peadiatric

Question 1

What is bioavailability?

Answer 1

fraction of an administered dose of

unchanged drug that reaches the systemic circulation

Question 2

what influences oral absorption of Oral Medicines?

Answer 2

Gastric & Intestinal pH (gastric pH is less acidic in children)
Gastric & Intestinal transit time
GI content e.g. microflora
Disease/Illness e.g. diarrhoea

Question 3

What happens to the bioavailability of weakly acidic drugs?

Answer 3

Bioavailability is reduced e.g. phenobarbital

Question 4

what happens to the bioavailability of basic drugs?

Answer 4

Bioavailability increased e.g. penicillins

Question 5

Explain the bioavailability of digoxin in 2-4-year-olds?

Answer 5

Bioavailability is reduced due to bacterial degradation in GI tract

Question 6

what is bile and when does it develop in children?

Answer 6

(Bile = produced by the liver aids digestion of lipids/ fat-soluble molecules in the small intestine
develops during the 5 weeks its absent at birth

Question 7

What factors affect drug distribution?

Answer 7

Vascular perfusion
body composition
tissue binding characteristics
plasma protein binding

Question 8

what happens to total body weight, total body water and extracellular fluid as child gets older?

Answer 8

volume decreases so the dose of water-soluble drugs required is larger in newborn than older children

Question 9

Distribution: Protein binding

Answer 9

drugs bind to proteins
protein binding limits free drug circulating in body
protein binding reduced in infants as they have less albumin and globulins
bilirubin and free fatty acids circulate in high concs in newborn which compete with drugs

Question 10

explain level of protein binding by 3-year old

Answer 10

by 3, level of protein binding similar to adults for ACIDIC drugs
for BASIC drugs level similar to adult at 7-12 years

Question 11

which enzyme involved in drug metabolism?

Answer 11

Cytochrome 450

CYP450

Question 12

What does CYP450 do?

Answer 12

Inactivates drugs during phase 1 reactions; oxidation, reduction, hydrolysis

Question 13

How is paracetamol metabolised in adults?

Answer 13

Metabolised via Glucuronidation

Question 14

How is paracetamol metabolized in children?

Answer 14

Metabolised via Sulphate conjugation

Question 15

What does renal elimination depend on?

Answer 15

Plasma protein binding
renal blood flow
tubular secretions
glomerular filtration rate

Question 16

how are medicines administered if the child has difficulty swallowing or if the child is unconscious?

Answer 16

Medicines and enteral nutrition may be
administered directly into the stomach via a
nasogastric tube

Question 17

what can high doses of corticosteroids lead to?

Answer 17

suppresses cortical axis and growth

Question 18

What is the role of Aspartame and its adverse effects

Answer 18

Aspartame is an artificial sweetener

Its a source of Phenylalanine- should be avoided in Phenylketonuria

Question 19

role of benzoic acid and its effect?

Answer 19

Benzoic acid is a preservative

jaundice in newborns (yellowing of the skin)

Question 20

role of ethanol and its effect?

Answer 20

ethanol is a solvent leads to intoxication (impairments)

Question 21

role of dyes/colorants and its effects for medicines?

Answer 21

dyes are used as colouring agents- causes hyperactive behaviour in children

Question 22

role of glucose and sucrose and its effects?

Answer 22

glucose and sucrose are used as sweetener- it may lead to obesity and tooth decay

Question 23

role of propylene glycol and its effect

Answer 23

propylene gylcol is a solvent has CNS effect e.g. seizures/agitation

Question 24

role of sorbitol and its effects?

Answer 24

sorbitol is used as a sweetener- may cause osmotic diarrhoea and GI discomfort

Question 25

what is phenylketonuria condition?

Answer 25

Phenylketonuria (PKU) is a rare but potentially serious inherited disorder. Children with PKU
can’t break down the amino acid phenylalanine, which then builds up in the blood and brain
leading to behavioural problems and seizures.

Question 26

what is passive immunity?

Answer 26

Passive immunity is provided when a person is given antibodies to a disease rather than producing them through his or her own immune system

Question 27

how can antibodies be transferred?

Answer 27

Naturally- from mother via placenta/breastmilk

Artificially- medically transferred

Question 28

what is active immunity?

Answer 28

= immune system builds up overtime by an
individual = long lasting.

Naturally- after exposure to infection
Artificially- immunisation/vaccination

Question 29

which Vaccines are administered at 8-weeks?

Answer 29

Diptheria with tetanus
Pertussis
Hepatitis B
Poliomyelitis Haemophilus influenza type B
Rotavirus

ALL FIRST DOSE

Question 30

Which vaccines are administered at 12 weeks?

Answer 30

Diphtheria with tetanus
Pertussis
Hepatitis B
Poliomyelitis and Haemophilus
Influenza type B 
rotavirus
ALL SECOND DOSE

Question 31

Which vaccines are given at 16 weeks?

Answer 31

Diphtheria with tetanus
Hepatitis B
Influenza type B
Poliomyelitis + haemophilus
pertussis
ALL THIRD DOSE
 AND
Menigococcal group B -second dose

Question 32

which vaccines are given to 1-year olds?

Answer 32

MMR- first dose
menigococcal group B- single booster
pneumococcal polysaccharide conjugate- single booster
haemophilus influenza type B with menigococcal group C- single booster

Question 33

which vaccines are given to 2 year olds?

Answer 33

Influenza vaccine - Live nasal spray is recommended