Developmental Pharmacology Flashcards
[T/F] Acid-labile drugs are absorbed by neonates during first day of life.
T.
gastric pH is alkaline at birth, falls to 1-3 after 24hrs, rise again during next 9-12 days
[T/F] Gastric emptying time is the same adults and in neonates/infants.
F.
Until 6th-8th month of life, gastric emptying time is delayed
[T/F] There is decrease absorption of IM/SQ of morphine and aminoglycosides in neonates.
F.
Absorption is erratic in neonates
[T/F] Skin testing to detect allergies in a 2-week old baby will yield accurate results.
F.
Histamine is absent in neonatal skin until 3rd week
[T/F] Lipophilic drugs have higher Vd in premature neonates.
T.
Higher ECF volume
How does plasma protein binding affect drug distribution in newborns?
Lower levels of most proteins –> Reduced protein binding –> higher Vd
Drug metabolizing enzymes that are not present in newborns.
CYP1A2, UGT2B7
Most abundant CYP enzyme in fetus
CYP3A7
[T/F] Glucuronidation is predominant in acetaminophen metabolism in children <3y/o.
F.
Sulfation is predominant - protective against liver toxicity because not a lot of NAPQI is produced
[T/F] More than 50% of theophylline is metabolized to caffeine in premature neonates.
F.
More than 50% is excreted unchanged
[T/F] The renal excretion of drugs in 8-12 month old infants is comparable with that observed in children and adults.
T
Pediatric-specific ADR: Furosemide
nephrocalcinosis
Pediatric-specific ADR: Indomethacin
EF, bowel perforation
Pediatric-specific ADR: adrenocorticoids
delayed development, growth suppression
Pediatric-specific ADR: tetracycline
discolored teeth
Pediatric-specific ADR: phenobarbital
hyperactivity, impaired intelligence
Pediatric-specific ADR: phenytoin
thickened skull, coarse features
Pediatric-specific ADR: chloramphenicol
gray baby syndrome
Pediatric-specific ADR: phenothiazines
extrapyramidal reaction
Pediatric-specific ADR: valproic acid
hepatotoxicity
Pediatric-specific ADR: aspirin
Reye’s syndrome in patients with chickenpox or influenza, not used in dengue fever
Causes rapid closure of patent ductus arteriosus
Indomethacin
causes patent ductus ateriosus to remain open, used in patients with Tetralogy of Fallot or Transposition of Great Vessels
Prostaglandin E1
