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Flashcards in Peds Deck (40):
1

 

What percentage of drugs are not FDA approved for children (and even fewer for infants)?

60%

2

What percentage of drugs lack dosing, efficacy, and safety data for children?

75%

3

How much can we round up dosese to avoid decimals?

limit round up to 10% of dose

4

What are some issues with IM administration of drugs in children?

not well tolerated

variable muscle mass in infants & young children

variable blood flow to muscle, SQ tissue

5

What are elixirs?

drug dissolved & evenly distributed in alcohol

caution with evaporation

6

What are some suspending agents for crushed tablets?

apple sauce

pudding

chocolate syrup

7

What age can we start giving capsules/tablets?

~ age 6

8

What age can we use a nebulizer?

age 3

9

What age can we start using MDIs?

age 5

10

What percentage of dosing errors occur in children?

~ 70%

11

What is the best source for drug dosing in children but frequently not available?

manufacturer's package insert information

12

What is the GI system like in neonates?

high gastric pH

irregular peristalsis

low levels pancreatic enzymes

bile acids can alter absorption

13

Why is topical absorption higher in neonates/infants?

thin stratum corneum

increase cutaneous perfusion

higher surface to weight ratio

14

Do neonates have less P450 activity?

yes; 50-70% adult levels

15

What is metabolism & renal elimination like in toddlers?

more rapid metabolism & renal elimination than adults

16

At what age can we start using the Cockroft-Gault Formula?

age 18

17

What is the BBB like in neonates and young children?

What does this impact?

BBB is less effective

greater opioid impact

bilirubin passes through also

18

In children who are teething, what drug to we need to be cautious with because of systemic absorption?

Lidocaine

19

What should we use to treat teething pain in children?

7.5% benzocaine gel without alcohol

20

What should we use to treat mild, non-candidal diaper rash?

zinc oxide cream, drying

21

What should we use to treat candial diaper rashes?

Clotrimazole 1% cream

nystatin ointment resistance issues

22

How should we treat mild diarrhea in children?

regular diet

absorb significant protein, fat, CHO

BRAT diet is less effective

23

What are otic suspensions?

acid pH to replicate normal ear canal environment

24

What happens when you give otic suspensions to children with vent tubes or recent perforation?

painful!

25

What should we give instead of otic suspensions for kids with otitis externa with vent tubes?

ophthalmic suspensions

26

What is the issue with antipsychotics and children/adolescents?

more susceptible to extrapyramidal symptoms, espiecally dystonias

more weight gain

27

What is the usual dosing for Acetaminopen?

What is the max dosing?

10-15 mg/kg/dose

max: 65 mg/kg/day

28

What is the regular dose of Amoxicillin?

High dose of Amoxicillin?

Maximum child dose?

regular: 40-45 mg/kg/day

high: 80-90 mg/kg/day

max child dose is adult dose

29

Should we use Aspirin in children?

no, especially febrile children

30

What can happen if we give Aspirin to children?

Reye's Syndrome

fatty liver degeneration, encephalopathy, liver failure

31

Why is benzocaine preferred over lidocaine in children?

benzocaine is poorly soluble in water & very slowly absorbed so don't get toxic levels as easily as lidocaine

32

What are some cautions with antidepressants in children?

suicide ideation

impulsivity

agitation

33

What are some cautions with antipsychotics in children?

more susceptible to extrapyramidal symptoms 

tardive dyskinesia

34

What is Phenobarbitol used for?

generalized motor seizures in infants

35

Who should we avoid using Tetracyclines in?

avoid in PG

&

children < 8yrs (dental staining)

36

What is a Vitamin A analogue that is teratogenic?

Isotretinoin

increases risk of malformed fetus 25x

I-PLEDGE program

2 forms contraception (one either surgical or hormonal)

37

What can we use as a barrier protection for diaper irriation?

(either in infants or nursing homes)

zinc oxide cream

38

What is Ethosuximide used to treat?

petit mal or absence seizures in children

39

When is the highest risk for suicide after starting a new anti-depressant?

within 2 weeks

so want to follow up within that time period

40

Can the location of medicine in the rectal vault influence rates of absorption?

yes