1. Peds Flashcards by Kira Harms

premature

<36 weeks gestational age

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term

> = 36 weeks gestational age

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neonate

birth - 1 month

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infant

1 month - 1 year

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child

1-11 years

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adolescent

12-16 years

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peds absorption of acid-labile drugs (peniccilling)

increased

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peds absorption of basic drugs

decreased

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peds TBW

85%
greater than adults

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peds volume of distribution

increased for water soluble drugs

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peds loading doses

may need to be increased

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peds duration of action in lipid soluble drugs

longer

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peds metabolism is decreased for which drugs

benzos
amide local anesthetics
barbituates

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peds moprhine clearnce

decr due to CYP450

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peds elimination affects

abx dosing

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fetal receptors have enhanced response to what NMB

depolarizing
(Sux)

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fetal receptors have relative decr response to what NMB

roc
vec

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peds diaphragm has more _____ fibers

Type 1 fibers

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peds diaphragm will recover _____ from NMB

faster

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neonates/infants need _____ plasma concentration of Non-depolarizing muscle relaxants

lower
(lower mx dose)

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neonates/infants need _____ loading dose of non-depolarizing muscle relaxants

higher

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peds ECF

greater than adults

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peds CO

higher

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higher CO means

faster onset

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peds are at higher risk for

bradycardia

which vasopressor should we be careful with for peds

phenylephrine

Cr clearance in peds is estimated using

Schwartz equation

CrCl =

CrCl = 0.413xL / Scr

to estimate CrCl we need to know

length or heigh serum Cr

peds are dosed

allometrically

highest danger in overdose toxicity pt population

< 1 yr old

NMB onset

faster

fastest NMB onset

sux

peds are more susceptible to what type of NMB

depolarizing agent

sux SE

transient incr HR bradycardia severe hyperkalemia rhabdo muscle spasm MH

non-depolarizer initial dose

higher neonate > infant > adult

which receptors are more senstive to non-depolarizers

neonates

non-depolarizer mx dose

lower dose for mx of relaxation

non-depolarized DOA

prolonged due to decr hepatic metabolism

which non-depolarizer has longest DOA

pancuronium especially w/renal insufficiency

which non-depolarizer has shorter DOA

cisatracurium

which peds pts can receive sugammadex

2+ year olds

neostigmine must be reversed with

glyco

edrophonium must be reversed with

atropine

which drug is given to reduce intubation brady or brady from sux for peds under 5?

atropine (20 mcg/kg)

midazolam mechanism

allosteric gaba receptor agonist

which drug should be co-administered with ketamin

atropine or glyco 0.01 mg/kg

ketamine indication

induction sedation

ketamine mech

blocks NE reuptake

precedex mech

alpha 2 agnoist

precedex SE

bradycardia

propofol induction dose is _______ in peds

higher

propofol clearance is

25% faster

propofol mx infusion dose is

higher because of incr clearance

opioids are most potent in which population

neonates

caution for opioids

sleep apnea premature infants

opioids SE

rigid chest effect

best drug for blunting intubation stimuli

fentanyl

remi Vd

smaller

remi cleareance

faster

NSAIDS mechanism

cox inhibitors

which pts are very reliant on glucose

newbors to 8 years

mx glu for peds

6 mg/kg/min

peds mx fluid should include

dextrose - dex 5%/0.45 NS - dex 5%/0.25 NS

which mx fluids for neonates

dex 5%/0.25 NS

dehydrated infants will present with

hypotension without tachycardia

deficit fluids should be replaced with

LR 0.45 NS

which procedure in peds is most likely to cause N/V

strabismus

Eberhart classification is used for

post-op vomiting

eberhart risk factors

surgery > 30 mins Age > 3 strabismus surgery hx or fam hx of POV

eberhart max points

high risk

3-4 factors

med risk

1-2 factors

low risk

0 factors

high risk anti emetics

ondansetron dexamethasone +/- TIVA

med risk anti emetics

ondansetron dexamethasone

which antiemetic has QT prolongation

ondansetron droperidol

which antiemetic is approved >= 1 month olds pts

ondansetron

which antiemetic has most evidence for use in peds

ondanestron

ondansetron metabolism

CYP ensymes

decadron onset

slower

H1 receptor antagonists

diphenydramine

H1R effect

sedation antimuscariinic

droperidol mech

dopa R antagonist

hyperkalemia management

hyperventilation CaCl/CaGlu Bicarb Dextrose + insulin albuterol Fuerosemide Keyexalate

which agents can cause anaphylaxis

NMB latex abx

anaphylaxis managment

100 FiO2 epi fluid bolus phenylephrine hydrocortisone diphenhydramine rantidine

MH managment

TIVA dantrolene 2.5 mg/kg every 3-5 mins hyperventilate 100 FiO2 10 L/min cool pt

laryngospasm managment

jaw thrus chin lift 2 hand mask propofol bolus