Pediatric & Geriatric Pharmaceutics Flashcards
(44 cards)
Define Paediatric Pharmaceutics.
Branch of pharmaceutical science specific to the use if medication in children, including dosage forms, pharmacokinetics/pharmacodynamics and special medicinal needs appropriate to young patients/consumers
In 1999, the FDA established regulations regarding labelling o new products for the safety of children. What else did the new regulations allow the FDA to do?
Require pediatric testing of-already marketed drugs when the drug is frequently prescribed to children.
List the five subgroups of pediatric population based on age.
Intrauterine- conception to birth Neonate- birth to 1 month Infant- 1 month to 2 years Child- 2 years to onset of puberty Adolescent- onset of puberty to adult
How are the most accurate doses decided for paediatrics?
Utilizing age and weigh
*surface area has no practical advantage
Does gastric acid output increase or decrease with age?
Lowest gastric acid output is observed in neonate of 10-30 days. Values approach adult levels by three months.
What other physiological features affect absorption in Neonates?
Gastric emptying time and intestinal transit time are erratic in Neonates. Pancreatic enzyme activity is low (lipid soluble drugs poorly absorbed).
When does the colonization and metabolic activity of GI flora approach adult values and what drug has an increased bioavailability due to this?
2-4 yrs
Digoxin
What reactions in metabolism are delayed in Neonates but are adult level by 4-6 months?
Phase 1 reactions
Oxidation, n-demethylation
When do conjugation pathways approach adult values?
3-4 yrs, can see prolonged half lives
What does renal excretion of drug depend on?
Glomerular filtration, tubular secretion and tubular absorption
When does tubular secretion approach adult values?
Between 2 -6 months, greatest variability of drug disposition
How do adverse reactions differ in the pediatric population?
In type and incidence, due to immature metabolic pathways
Ex) theophylline, antibiotics, antihistamines
What excipients/additives can be an issue in pediatric patients?
Dyes and sweeteners; hypersensitivity
Give example of dyes that are known for hypersensitivity reactions.
FD&C Yellow #5 and #6
Tartrazine-induced bronchoconstriction (ASA-cross sensitivity)
What is the most popular sweetener?
Sucrose
Chewable may contain up to 20-60%
Liquids may contain up to 85%
This preparation can represent a substantial carbohydrate load to children with diabetes.
Oral liquid
Why is lactose not recommended as a sweetener pediatric populations?
High incidence of lactose intolerance.
This ingredient is second only to water in its use in liquid preparations, acting a preservative and flavoring agent.
Ethanol
May also enhance the oral absorption of some active ingredients
What is the largest level of ethanol in the blood suggested for children in single dose?
25mg/dL because they have a limited ability to metabolize and detoxify ethanol
What is the preferred route of administration for children?
Oral administration
Younger than what age have difficulty or are unable to swallow solid oral dosage forms?
5 years old
What are the downsides to liquid dosages?
Unstable and have short half lives.
Difficulty in accurate measurement and administration
What is an alternative formulation that is widely accepted by children under three and their parents?
Chewable tablets and sprinkle capsules
Consider the benefits and the risks of rectal administration in paediatrics.
Wide variability in the rate and extent of absorption in children
Inflexibility of fixed dose.
Not promoted for paediatrics
