Pediatric Dosing Flashcards

(39 cards)

1
Q

Is there a standard dose for pediatric medicines?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List some reasons as to why there is not a standard dose for pediatric medicines?

A

Rapid child growth is accompanied with changes in:

  • absorption
  • elimination
  • metabolism
  • distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At what age will children usually have mature and active enzymes as well as an adult level GFR?

A

2 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What anatomical items alter the distribution of a pediatric drug?

A

Fat and water content – changes with childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 2 ways that a pediatric dose can be written?

A
  1. mg/kg/day

2. mg/kg/dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What must a child’s weight in pounds be converted to and how?

A

Kg
== divide lbs by 2.2
(1 kg = 2.2 lb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The starting dose can be based on what 3 things for a child?

A

Age
Weight
Body Surface Area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If a drug is based off a child’s body surface area, what is likely an attribute of the drug?

A

TOXIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explain how to calculate a dose if a child weighs 22 lbs, the dosing range is 90 mg/kg/day and they want to give 2 doses a day.

A
  1. 22 lbs/2.2 = 10 kg
  2. 10 kg X 90 mg/kg/day = 900 mg/day
  3. 900 mg/2 = 450 mg twice a day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What dose is often considered the maximum dose for a child?

A

Adult dose = Maximum dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Body Surface Area is more accurate with dosing but is only used when? What is an example?

A

With drugs that have a high risk of toxicity

– chemo drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the parameters for when dosing by weight is accurate?

A

< 18 yo

< 40 kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If a child weighs more than 40 kg, dosing by weight is not as accurate. What dose should you use?

A

Adult dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

With a child that weighs more than 40 kg, you should use weight based dosing unless it exceeds ____

A

Adult dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Can mg/kg/dose or /day be abbreviated with /d?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What measurement should meds be ordered in?

17
Q

Normally, how much water is needed for every _____ of energy expended?

A

100 mL of water needed for every 100 kcal/kg of energy expended

18
Q

What classifies insensible water loss?

A

Water loss that is not perceived like skin and respiratory tract

19
Q

What classified sensible water loss?

A

Sweat, urine and stool

20
Q

What does the Holliday - Segar Method calculate?

A

Fluids needed

21
Q

The 4-2-1 rule (holliday-segar method) calculates?

A

Fluids needed for HOURLY replacement

22
Q

Describe the HOURLY fluid replacement rule (4-2-1)?

A
  1. < 10kg = 4 ml/kg/hr
  2. 10 - 20 kg = 40 ml + 2 ml/kg for every kg above 10 kg
  3. > 20 kg = 60 ml + 1 ml/kg for every kg above 20 kg
23
Q

Describe the HOURLY fluid replacement rule (4-2-1)?

A
  1. < 10 kg = 4 ml/kg/hr
  2. 10 - 20 kg = 40 ml + 2 ml/kg for every kg above 10 kg
  3. > 20 kg = 60 ml + 1 ml/kg for every kg above 20 kg
24
Q

If you are concerned about hypoglycemia, what can be added to the fluids?

25
Ex. What is the hourly and daily fluid maintenance replacement amount for a 25 kg child.
60 ml + 1 X 5 = 65 ml/hr | => Daily = 65 X 24 = 1560 ml/day
26
Ex. What is the hourly fluid maintenance for a 5 kg child?
4ml X 5 kg = 20 ml/hr
27
With Rehydration, what type of fluid should you use?
Isotonic fluid always
28
Rehydration fluids are always isotonic fluid. Maintenance fluids can be either 1/2 or normal saline. What is the benefit of normal saline? (isotonic)
Prevents against hyponatremia | -- especially with adding KCl and Dextrose
29
What is normal saline?
0.9% NaCl
30
What are the mEq of Na and Cl in normal saline?
154 mEq per liter
31
If you have 154 mEq of Na or Cl, what type of saline do you have?
Normal saline = 0.9% NaCl
32
In order to determine the degree of dehydration in a child, what is beneficial to have?
Pre-weight and post-weight
33
With dehydration, what fluids are needed?
Replacement fluids for what was lost + MAINTENANCE hourly fluids
34
With replacement fluids with dehydration, what is the rate of replacement over 24 hours?
1/2 replaced in the first 8 hours | 1/2 replaced in the next 16 hours
35
Ex. Determine how much fluid is lost if a 20 kg child is 10% dehydrated
20 kg X 0.1 = 2 kg = > 2000 mg(cc) fluids LOST = replacement fluids
36
If a dehydrated child (20 kg) needs 2000 ml of replacement fluids, what else must be added to that?
Maintenance hourly fluids | = 60 ml/hr
37
What bolus of isotonic fluid is given for dehydration?
10-20 cc/kg/bolus
38
4 signs of dehydration in a child?
Abnormal appearance Dry mucus membranes No tears Cap refill > 2 seconds
39
4 signs of dehydration in a child?
Abnormal appearance Dry mucus membranes No tears Cap refill > 2 seconds