalence of asthma in children?

Answer 33

1 in 11

Question 34

How many new diagnoses of Type 1 Diabetes occur annually?

Answer 34

30,000

Question 35

What percentage of children with diabetes use insulin pumps?

Answer 35

38.5%

Question 36

What is the special educational needs (SEND) population in the UK?

Answer 36

1.7 million (18% of all children)

Question 37

What happens during the 1st trimester (0-12 weeks) of pregnancy?

Answer 37

Organ formation, umbilical cord forms, heart beats week 6

Question 38

What significant developments occur in the 2nd trimester (13-26 weeks)?

Answer 38

Baby starts to move, features like hair and muscles form

Question 39

What is a key development in the 3rd trimester (27-40 weeks)?

Answer 39

Lungs mature with surfactant

Question 40

What is the commonest childhood illness?

Answer 40

Common cold

Question 41

What are the symptoms of ear infections in children?

Answer 41

Ear pain, fever, irritability

Question 42

What is the common name for influenza?

Answer 42

Flu

Question 43

What causes bronchiolitis?

Answer 43

Swelling of airways and mucus production in the lungs

Question 44

What are the symptoms of respiratory syncytial virus (RSV)?

Answer 44

Mild cold-like symptoms, can cause pneumonia in infants

Question 45

What age group is most affected by Hand, Foot, and Mouth Disease?

Answer 45

Infants and children under five years old

Question 46

What are the signs of conjunctivitis?

Answer 46

Redness, discharge, itchiness, swelling

Question 47

What is gastroenteritis commonly known as?

Answer 47

Stomach flu

Question 48

What are the symptoms of sinusitis?

Answer 48

Runny nose, headache, facial pressure

Question 49

What bacteria causes strep throat?

Answer 49

Streptococcus pyogenes

Question 50

What is the incidence of congenital heart defects?

Answer 50

1 in 110 births

Question 51

What is hypospadias?

Answer 51

Male defect in the opening of the urethra

Question 52

What does VSD stand for?

Answer 52

Ventricular septal defect

Question 53

What is the incidence of Down's syndrome?

Answer 53

1 in 700 births

Question 54

What is the treatment for cleft lip with cleft palate?

Answer 54

Surgery at 12-18 months

Question 55

What does AVSD stand for?

Answer 55

Atrioventricular septal defect

Question 56

What are limb deformities and their incidence?

Answer 56

Deformities usually in arms or legs, 1 in 1943 births

Question 57

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Answer 57

YES THE FUCK SHE ISSSS SHE GONNA PASS AND GRADDUUUAATTEEEE 2025

Question 58

What should be given for hypoglycaemia?

Answer 58

Glucose, glucagon or diazoxide ## Footnote Hypoglycaemia refers to low blood sugar levels.

Question 59

What should be given for hyperglycaemia?

Answer 59

Insulin infusion ## Footnote Hyperglycaemia refers to high blood sugar levels.

Question 60

What is recommended for skin treatment in babies?

Answer 60

Olive oil, hyaluronidase for extravasation injury ## Footnote Olive oil can help moisturize skin, while hyaluronidase helps in breaking down hyaluronic acid in extravasation injuries.

Question 61

What is used for eye treatment in babies?

Answer 61

Chloramphenicol, preparation for retinal examination ## Footnote Chloramphenicol is an antibiotic used for eye infections.

Question 62

What should be used for pain relief in babies?

Answer 62

Pain assessment tools, sucrose ## Footnote Sucrose is often used as a sweetening agent to help soothe infants during painful procedures.

Question 63

List some immunizations and vaccines for babies.

Answer 63

* BCG * Hep B * Childhood immunizations * Palivizumab * Nirsevimab (75% effective) ## Footnote These immunizations help protect infants from various infectious diseases.

Question 64

What are the treatments for anaemia?

Answer 64

Packed cells, FFP, platelets or IV albumin ## Footnote FFP stands for Fresh Frozen Plasma, and these treatments help restore blood components.

Question 65

What can be given for jaundice in babies?

Answer 65

IVIG ## Footnote IVIG stands for Intravenous Immunoglobulin, used to treat certain types of jaundice.

Question 66

What are neonatal liver issues related to?

Answer 66

Drugs altered structurally by reduction, hydrolysis, or oxidation; problematic in immature liver.

Question 67

Why can neonates metabolise anti-epileptic drugs?

Answer 67

Because they have a narrow therapeutic index (NTI).

Question 68

What can cause liver enzymes to be reduced in neonates?

Answer 68

Drug-drug interactions (DDIs).

Question 69

What problem can arise from long-term TPN in neonates?

Answer 69

Cholestasis.

Question 70

What happens during neonatal kidney issues when in renal failure?

Answer 70

Reduced blood flow causes damage, and post-renal means urine flow is obstructed.

Question 71

How long does the kidney have to remove drugs, extracellular fluid (ECF), and sodium in neonates?

Answer 71

3-5 days for weight loss.

Question 72

What is a critical factor regarding a baby's glomerular filtration rate (GFR)?

Answer 72

It is changing, posing a risk of nephrotoxicity.

Question 73

Why is fluid balance critical in neonates?

Answer 73

Due to the changing GFR and risk of nephrotoxicity.

Question 74

What are the options for neonatal fluid management?

Answer 74

1. TPN; vamin or intralipid solutions 2. IV fluids; 10% glucose and IV additives of Na, K and Ca 3. IA fluids; give with heparinised 0.9% NaCl ## Footnote TPN stands for Total Parenteral Nutrition, which provides essential nutrients intravenously.

Question 75

What is the initial management for sepsis in neonates?

Answer 75

Admission screen and start on first line antibiotics ## Footnote First line antibiotics typically include gentamicin or benzylpenicillin.

Question 76

What should be done after the initial sepsis management in neonates?

Answer 76

Acquired infections screen then start second line antibiotics ## Footnote Second line antibiotics may include flucloxacillin, vancomycin, or cefotaxime.

Question 77

What is SFGA used for in neonatal care?

Answer 77

SFGA can be used for viral infections ## Footnote SFGA stands for Specific Fungal Growth Assessment.

Question 78

What are the common first-line drugs used in neonatal infections?

Answer 78

Gentamicin or benzylpenicillin ## Footnote These drugs are crucial for treating bacterial infections in neonates.

Question 79

What are the common second-line drugs for neonatal infections?

Answer 79

Fluxcloxacillin, vancomycin, cefotaxime ## Footnote These antibiotics are used when first-line treatments are ineffective.

Question 80

What is the prophylactic drug used in neonates?

Answer 80

Trimethoprim ## Footnote Trimethoprim is often used to prevent infections in at-risk neonates.

Question 81

What is the use of mupirocin in neonatal care?

Answer 81

HAC; mupirocin ## Footnote HAC stands for Hospital Acquired Colonization, where mupirocin is used to manage bacterial colonization.

Question 82

Which antiviral drugs are commonly used in neonates?

Answer 82

Zidovudine, acyclovir ## Footnote These medications are used for treating viral infections in neonates.

Question 83

What antifungal agents are used in neonatal care?

Answer 83

Fluconazole or miconazole ## Footnote These antifungals are used to treat fungal infections in neonates.