Chapter 10, 11, 42 Flashcards
Premature infants are less than ____ weeks
less than 36 weeks gestational age
Full-term infants are ___ weeks
between 36-40 weeks
Neonates: ____ weeks
first 4 postnatal weeks
Infants: weeks _____
5-52 postnatal
children: _____ years
1-12 years old
Adolescents: ___ years
12-16 years old
___ of drugs used in pediatrics have never been tested in children
2/3
of drugs studied:
___ ineffective in children
___ unanticipated side effects
___ required dosage adjustments
20%
30%
20%
Why are very young children highly sensitive to drugs?
BC of organ system immaturity
In neonate and young infants, drug responses are usually ___ and ___
intense and prolonged
absorption of IM drugs in neonates is ___ than in adults
slower
Absorption of IM drugs in infants is ___ than in adults
more rapid
Infants metabolize drugs faster than adults until age ___ when rates start to decline
2 years
___ stain children’s teeth and should be avoided bc they are a teratogen
Tetracyclines
__ causes growth suppression in kids but once stopped they will catch back up.
Steroids
The elderly are __ of population and __ of nation’s prescribed drugs
12%
31%
The elderly often have complications to drugs bc:
4
- organ system degernation
- multiple and severe illnesses
- Multidrug Therapy
- Poor Adherence
The __ of drug absorption changes in older adults
rate
reduced liver function may ___ drug effects
prolong
___ ____ ___ with resultant drug accumulation is the most important cause of adverse drug reactions in older adults.
Reduced renal function
The lab value that you should always pay attention to in older adults is the: ___
creatinine levels (kidney function)
ADR’s are __ more common in elderly
7x
Elderly ADR’s account for __ of hospital admission and ___ of all medication related deaths
16%
50%
__ to ___ of elderly do not take meds as prescribed
26%-59%
Described in terms of sodium content of plasma:
osmolality
Normal Sodium (Na) : ___ to ___ mEq/L
135-145mEq/L
this is in the blood, not cellular levels
Osmolality : ___ to __-
280-300
Fewer particles extracellularly than intracellularly
Fluid moves into the cell
Hypotonic solution
- cell swells
more substance extracellularly than intracellularly. Fluid moves out of cell
Hypertonic solution
- cell shrinks
Isotonic volume contractions are caused by:
treatment:
vomiting, diarrhea, kidney disease, diuretics
replaced with isotonic solution (0.9%) NaCl
Hypertonic Volume Contractions are caused by:
treatment:
exc sweating, osmotic diuresis, lose more water than sodium
- replace hypotonic fluids (.11% NaCl, sterile water)
Hypotonic Volume Contractions are caused by:
treatment:
diuretics, CRI, lack of aldosterone
isotonic or hypertonic replacement
** can be detrimental to pt***
Volume expansion is caused by:
treatment:
overdose w/fluids, heart failure, nephrotic syndrome, cirrhosis of liver
treatment: diuretics
Potassium is important for ________
conducting nerve impulses, electrical excitability of muscle (including cardiac)
normal levels of potassium
3.5-4.5 K+
a deficiency of potassium in the blood
Hypokalemia
what causes hypokalemia, what are its effects, how do you treat it?
causes: diuretics, poor intake, excessive insulin, alkalosis, urinary loss, vomiting, diarrhea, laxatives, sweat
Effects: weakness, paralysis of skeletal muscle, dysrhyhtmias, slowing of gut, digoxin toxicity
Treatment: IV replacement, potassium chloride tablets
You should NEVER give __ as an IV push. it will kill them
Potassium
You would treat respiratory or metabolic acidosis with __ ___
sodium bicarbonate
What causes Hyperkalemia?
tissue trauma, Addison’s disease, acidosis, K+ sparing diuretics
Hyperkalamia can cause:
lethal cardiac electrical abnormalities
To treat Hyperkalemia, you should:
begin by withdrawing potassium containing foods and drugs that promote potassium accumulation
- infuse calcium salt to offset cardiac effects
- infuse glucose and insulin to promote K+ uptake by cells
- infuse sodium bicarbonate if acidosis is present
__ is needed for enzymes & RNA activity, neurochemical transmission and muscle excitability
Magnesium
Hypomagnesemia is caused by:
diarrhea, dialysis, kidney disease, IV feedings, chronic alcoholism, DM, pancreatitis
Treatment fo Hypomagnesemia:
IM or IV magnesium sulfate or oral magensium
Hypermagnesemia causes:
muscle weakness, hypotension, confusion, sedation, EKC changes, respiratory paralysis
