Chapter 9- Paediatrics Flashcards

1
Q

When does pH and gastric emptying times normalise?

A

Around 3 years of age

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2
Q

Why should you avoid IM in children?

A

Neonates have reduced variable blood flow so erratic IM absorption
Low muscle mass
Painful/distressing

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3
Q

What medication is given IM in children?

A

Vaccines

Vitamin K

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4
Q

Why do you need to give vitamin K to neonates for the first 3 months?

A

At risk of vit K deficiency bleeding as vitamin K passes poorly via placenta

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5
Q

Why do you get increased systemic absorption of topical substances in neonates and infants?

A

Higher SA:body weight
Immature epidermal barrier
Well hydrated skin

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6
Q

Why do neonates need higher doses of water soluble drugs like penicillin?

A

Cos they have higher volume of distribution for water soluble drugs

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7
Q

True or false: fat soluble drugs eg diazepam need smaller doses in neonates?

A

TRUE

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8
Q

Why is there decreased plasma protein binding in neonates?

A

Total protein conc and serum albumin is lower

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9
Q

In neonates what effect does low protein binding have on drugs?

A

Highly protein bound drugs will be more free to exert effect- MONITOR

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10
Q

When do hepatic phase 1 reactions appear to mature?

A

First few months of life - reach adult capacity by about 6 months of age

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11
Q

When do hepatic phase 2 reactions appear to mature

A

Increase significantly over the first 2-3 months and fully mature by about 3 years of age

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12
Q

How do neonates metabolise paracetamol?

A

Sulfation

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13
Q

How do children/adult metabolise paracetamol?

A

Glucuronidation

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14
Q

What do neonates metabolise theophylline to?

A

Caffeine (active)

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15
Q

What do children/adults metabolise theophylline to?

A

Methyluric acid

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16
Q

What is GFR highly dependent on at birth?

A

Gestational age

17
Q

When does renal function completely mature?

A

Around 6-8 months of age

18
Q

Clearance of renally excreted medications is what in infants/premature babies?

A

Prolonged

19
Q

What does PUMA stand for?

A

Paediatric use marketing authorisation

20
Q

How is oral absorption different at birth?

A

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

21
Q

Define extemporaneous dispensing

A

When a pharmacist makes meds from raw materials