Drug Therapy in Pediatric Patients Flashcards
Pediatric patients are more sensitive to drugs than adults, they show ____
greater individual variation
Drug sensitivity in the very young results from
organ system immaturity
Because of heightened drug sensitivity, they are at increased risk for
adverse drug reactions
Increased sensitivity in infants is due too the immature state of 5 pharmacokinetic processes:
drug absorption protein binding of drugs exclusion of drugs from CNS by BBB hepatic drug metabolism renal drug excretion
IV administration: infant levels _____ than adults. As a result, drug concentration in infants is higher
decline more slowly
SubQ administration: infant levels remain_______ causing effects to be more intense and prolonged
higher for longer
Gastric emptying is _________ in early infancy. Then reaches adult values by _______
prolonged and irregular
6-8 months
For drugs that are absorbed in the stomach, delayed gastric emptying ____ absorption
enhances
For drugs that are absorbed in the intestine absorption is _____
delayed
Gastric acidity is very low for _____ after birth and does not reach adult values for ______
24 hours
2 years
Drug absorption after IM injection in the neonate is ______ due to low blood flow through muscle during the first days of postnatal life
slow and erratic
By early infancy, absorption of IM drugs becomes
more rapid
Drug absorption through skin is ____ in infants than in older children and adults
more rapid and complete
Due to infants skin being very thin and enhanced absorption, infants are at risk for
toxicity from topical drugs
In infants, amount of serum albumin is ____ and endogenous compounds compete with drugs for available binding sites
low
Concentrations of ____ of drugs are high in the infant and intensify effects
free levels
Protein binding capacity reaches adult values within
10-12 months
Medicines like morphine and phenobarbitol should be given in ___ dosage
reduced
Drug metabolizing capacity of newborns is ____ and dosages must be ____
low
reduced
Complete maturation of the liver develops by
1 year
Renal blood flow, GFR, and active tubular secretion are all ____ during infancy
low
Adult renal function is achieved by
1 year
Most pharmacokinetic parameters in children are similar to adults by
1 year
How do children differ pharmacokinetically from adults?
they metabolize drugs faster
drug metabolizing capacity is elevated until age ___ then declines
2
Age related adverse effects include:
growth suppression by glucocorticoids
discoloration of teeth by tetracyclines
kernicterus by sulfonamides
Method of conversion most commonly based on
BSA
Pedi dosage
childs BSA x adult dose/1.73m2
Monitor pediatric patients for _______as a component of optimizing dosage
therapeutic and adverse responses
________ should be provided to reinforce verbal instructions
written instructions
If a child spits out med
parents should estimate the amount lost and readminister that amount
