Waller - Intro to Peds Pharm Flashcards
What percentage of FDA approved drugs are approved for pediatric use?
<50%
What complication are sulfonamide abx associated with in pediatric pts?
These abx displace bili from protein binding sites, resulting in more free bili. The free bili will cross the BBB and result in encephalopathy and kernicterus
What complication is chloramphenicol associated with in pediatric patients?
Gray baby syndrome
Abd distension, vomiting, diarrhea, respiratory distress
How does the ratio of gastric volume compare between peds and adults?
Gastric volume is comparatively lower in peds
How do gastric acid differences in peds affect oral drug absorption?
Higher gastric acid pH and decreased amount
Increased absorption of acid-labile drugs (i.e. PCN, erythromycin) - drugs aren’t broken down as much
Decreased absorption of weakly acidic drugs (phenobarb, phentoin)
What are the differences in total body water in neonates compared to older children?
The younger the child, the greater the percent total body water. This means hydrophilic drugs will distribute further and dilute out more the younger the child is.
How is body fat different in neonates compared to older children?
Neonates have less % body fat compared to older children. Therefore, the dose of lipophilic drugs is lower in neonates compared to older children.
How is protein binding different in newborns compared to older children?
Neonates have decreased protein binding due to lower levels of albumin and other plasma proteins. Therefore, there is more free drug available. Also, drugs can displace bilirubin from proteins and increase free bili in blood
How do pediatric pts handle Phase II metabolism?
Glucoronidation pathways are undeveloped.
Sulfation pathways are well developed and compensate for lack of glucoronidation.
What is true of Phase I metabolic pathways in pediatric pts?
Different enzymatic pathways develop at different ages as the child gets older.
MOA of ampicillin
β-lactam that inhibits cell wall synthesis
MOA of gentamicin
Inhibits bacterial protein synthesis
MOA of third generation cephalosporins
β lactams that inhibit cell wall synthesis
MOA of IVIG
Mostly IgG, some IgA and IgM
Protects recipient against infection and suppresses inflammatory and immune mediated processes
