Chapter 12: Drug Therapy in Pediatric Patients

Question 1

how old are paediatric patients

Answer 1

all patients younger than 16 years old

Question 2

how do pediatric patients respond differently to drugs

Answer 2

• more sensitive
• show greater individual variation
• sensitivity mainly due to organ system immaturity
• increased risk for adverse drug reations

Question 3

elevated drug levels =

Answer 3

more intense response

Question 4

delayed elimination =

Answer 4

prolonged response

Question 5

pharmacokinetics

Answer 5

determine the concentration of a drug at its sites of action and thus determines the intensity of the duration of the response

Question 6

increased sesnativity in infants is cuased by immature state of which 5 pharmacokinetic processes

Answer 6

• absorption
• protein binding of drugs
• blood brain barrier
• heptic metabolism
• renal drug excretion

Question 7

oral administration in neonates and infants

Answer 7

• prolonged gastric emptying time

Question 8

when do pediatric patients gain normal adult function of their gastric emptying

Answer 8

6 to 8 months

Question 9

gastric acidity in Neonates and Infants

Answer 9

• very low 24 hours after birth
• does not reach adult value for 2 years

Question 10

when do infants reach adult values for gastric acidity

Answer 10

2 years

Question 11

low acidity

Answer 11

absorption of acid-labile drugs is increased

Question 12

Intramuscular administration in neonates and infants

Answer 12

• slow
• erratic
• delayed absorption (low blood slow during first few days of life)

Question 13

transdermal absorption in neonates and infants

Answer 13

• more rapid and complete (stratum corneum is thin, blood flow to skin is greater)
• increased risk

Question 14

Protein binding in neonates and infants

Answer 14

• binding of drugs to albumin and other plasma proteins is limited
• amount of serum albumin is relatively low

Question 15

Endogenous compounds complete with drugs for available binding sites in neonates and infants

Answer 15

• limited drug/protein binding in infants
• reduced dosage needed

Question 16

when do infants reach adult protein binding capacity

Answer 16

10-12 months

Question 17

blood brain barrier in neonates and infants

Answer 17

• not fully developed at birth
• especially sensative to drugs at the CNS (dosage should be reduced)

Question 18

where are most drugs metabolized

Answer 18

liver

Question 19

drug metabolizing capacity of infants

Answer 19

low

Question 20

complete liver maturation occurs at what age

Answer 20

1 year of age

Question 21

where are most drugs excreted

Answer 21

the kidneys

Question 22

excretion in neonates and infants

Answer 22

• low renal blood flow, glomerular filtration and active tubular secretion

Question 23

drugs eleiminated primarily by renal excretion must be given

Answer 23

at a reduced dosage or at longer dosing intervals

Question 24

adult levels or renal function are achieved by

Answer 24

1 year

Question 25

Pharmacokinetics: children age 1 year and older

Answer 25

metabolize drugs faster than adults

Question 26

are children more vulnerable to unique adverse effects

Answer 26

yes

Question 27

growth suppression is caused by

Answer 27

glucocorticoids

Question 28

discoloration of developing teeth can be caused by

Answer 28

tetracyclines

Question 29

kernicterus can be caused by

Answer 29

sulfonamides

Question 30

dosing for pediatric patients when converting from adult doses is based on

Answer 30

body surface area

Question 31

Dosage determination for a child formula

Answer 31

(body surface area x adult dose) / 1.73m

Question 32

client should recieve information in

Answer 32

writing

Question 33

effective education should include:

Answer 33

• dosage size and timing
• route and technique administration
• duration of treatment
• drug storage
• nature and time course of desired responses
• nature and time course of adverse effects