Pharmacology

Question 1

Can breast fed infants be affected by their mothers medication?

Answer 1

Yes

Question 2

Neonates/infants response to drugs compared to adults

Answer 2

More sensitive

Question 3

What do neonates/infants show increased risk for?

Answer 3

Adverse drug reactions

Question 4

The young child has enhanced what?

Answer 4

Metabolism

Excretion

Question 5

What produces major changes in body size and composition in adolescence?

Answer 5

Sexual development

Question 6

What can alter drug metabolism in adolescence?

Answer 6

Psychological changes and peer pressure resulting in behaviour e.g. smoking, alcohol and elicit drug use

Question 7

What SSRI is used in childhood depression?

Answer 7

Paroxetine

Question 8

How can drugs be administered in children?

Answer 8

Oral
Parenteral
Topically
Rectally

Question 9

Differences in children with oral medicines

Answer 9

Reduced gastric acid and delayed gastric emptying. adult levels reached at 3 years
Absorption reaches adult values by 6-8 months
A lot of variability

Question 10

Who gets rectal medication?

Answer 10

Vomiting

Unwilling to take oral medication

Question 11

What does rectal medication avoid?

Answer 11

First pass metabolism

Question 12

Drug Distribution in infants

Answer 12

Newborn infants high extracellular fluid of 45%
Total body water is high 75-92%
Fat content low 12% in term infants

Question 13

Drug doses in children

Answer 13

Larger initial doses on a mg/kg body weight needs to be given to achieve a correct plasma concentration

Question 14

Plasma protein binding in neonates

Answer 14

Reduced in neonates

Results in a great unbound or active drug

Question 15

Drug elimination in neonates

Answer 15

Neonate liver metabolism is immature and thus drugs eliminated by the liver have a longer half life

Question 16

Hepatic metabolism in the neonatal period

Answer 16

Very slow
Oxidation and glucuonidation
Especially sensitive to drugs eliminated by hepatic metabolism
Metabolic activity increases rapidly from about 1 month after birth with adult activity by 1 year of age

Question 17

Drug changes in older children

Answer 17

Because of hepatic metabolism the dose-age of some drugs e.g. anti epileptics would be greater

Question 18

Renal excretion in neonates

Answer 18

Decreased in neonates
Shows progressive maturation with age
Adult values achieved at 3-6 months
For most drugs t1/2 is prolonged

Question 19

Pharmokinetics of new borns and babies in first year of life compared to adults

Answer 19

decreased Albumin proteins mean free drug increases
Increased free drug levels leads to increased response
Decreased hepatic metabolism leads to increased response
Decreased renal elimination leads to increased response
Decreased BBB leads to increased CNS effects

Question 20

Sensitivity to drugs is increased by…

Answer 20

Fever
Dehydration (increased effects of many drugs)
Acidosis (decreased cellular penetration of basic drugs)