Block I - Pediatric

Question 1

In regards to neonate and infant, unique absorption

Answer 1

GI function (takes longer than 24 hours to lower pH to 1-3 range, acidic drugs might not work), GI motility = slower = takes neonate longer to get same amount. Topical - have greater body surface area, thinner skin, more hydration = neonates absorb more.

Question 2

In regards to neonate and infant, unique distribution

Answer 2

Relatively high % TBW = drug distributed more. Lipophilic drugs go into fat in chubby babies (20-24%) vs neonates (15%) = less fat in neonate = less distribution. Lower plasma proteins in neonates = more free drug

Question 3

In regards to neonate and infant, unique metabolism

Answer 3

Usually slower in infants = slower clearance = increased half-lifes

Question 4

In regards to neonate and infant, unique elimination

Answer 4

Kidneys not fully functional = slower clearance

Question 5

In regards to neonate and infant, unique pharmacodynamics

Answer 5

More sensitive to CNS inhibitory effects of opioids = codeine exposure in breast milk

Question 6

Medications can undergo kinetic changes in peds

Answer 6

A: GI motility increased/decreased, D: Decreased protein binding leads to more free drug increased by other drugs, M: Enzyme activity lower = longer drug half-lifes, E: GFR low, reaches adult levels between 6-12 months, some drugs can decrease.

Question 7

Problems with proportional dosing

Answer 7

Many variables in ped pt. Affect way they absorb, distribute, metabolize, and excrete drugs. Different pharmacokinetics at different ages. Need to be considered.

Question 8

High potential for ADR in peds: oral

Answer 8

Prolonged GI motility and emptying, premies have delayed development of acidic stomach = drug remains in system longer

Question 9

High potential for ADR in peds: transdermal

Answer 9

Large surface area relative to body size, thinner skin, increased skin hydration = faster absorption