2.7 Prescribing for Peds

Question 1

What is a major factor in gaining medication compliance in kids

Answer 1

taste of medication

Question 2

Convenience is a major factor in compliance as well with kids- what type of inhaler is easier to use in older kids

Answer 2

turbuhaler for bronchodilator because can carry in pocket as opposed to spacer and aerosolized device

Question 3

At what age can kids typiaclly use a turbhaler

Answer 3

7 years old

Question 4

What is important to consider with formulation and dose/volume in kids

Answer 4

choose formulation and delivery method that can be easily measured out by parent

Question 5

What is optimal dosing schedules for kids

Answer 5

once or twice daily as opposed to TID or QID where possible

Question 6

What should parents not refer to medication as

Answer 6

candy

Question 7

What should be avoided when giving instuctions on prescriptions for use

Answer 7

avoid vague instructions such as “take as directed”

Question 8

What should be added to the script for a peds that is not on an adult script

2

Answer 8

kids height and weight

to ensure appropriate dosing

Question 9

What two body systems need to be assessed for maturation when prescribing scripts for kids

Answer 9

renal and hepatic

needed to produce enzymes and clear drugs

Question 10

The absorption rate of medications administered through subcutaneous or intramuscular injection is affected by the blood flow to those tissues in kids, where poor blood flow can result in __________ or reduced ______ .

Answer 10

delayed or reduced absorption

Question 11

How does the immature GI tract of neonates and infants influence the absorption of meds

3

Answer 11

• decreased acid secretion
• prolonged emptying
• irregular peristalsis

Question 12

What are the two concerns for topical absoprtion in children

Answer 12

• thin stratum
  large body surface area

Question 13

The younger the child, the most _____ varies

Answer 13

absorption

Question 14

What is important to note about the blood brain barrier in infants esp premature infants

Answer 14

BBB is more permeable therefore drug can cross more readily

Question 15

How does the funtion of liver enzymes change from neonates and infants to children in the context of drug metabolism

Answer 15

Neonates/infants- immature function of liver- prolonged elimination and clearance

Children- liver metabolism speeds up and can exceed adult levels therefore needing more frequent/higher doses

Question 16

The maturity of a childs renal system has significant effect on _____

Answer 16

drug elimination

The maturity of a child’s renal excretion system
has a significant effect on drug elimination.

Glomerular filtration rate in neonates is approximately 30% to 40% of adults, how-
ever, the adult value is usually reached by 6 to 12 months of life.

Common drugs cleared by the renal system (e.g., penicillin, gentamicin, digoxin) require dosage and dosing schedule changes and close monitoring in ill or immature infants

Question 17

With school aged children what can be helpful when speaking to the children about the medication

Answer 17

letting them choose the formulation if possible (liquid, pill, chewable)

Question 18

What is helpful when working with adolescents regarding medication

Answer 18

allow them input into dosing schedule when possible because they often administer their own meds

Question 19

In school aged kids what should be avoided for med administration

Answer 19

avoid dosing during school hours where possible

Question 20

What is drug chronotherapy

Answer 20

field of study about metabolism and tolerability of drugs depends on each individual persons organs, tissues, cells and their circadian rhythm of those structures