Week 6- Paediatrics

Question 1

what is the definition for a premature baby?

Answer 1

less than 37 weeks old

Question 2

what is the definition for a full term baby?

Answer 2

38-42 weeks old

Question 3

what is the definition for a neonate?

Answer 3

less than 1 month baby

Question 4

what is the definition for a infant?

Answer 4

less than 1 year

Question 5

what is the definition for a child?

Answer 5

1-12 years old

Question 6

what is the definition for a young adult/adolescent?

Answer 6

13-19 years old

Question 7

what is the gastric pH at birth?

Answer 7

6-8 then reduces when the child is around 2-3years old to around pH2

Question 8

What route of administration of drugs is normally avoided in paediatrics? why

Answer 8

intramuscular
-painful
-poor perfusion

Question 9

what is the difference in drug distribution in paediatrics compared to adults?

Answer 9

paediatrics have a higher total body water and ECF volume but this decreases with time, therefore volume of distribution is greater in neonates & infants for water-soluble drugs. Greater doses on a weight-for-weight basis

Question 10

what are the two methods of treating paediatrics with medications when it is not licenses for the use or not in the correct formulation for paediatrics?

Answer 10

-unlicensed use
-off-label use

Question 11

what is the meaning of off-label use in paediatrics?

Answer 11

when there is a drug that is not licensed for paedatric use but there is a liquid formulation of it e.g. for adults to use.

Question 12

what is the meaning of unlicensed uses of medication in paediatrics?

Answer 12

when the drug doesn’t have a licensed use in paediatrics and when their is a suitable formulation for the drug so you have to modify it to use it

Question 13

when can you stumble across dosing problems with paediatrics?

Answer 13

-insufficient rounding= need to round to the nearestnumebr we can administer
-decimal point e.g. 4.0mg can me mistaken as 40mg
-different liquid strengths e.g. propranolol 5mg/5mL, 10mg/5mL, 40mg/5mL, 50mg/5mL ‘patient takes 5ml BD’
-wrong weight documented in lbs rather than kg, not changing the weight
-displacement values not considered

Question 14

what are some counselling point for using oral syringes?

Answer 14

Counselling points:
 Ensure child is sitting upright
 Syringe placed just inside mouth & pointing towards cheek
 Slowly press the plunger to expel the medicine
 Do not squirt the medicine to the back of the child’s mouth or throat, as they may choke.

Question 15

what are some formulation issues that can be considered for paediatrics?

Answer 15

Lactose
 Intolerance?
Sugar content
 Dental cavities with long-term treatment
Sorbital & glycerol
 May cause diarrhoea in large doses
Alcohol Content
 Phenobarbitone solution BP contains 38% alcohol
Osmolarity
 Increased osmolarity can damage GI tract  e.g. propylene glycol Colourings & E Numbers
 Hyperactivity?

Question 16

what needs to be considered when selecting a dose of paediatrics?

Answer 16

 Age/weight/surface area
 Appropriate dose and interval
 Route of administration
 Expected response and monitoring parameters
 Interactions
 Legal Considerations

Question 17

when do you refer paedatrics?

Answer 17

Symptoms or conditions lasting for long periods,
recurring or worsening rather than improving
Failure of symptoms to respond to medicines
Severe pain
The presence of danger/red flag symptoms

Question 18

what are some danger/red flag symptoms in paediatrics?

Answer 18

 Unexplained loss of appetite
 Unexplained weight loss
 Persistently raised temperature (referral if temperature
38C+ for < 3 months
39C+ for 3-6 months)
 Abnormal drowsiness
 Loss of consciousness
 Unilateral nasal discharge
 Difficulty breathing
 Cough with vomiting
 Blood in sputum
 Unexplained bleeding
 Persistent night-time cough
 Photophobia
 Rashes which do not blanch under pressure