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Fa: Pharm 3 > 1. Peds > Flashcards

1. Peds Flashcards

1
Q

premature

A

<36 weeks gestational age

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2
Q

term

A

> = 36 weeks gestational age

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3
Q

neonate

A

birth - 1 month

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4
Q

infant

A

1 month - 1 year

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5
Q

child

A

1-11 years

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6
Q

adolescent

A

12-16 years

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7
Q

peds absorption of acid-labile drugs (peniccilling)

A

increased

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8
Q

peds absorption of basic drugs

A

decreased

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9
Q

peds TBW

A

85%
greater than adults

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10
Q

peds volume of distribution

A

increased for water soluble drugs

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11
Q

peds loading doses

A

may need to be increased

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12
Q

peds duration of action in lipid soluble drugs

A

longer

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13
Q

peds metabolism is decreased for which drugs

A

benzos
amide local anesthetics
barbituates

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14
Q

peds moprhine clearnce

A

decr due to CYP450

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15
Q

peds elimination affects

A

abx dosing

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16
Q

fetal receptors have enhanced response to what NMB

A

depolarizing
(Sux)

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17
Q

fetal receptors have relative decr response to what NMB

A

roc
vec

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18
Q

peds diaphragm has more _____ fibers

A

Type 1 fibers

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19
Q

peds diaphragm will recover _____ from NMB

A

faster

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20
Q

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

A

lower
(lower mx dose)

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21
Q

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

A

higher

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22
Q

peds ECF

A

greater than adults

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23
Q

peds CO

A

higher

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24
Q

higher CO means

A

faster onset

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25
Q

peds are at higher risk for

A

bradycardia

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26
Q

which vasopressor should we be careful with for peds

A

phenylephrine

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27
Q

Cr clearance in peds is estimated using

A

Schwartz equation

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28
Q

CrCl =

A

CrCl = 0.413xL / Scr

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29
Q

to estimate CrCl we need to know

A

length or heigh
serum Cr

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30
Q

peds are dosed

A

allometrically

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31
Q

highest danger in overdose toxicity pt population

A

< 1 yr old

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32
Q

NMB onset

A

faster

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33
Q

fastest NMB onset

A

sux

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34
Q

peds are more susceptible to what type of NMB

A

depolarizing agent

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35
Q

sux SE

A

transient incr HR
bradycardia
severe hyperkalemia
rhabdo
muscle spasm
MH

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36
Q

non-depolarizer initial dose

A

higher
neonate > infant > adult

37
Q

which receptors are more senstive to non-depolarizers

A

neonates

38
Q

non-depolarizer mx dose

A

lower dose for mx of relaxation

39
Q

non-depolarized DOA

A

prolonged due to decr hepatic metabolism

40
Q

which non-depolarizer has longest DOA

A

pancuronium
especially w/renal insufficiency

41
Q

which non-depolarizer has shorter DOA

A

cisatracurium

42
Q

which peds pts can receive sugammadex

A

2+ year olds

43
Q

neostigmine must be reversed with

A

glyco

44
Q

edrophonium must be reversed with

A

atropine

45
Q

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

A

atropine
(20 mcg/kg)

46
Q

midazolam mechanism

A

allosteric gaba receptor agonist

47
Q

which drug should be co-administered with ketamin

A

atropine or glyco
0.01 mg/kg

48
Q

ketamine indication

A

induction
sedation

49
Q

ketamine mech

A

blocks NE reuptake

50
Q

precedex mech

A

alpha 2 agnoist

51
Q

precedex SE

A

bradycardia

52
Q

propofol induction dose is _______ in peds

A

higher

53
Q

propofol clearance is

A

25% faster

54
Q

propofol mx infusion dose is

A

higher because of incr clearance

55
Q

opioids are most potent in which population

A

neonates

56
Q

caution for opioids

A

sleep apnea
premature infants

57
Q

opioids SE

A

rigid chest effect

58
Q

best drug for blunting intubation stimuli

A

fentanyl

59
Q

remi Vd

A

smaller

60
Q

remi cleareance

A

faster

61
Q

NSAIDS mechanism

A

cox inhibitors

62
Q

which pts are very reliant on glucose

A

newbors to 8 years

63
Q

mx glu for peds

A

6 mg/kg/min

64
Q

peds mx fluid should include

A

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

65
Q

which mx fluids for neonates

A

dex 5%/0.25 NS

66
Q

dehydrated infants will present with

A

hypotension without tachycardia

67
Q

deficit fluids should be replaced with

A

LR
0.45 NS

68
Q

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

A

strabismus

69
Q

Eberhart classification is used for

A

post-op vomiting

70
Q

eberhart risk factors

A

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

71
Q

eberhart max points

A

4

72
Q

high risk

A

3-4 factors

73
Q

med risk

A

1-2 factors

74
Q

low risk

A

0 factors

75
Q

high risk anti emetics

A

ondansetron
dexamethasone
+/- TIVA

76
Q

med risk anti emetics

A

ondansetron
dexamethasone

77
Q

which antiemetic has QT prolongation

A

ondansetron
droperidol

78
Q

which antiemetic is approved >= 1 month olds pts

A

ondansetron

79
Q

which antiemetic has most evidence for use in peds

A

ondanestron

80
Q

ondansetron metabolism

A

CYP ensymes

81
Q

decadron onset

A

slower

82
Q

H1 receptor antagonists

A

diphenydramine

83
Q

H1R effect

A

sedation
antimuscariinic

84
Q

droperidol mech

A

dopa R antagonist

85
Q

hyperkalemia management

A

hyperventilation
CaCl/CaGlu
Bicarb
Dextrose + insulin
albuterol
Fuerosemide
Keyexalate

86
Q

which agents can cause anaphylaxis

A

NMB
latex
abx

87
Q

anaphylaxis managment

A

100 FiO2
epi
fluid bolus
phenylephrine
hydrocortisone
diphenhydramine
rantidine

88
Q

MH managment

A

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

89
Q

laryngospasm managment

A

jaw thrus
chin lift
2 hand mask
propofol bolus

Fa: Pharm 3 (10 decks)

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