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Clinical PK Exam 3 > Pediatric Developmental Pharmacology & Clinical PK > Flashcards

Pediatric Developmental Pharmacology & Clinical PK Flashcards

(62 cards)

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1
Q

Is percutaneous skin thick or thin in pre-term neonate

A

thinner

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2
Q

In percutaneous skin is perfusion greater or less in neonates

A

greater

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3
Q

in percutaneous skin is hydration greater or less in neonates

A

greater

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4
Q

In percutaneous skin is BSA greater or less in neonates?

A

greater

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5
Q

What are some potential implications of topically applied medications in neonates

A

increased absorption that leads to increase toxicity

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6
Q

How is water loss controlled or prevented?

A
  1. using a product that holds moisture in
  2. incubator (humidity control)
  3. IV fluids
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7
Q

T/F rectal absorption is not realiable

A

False, it is reliable because neonates cannot take a pill

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8
Q

what are the benefits of rectal absorption?

A

Increased bioavailability in neonates

  • limited first pass metabolism
  • decreased hepatic metabolism
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9
Q

What type of suppositories are best to give neonates?

A

quick melting suppositories

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10
Q

Why is IM absorption unpredictable?

A
  1. decreased muscle mass
  2. decreased muscle activity
  3. decreased blood flow
  4. increased capillary density
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11
Q

Why is it not good to give neonates rectal suppositories?

A

neonates have a pulsating rectum

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12
Q

What medications may be given IM to neonates

A
  1. Immunizations*
  2. aminoglycosides
  3. beta lactams
  4. palivizumab
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13
Q

what is the significance of intrapulmonary in neonates?

A
  1. lung architecture changes over time

2. majority as localized treatments

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14
Q

When are lungs fully developed in a pediatric patient?

A

7-8 years of age

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15
Q

Do medications administered via nebulizer or inhaler have systemic absorption?

A

yes

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16
Q

what are neonates pH at birth?

A

neutral (~7)

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17
Q

within 24-48h of birth what are neonates pH?

A

~1-3

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18
Q

during neonates first week of life what is there pH?

A

neutral

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19
Q

What are neonates gastrointestinal affected by?

A
  1. gastric pH
  2. biliary function
  3. motility
  4. gastric emptying
  5. surface area
  6. blood flow
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20
Q

What is gastric pH determined by?

A
  1. Solubility of medications
  2. Ionization of medications
  3. Stability of medications
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21
Q

Which gastric pH is more important in neonates

A

Stability

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22
Q

Is Vitamin D2 absorbed better in term neonates or preterm neonates

A

term

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23
Q

Why is there lower bile salts in GI biliary tract

A
  1. Decreased lipophilic medication absorption

2. Decreased lipid vehicle based medication absorption

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24
Q

When do villi mature

A

around 20 weeks gestation

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25
if a patient is born at 23 weeks will they have more or less villi
less villi
26
when does gastric emptying increase in neonates
first week of life
27
when do neonates motility reach adult fucntion
around 6 months of life
28
Is there an increase or decrease in contractility in neonates
decrease
29
Is there a decrease or increase spread of medication to absorption sites in neonates
decrease
30
does blood flood increase or decrease with age ?
increase
31
does blood flow increase or decrease with feeding
increase
32
does the concentration gradient change with blood flow
yes
33
what percent of total body weight is water in preterm neonates
85%
34
what percent of total body weight is fat in preterm neonates
1%
35
What percent of total body weight is water in term neonates
75%
36
What percent of total body weight is fat in term neonates
15%
37
What percent of extracellular water is in neonates
40& of total body weight
38
what percent of extracellular water is in adults
20% of total body weight
39
Are hydrophilic medications higher or lower in neonates
higher
40
Are lipophilic meds typically lower or higher in neonates
lower
41
compare a neonate to an adult
1. decreased plasma proteins 2. lower binding capacity 3. decreased affinity for medications
42
What are the implications of a neonate compared to an adult
1. greater drug effect 2. increased clearance 3. greater toxicity risk
43
what are some examples of phase 1 enzymatic processes
1. oxidation 2. hydrolysis 3. hydroxylation 4. reduction
44
What percentage is CYP3A responsible for medication metabolism?
~50%
45
which CYP enzyme is the primary member until 6 months of age
3A7
46
when does CYP3A reach adult function
around 1 year of life
47
what are the substrates of CYP2C?
1. 2C9 | 2. 2C19
48
How much is CYP2C responsible of medication metabolism
~20%
49
when does 2C9 reach adult function
5 months of age
50
when does 2C19 reach adult level
10 years of age
51
what does phase 2 of the enzymatic process consist of
1. conjugation 2. glucuronidation - matures by 3 years of age - exceeds adult function during childhood 3. sulfation - matures at birth 4. alcohol dehydrogenase - matures at 5 years of age 5. methylation - infants, not adults
52
what does theophylline make in neonates
caffine
53
what are the 3 metabolism outcomes
1. activating medication 2. inactive medication 3. form active metabolites
54
what is elimination affected by
1. glomerular filtration 2. tubular secretion 3. tubular reabsorption
55
At what age does tubular secretion reach adult function
12 months of life
56
when does glomerular filtration increase
first 2 weeks of life
57
when does glomerular filtration reach adult function
8-12 months of life
58
how long is neonates serum creatinine equivalent to mothers
~ 1 week
59
what does k stand for in the GFR equation
age constant
60
what does L stand for in the GFR equation
length in cm
61
what does PCr = to? in the GFR equation
SCr
62
Does serum therapeutic concentrations of aminoglycosides and vancomycin, are they different from pediatrics, neonate, and adult, do they vary based on age?
No, they are the same

Clinical PK Exam 3 (5 decks)

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