Chapter 10 - Drug Therapy in Pediatric Patients

Question 1

Drug sensitivity in the very young results largely from

Answer 1

organ system immaturity

Question 2

Because of heightened drug sensitivity, pediatrics are at increased risk of

Answer 2

adverse drug reactions

Question 3

What two laws where designed to promote drug research in children

Answer 3

Best Pharmaceuticals for Children Act (BPCA), passed in 2002, and the Pediatric Research Equity Act (PREA) of 2003.

Question 4

The increased sensitivity of infants is due largely to the immature state of what five pharmacokinetic processes:

Answer 4

(1) drug absorption,
(2) protein binding of drugs,
(3) exclusion of drugs from the central nervous system (CNS) by the blood-brain barrier,
(4) hepatic drug metabolism, and
(5) renal drug excretion.

Question 5

Gastric emptying time is both ______and______ in early infancy, and then gradually reaches adult values by _____

Answer 5

prolonged ; irregular

6 to 8 months

Question 6

For drugs that are absorbed primarily from the stomach, delayed gastric emptying
______ absorption

Answer 6

enhances

Question 7

for drugs that are absorbed primarily from the intestine, absorption is ______.

Answer 7

delayed

Question 8

Drug absorption following IM injection in the neonate is _____

Answer 8

slow and erratic - due in part o low blood flow through muscles during the first days of postnatal life.

Question 9

Drug absorption through the skin is more ___ and_____ in infants than in older children and adults

Answer 9

rapid ; complete – The stratum corneum of the infant’s skin is very thin, and blood flow to the skin is greater in infants than in older patients. This can cause toxicity from topical drugs.

Question 10

Binding of drugs to albumin and other plasma proteins is limited in the infant, because

Answer 10

(1) the amount of serum albumin is relatively low and (2) endogenous compounds (eg, fatty acids, bilirubin) compete with drugs for available binding sites

This causes the concentration of free levels of such drugs to be high

Question 11

The drug-metabolizing capacity of newborns is

Answer 11

low

Question 12

Renal drug excretion is significantly ______at birth

Answer 12

reduced

Question 13

By what age are most pharmacokinetic parameters in children are similar to those in adults

Answer 13

one year

Question 14

Complete maturation of the liver develops by

Answer 14

1 year

Question 15

Drug-metabolizing capacity is markedly elevated until age

Answer 15

2 years