Chapter 9- Paediatrics Flashcards
When does pH and gastric emptying times normalise?
Around 3 years of age
Why should you avoid IM in children?
Neonates have reduced variable blood flow so erratic IM absorption
Low muscle mass
Painful/distressing
What medication is given IM in children?
Vaccines
Vitamin K
Why do you need to give vitamin K to neonates for the first 3 months?
At risk of vit K deficiency bleeding as vitamin K passes poorly via placenta
Why do you get increased systemic absorption of topical substances in neonates and infants?
Higher SA:body weight
Immature epidermal barrier
Well hydrated skin
Why do neonates need higher doses of water soluble drugs like penicillin?
Cos they have higher volume of distribution for water soluble drugs
True or false: fat soluble drugs eg diazepam need smaller doses in neonates?
TRUE
Why is there decreased plasma protein binding in neonates?
Total protein conc and serum albumin is lower
In neonates what effect does low protein binding have on drugs?
Highly protein bound drugs will be more free to exert effect- MONITOR
When do hepatic phase 1 reactions appear to mature?
First few months of life - reach adult capacity by about 6 months of age
When do hepatic phase 2 reactions appear to mature
Increase significantly over the first 2-3 months and fully mature by about 3 years of age
How do neonates metabolise paracetamol?
Sulfation
How do children/adult metabolise paracetamol?
Glucuronidation
What do neonates metabolise theophylline to?
Caffeine (active)
What do children/adults metabolise theophylline to?
Methyluric acid
What is GFR highly dependent on at birth?
Gestational age
When does renal function completely mature?
Around 6-8 months of age
Clearance of renally excreted medications is what in infants/premature babies?
Prolonged
What does PUMA stand for?
Paediatric use marketing authorisation
How is oral absorption different at birth?
Reduced gastric acid secretion and an increased emptying time at birth= increased oral absorption of penicillins and reduced oral absorption of phenobarbital, phenytoin and rifampicin in infants
Define extemporaneous dispensing
When a pharmacist makes meds from raw materials
