[2] Developmental Pharmacology Flashcards
What are some of the most disastrous therapeutric misadventures in pediatrics?
Thalidomide 1957
Chloramphenicol 1959
Diethylstilbestrol 1971
What is the Harris Drug Amendment of 1962?
Required demonstrated efficacy and safety for FDA Approval and USA marketing
Are children small adults?
No, unless they’re midgets.
Weight doubles by?
5 months
Weight triples by?
1 year
Body surface area doubles by?
1 year
Caloric expenditure increases 3-4 fold by?
1 year
Define: Adolescence
Transition to adulthood
Dosing depends on?
Size of the child
Pharmacokinetics: ADME
Need for special formulations
[T/F] FOR DJ VILLEZA
For the MOST FRAGILE of patients you are allowed to have EXTREMELY LARGE MARGINS OF ERROR.
Gee I don’t know DJ what do you think
For other people please email DJ at jesusvilleza.jr@gmail.com for the answer
2 Main Factors of Drug Absorption
Characteristic of the Drug/Active Ingredient
Host Factors
When do humans start developing CYP1A1?
3 months of age
When do humans start developing Intestinal Glutathione Conjugation?
1-3 years of age
At birth what is the gastric pH?
Alkaline (pH 6-8)
Falls to pH 1-3 after 24 hours
Rises again during the next 9-12 days
Compare gastric emptying time of neonates and adults
Infants: 6-8 Hours
Adults: 2 Hours
Why is Paracetamol not given to neonates?
They are poorly absorbed because weakly acidic, non-ionized drugs are better absorbed by infants
Compare blood flow in intestinal smooth muscles of neonates as compared to infants and children and adults
Neonates < Infants and Children > Adults
Compare Percutaneous Absorption in neonates, children, and adults
Neonates > Children > Adults
Histamine is not present in neonates until?
Why is this important?
3rd week of life
No need to perform allergy skin tests because results will not yield any useful information
(Very important, make sure to memorize)
What is the earliest age that inhalational devices can be effective for children?
6 months
Compare Total Body Water of infants as compared to Adults?
Infants: 80% > Adults: 55-60%
Which has a higher TBW content? Preterm or Full Term Infants?
Preterm Infants
Presence of Fetal Albumin in Newborns, Infants, and Children
N: Present
I: Absent
C: Absent
Acidic drugs bind to?
Albumin
Basic drugs bind to?
Alpha-Glycoprotein
Neonatal proteins have increased binding capacity with?
Bilirubin
Define: Kernicterus
Highly protein bound drugs can displace bilirubin from albumin binding sites
Most abundant hepatic P450 Enzyme
CYP3A4
Cytochrome P450 Enzymes Present in the Fetus
CYP3A7*
CYP1A1
CYP3A5
*Most abundant
How long does it take for neonates to reach adult levels of GFR?
1 year of age
GFR of neonates is what % of adult value?
30-40%
How does Edema affect drug absorption?
Low albumin levels would affect protein binding drugs
Reaction of Children to Tetracycline
Discolored Teeth
Reaction of Children to Phenobarbital
Hyperactivity
Impaired Intelligence
Reaction of Children to Chloramphenicol
Gray Baby Syndrome
Reaction of Children to Phenytoin (Dilantin)
Thickened Skull
Coarse Features
Reaction of Children to Valproic Acid (Depakene)
Hepatotoxicity
Reaction of Children to Aspirin
Reye’s Syndrome in patients with Chickenpox or Infleunza
What drug causes rapid closure of patent ductus arteriosus?
Indomethacin
What drug causes the ductus to remain open?
Prostaglandin E1
