Drug Therapy

Question 1

What are the favourable features of azithromycin for use in the pediatric population?

Answer 1

• availability in oral suspension
• once-a-day dosing
• short treatment duration
• favourable side effect profile

Question 2

What trends have lead to the increased use of macrocodes as first-line therapy for respiratory infections?

Answer 2

• emerging pneumococcal resistance to penicillin
• recognition that resistance can lead to more serious complications
• identification of atypical bacteria causing respiratory infections

Question 3

List the incorrect practices that have contributed to the emergence and spread of macrolide-resistant pneumococci

Answer 3

• using antibiotics to treat non-bacterial infections (ie. viral infections)
• under/overprescribing (too narrow or too broad spectrum)
• inappropriate dosing
• inadequate therapy duration

Question 4

According to the CPS statement, azithromycin should not be used to treat acute pharyngitis, acute otitis media or community-acquired pneumonia in otherwise healthy children, except in which cases?

Answer 4

• in patients with life-threatening beta-lactam allergy, for treatment of acute pharyngitis caused by macrolide-sensitive group A beta-hemolytic streptococcus
• in patients suspected to have an atypical bacteria pneumonia

Question 5

List 3 factors associated with fatalities from over-the-counter cough and cold medications in children

Answer 5

-

Question 6

What alternative treatment would you suggest to help with cough and cold symptoms in children?

Answer 6

• Fluid intake
• 2.5mL of honey prior to sleep (pasteurized, only in children >1 year old)
• ? Vitamin C

Question 7

List two types of medications that increase the risk of neural tube defects

Answer 7

• valproic acid

- carbamazepine

Question 8

What ethnic groups are at increased risk of neural tube defects?

Answer 8

• Welsh
• Irish
• Sikh

Question 9

What is the recommended dose of folic acid for women of child-bearing age for reducing the risk of neural tube defects?

Answer 9

0.4-0.8mg po daily

Question 10

What is the recommended dose of folic acid for women who have had a previous child with a neural tube defect

Answer 10

• 0.8mg - 4.0mg po daily

Question 11

Lis the main modalities used in traditional chinese medicine

Answer 11

• Traditional Chinese diagnosis
• Acupuncture/acupression
• Traditional Chinese herbal remedies
• Traditional Chinese dietary therapy
• Traditional Chinese and natural health products

Question 12

Which groups have higher use of natural health products

Answer 12

• Arthritis
• Cancer
• Rheumatoid arthritis
• Cystic fibrosis
• Eating disorder patients
• Homeless youth
• Autism

Question 13

What elements contribute to the heterogeneity of natural health products?

Answer 13

• Species (mis)identification
• What part of plant is collected
• Extraction technique
• Adulteration
• Variations in purity and potency
• Contamination

Question 14

List the unique aspects of children compared to adults with respect to drug therapy?

Answer 14

• Higher body water content
• Lower body fat content
• Higher body surface area to weight
• Blood brain barrier less mature
• slower hepatic and renal clearance
• Rapid weight changes, requiring dose adjustments

Question 15

What are the three factors that combine to increase the likelihood of drug herb interactions?

Answer 15

• Patients with serious, chronic or recurrent illnesses are more likely to use CAM and are most likely on other prescription medications
• Patients using CAM use it to complement, not replace their health care
• Patients using one CAM medication are likely to use more at the same time