paediatrics

Question 1

at what age range is there is a rapid change in new born infants

Answer 1

there is rapid change in body size organ size and function from 0-1

Question 2

Children have a high gastric PH what does this effect?

Answer 2

This will enhance the BA of basic compounds
reduce the BA of acidic compounds
reduce the BA of prodrugs that need solubilisation or hydrolysis for absorption

Question 3

How does a childs gastrointestinal motility affect bioavalibility?

Answer 3

it affects physio-chemical properties and interactions with anatomical and physiochemical properties.

Question 4

how does a child’s gastroinestinal metabolism affect drug absorption.

Answer 4

a child can has an immature bacteria flora which limits the extent of drug absorption as the GI system cannot metabolise compounds

Question 5

how does a childs first pass effect alter absorption?

Answer 5

Children have. reduced first pass effect and can have an improved bioavalibilty as it immature transporters mean drugs just get through but a reduced BA if an uptake transported is need ed as they are not present

Question 6

how is distribution affected in a child ?

Answer 6

Infants have a high body water content so drugs that are water soluble have a high volume of distribution.
- drugs that are fat soluble have a low volume of distribution as children have a low proportion of fat

Question 7

How is plasma binding protein altered in children?

Answer 7

Children have less plasma proteins to bind to so less binding to plasma protein so more free drug available

Question 8

How is binding affinity to albumin or AA1 affected in children?

Answer 8

children have a lower binding affinity to albumin and AA1

Question 9

how is hepatic clearance affect in children?

Answer 9

children have reduced enzyme metabolism so a difference in clearnace
there is a difference in glucuronidation, salvation , glutathione conjugation and acetylation

Question 10

how is renal clearance ?

Answer 10

maturation rates vary for glomerular filtration , tubular secretion and tubular reabsorption

Question 11

how does elimination rates vary from an adults ?

Answer 11

from the age of 1 the elimination rate for an adult are the same

Question 12

what does safeguarding mean?

Answer 12

it is to protect peoples mental health , welfare being and human rights allowing them to live freely from harm abuse and neglect.
its fundamental to high quality and social care

Question 13

what does a venerable adult mean?

Answer 13

any adult over the age of 18 who is at risk of neglect or abuse because of their needs for care or support. they may lack mental capacity

Question 14

what does a child mean?

Answer 14

anyone 18 years or under

Question 15

give some examples of a venerable adult?

Answer 15

• mental illness e.g dementia or personality disorder
• elderly or frail
• substance misuser
• homelss
• learning disability
• physical disability

Question 16

what are the parent career signs of neglect?

Answer 16

• delays seeking medical advice
• reluctant to allow treatment or information
• detachment from the child
• lacks concern for the severity or extent of the issue
• aggressive to child or other venerable person

Question 17

what are some prescribing similarities between children and adults?

Answer 17

general ward visits 
drug histories
inpatient review 
TTa's
Counselling 
many use of the same drugs

Question 18

what are some of the prescribing differences between children and adults?

Answer 18

• some information differs when asking in the drug history
• formulation of drugs
• considerations for medicines at home
• parents rights

Question 19

what does gestation mean?

Answer 19

time elapsed between the first day of the mothers last menstrual cycle to estimated delivery day
average is 40 weeks

Question 20

what are some of the short term complications of prematurity ?

Answer 20

• breathing difficulties
• anemia and new bone jaundice
  hypoglycaemia
  immune system problems
  heart problems

Question 21

what are some of the long term complications of prematurity ?

Answer 21

cereal palsy
impaired learning
dental problems
behavioural and psychological problems

Question 22

what is patent ductus arteries?

Answer 22

when a baby is born premature and the duct stays open and the baby starts to rely on its own blood supply.
use paracetamol and ibuprofen to close the duct as prostaglandin keeps the duct open
This will increases oxygen saturation

Question 23

what is hyperplasia left heart valve ?

Answer 23

• when a babies haven’t developed a left vertical and if the patent ductus closes there will be no blood flow
  use a prostaglandin analogue as then it will keep the duct open until the baby is a certain weight so a baby can have cardio surgery