chap 50: Pediatric Patients

Question 1

1. The Pediatric Research Equity Acts requires:
2. All children be provided equal access to drug research trials
3. Children to be included in the planning phase of new drug development
4. That pediatric drug trials guarantee children of multiple ethnic groups are included
5. All applications for new active ingredients, new indications, new dosage forms, or new routes of administration require pediatric studies

Answer 1

4. All applications for new active ingredients, new indications, new dosage forms, or new routes of administration require pediatric studies

Question 2

2. The Best Pharmaceuticals for Children Act:
3. Includes a pediatric exclusivity rule which extends the patent on drugs studied in children
4. Establishes a committee that writes guidelines for pediatric prescribing
5. Provides funding for new drug development aimed at children
6. Encourages manufacturers specifically to develop pediatric formulations

Answer 2

2. Establishes a committee that writes guidelines for pediatric prescribing

Question 3

3. The developmental variation in Phase I enzymes has what impact on pediatric prescribing?
4. None, Phase I enzymes are stable throughout childhood.
5. Children should always be prescribed lower than adult doses per weight due to low enzyme activity until puberty.
6. Children should always be prescribed higher than adult doses per weight due to high enzyme activity.
7. Prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and other times higher than adult doses based on the age of the child.

Answer 3

4. Prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and other times higher than adult doses based on the age of the child.

Question 4

4. Developmental variation in renal function has what impact on prescribing for infants and children?
5. Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.
6. Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.
7. Renal excretion rates have no impact on prescribing.
8. Parents need to be instructed on whether drugs are renally excreted or not.

Answer 4

1. Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.

Question 5

5. Topical corticosteroids are prescribed cautiously in young children because:
6. They may cause an intense hypersensitivity reaction
7. Of hypothalamic-pituitary-adrenal axis suppression
8. Corticosteroids are less effective in young children
9. Young children may accumulate corticosteroids, leading to toxic levels

Answer 5

2. Of hypothalamic-pituitary-adrenal axis suppression

Question 6

6. Liza is breastfeeding her 2-month-old son and has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant?
7. Maternal drug levels
8. Half-life
9. Lipid-solubility
10. All of the above

Answer 6

4. All of the above

Question 7

7. Drugs that are absolutely contraindicated in lactating women include:
8. Selective serotonin reuptake inhibitors
9. Antiepileptic drugs such as carbamazepine
10. Antineoplastic drugs such as methotrexate
11. All of the above

Answer 7

3. Antineoplastic drugs such as methotrexate

Question 8

8. Zia is a 4-month-old patient with otitis media. Education of his parents regarding administering oral antibiotics to an infant includes:
9. How to administer an oral drug using a medication syringe
10. Mixing the medication with a couple of ounces of formula and putting it in a bottle
11. Discontinuing the antibiotic if diarrhea occurs
12. Calling for an antibiotic change if the infant chokes and sputters during administration

Answer 8

1. How to administer an oral drug using a medication syringe

Question 9

9. To increase adherence in pediatric patients a prescription medication should:
10. Have a short half-life
11. Be the best tasting of the effective drugs
12. Be the least concentrated form of the medication
13. Be administered 3 or 4 times a day

Answer 9

2. Be the best tasting of the effective drugs

Question 10

10. Janie is a 5-month-old breastfed infant with a fever. Treatment for her fever may include:
11. “Baby” aspirin
12. Acetaminophen suppository
13. Ibuprofen suppository
14. Alternating acetaminophen and ibuprofen

Answer 10

2. Acetaminophen suppository