Pharmacy Flashcards
(79 cards)
TX Colic
Medications and CAM havenot shown to be effective and may be harmful
TX teething
Benzocaine gel w/o alcohol (orajel)
Ibuprofen HS shown to be effective
systemic absorption of Lidocaine
TX Diaper Rash
Mild, non-candidal: Zinc Oxide Cream
Candida rash: Clotrimazole 1% Cream
TX Diarrhea/hydration
Maintenance Fluid Requirements:
Less than 10kg 100mL/kg/day
11-20 kg 1,000 mL + 50 mL/kg over 10kg
Greater than 20 kg1,500mL + 20mL/kg over 20kg
Mild Diarrhea
Keep regular diet
Absorb significant protein, fat, CHO
Rehydrate with oral electrolyte solution such as pedialyte
TX Otitis Externa
Otic Suspensions
Acid to replicate normal ear canal environment
If pt has vent tubes or recent perforation painful then
Ophthalmic Suspensions
Balanced pH and More viscous
Add 2-3 gtts of NSS to 5mL bottle
Anti-depressants in Adolescents
Causes increased impulsivity, silliness, daring conduct, agitation
Black Box Warning: Antidepressants and increased suicidal ideation/risk:
Initial months of therapy or dose changes
Anti-psychotics in Adolescents
Susceptible to extrapyramidal symptoms especially dystonias and weight gain use lower doses
Acetaminophen-Common Formulations and Dosing
Acetaminophen
Formulations:
Infant Drops (80mg/0.8mL)
Liquid (160mg/5mL)
Dosing: 10-15mg/kg/dose Q4-6H Max 65mg/kg/Day
Amoxicillin- Dosing
Regular 40-45/kg/Day
High dose: 80-90mg/kg/day
Why don’t you use Aspirin in children?
Reye’s syndrome:
Fatty Liver degeneration, encephalopathy and system failure
Why is Benzocaine preferred over Lidocaine?
Benzocaine is poorly soluble in water and very slowly absorbed so don’t get toxic levels as easily as lidocaine
Lidocaine
Not for repeated topical application in children due to rapid absorption & toxicity
Very short term use
When are fluroquinolones used in children?
Have been used in children with cystic fibrosis without significant problems
Fluroquinolones
Such as Ciprofloxacin, levofloxacin, moxifloxacin
May cause joint space crystalization in children
Ibuprofen- Common formulations and Dosing
Infant Drops Children’s Suspension Children’s Chewable Tablets Dosing: 5-10 mg/kg/dose Q6-8H Max 40mg/kg/Day
How does a childs body metabolize and excrete Erythromycin and Clarithromycin?
Primarily hepatic metabolism Biliary excretion
P450 interactions causing nausea, increased gastric motility
How does a childs body metabolize and excrete Azithromycian?
Minimal hepatic metabolism and is primarily excreted in bile
What is Phenobarbital used for in children?
Used in infants with generalized motor seizures
Who should you avoid using tetracyclines like doxy in and why?
Avoid in pregnancy and children under 8 years old because of dental staining
Why are vitamin A analogues like Isotretoin dangerous?
Isotretoin is teratogenic
Needs 2 forms contraception, regular PG testing and to fill Rx w/in 7 days and max 30 day supply
When is zinc oxide used?
Barrier protection for diaper irritation used in both Infants and elder in homes
When do glomerular filtrations rates reach adult rate?
At adult rates by 6-12 months
End of week 3 at 50-60% adult rates
How do toddlers metabolism differ from an adults metabolism?
Toddlers metabolism is more rapid and renal elimination than adults
What formula can be used to calculate creatinine clearance in children?
Schwartz’s Equation (til 18)
CrCl = k x Length (in cm)/ Scr
How do neonates P450 activity differ from adults?
CYP450 enzymes develop at variable points up to 3 years of age
Phase 1 reactions and enzymes impaired in preterm infants, neonates
less P450 activity
(50-70% adult levels)
Alcohol dehydrogenase may develop late childhood or early adolescence
How is the metabolic enzyme activity rate effect in children taking anti-convulsants?
Variable rates of hepatic metabolic enzyme activity
2x adult rate @ 6 months persisting to 9-12 years of age
Infants of mothers on drugs that induce hepatic enzymes (phenobarbitol) may have increased metab rates early
