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Neonatal/Ped Pharm > Final (Exam 3) > Flashcards

Final (Exam 3) Flashcards

1
Q

Alprazolam (Xanax)

A

[Benzodiazepine]

  • Onset: 60 min
  • 1/2 life: 11 hrs
  • Active metabolites
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2
Q

Clonazepam (Klonipin)

A

[Benzodiazepine]

  • Onset: 20-40 min
  • 1/2 life: 22-23 hrs
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3
Q

Diazepam (Valium)

A

[Benzodiazepine]

  • Onset: 10-20 min
  • 1/2 life: Up to 48 hrs
  • Active metabolites
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4
Q

Lorazepam (Ativan)

A

[Benzodiazepine]

  • Onset: 30-60 min
  • 1/2 life: ~15 hrs
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5
Q

Citalopram (Celexa)

A

[SSRI]

- 1/2 life: 35 hrs

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6
Q

Escitalopram (Lexapro)*

A

[SSRI]

  • 1/2 life: 3- hrs
  • Approved >12 yo*
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7
Q

FLUoxetine (Prozac)*

A

[SSRI]

  • 1/2 life: 4-6 days
  • Active metabolites 7-9 days
  • Approved >8 yo*
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8
Q

FluvoxaMINE*

A

[SSRI]

  • 1/2 life: 16 hrs
  • Approved for pediatric OCD*
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9
Q

PARoxetine (Paxil)

A

[SSRI]

- 1/2 life: 24 hrs

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10
Q

Sertraline (Zoloft)*

A

[SSRI]

  • 1/2 life: 26 hrs
  • 70-80 hrs
  • Approved >6 yo*
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11
Q

Duloxetine (Cymbalta)

A

[SSRI/SNRI]

- 1/2 life: 12 hrs

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12
Q

Venlafaxine (Effexor)

A

[SSRI/SNRI]

Approved for pediatric use

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13
Q

Desvenlafaxine (Pristiq)

A

[SSRI/SNRI]

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14
Q

Benzodiazepines - MOA

A

Binds to GABA receptors halting neuronal stimulation

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15
Q

SSRI’s - MOA

A

Binds to SRR preventing serotonin from being taken back into the pre-synaptic cell

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16
Q

Tricyclic Antidepressants (TCAs) - MOA

A

Inhibits the reuptake of 5-HT & NE increasing synaptic concentrations

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17
Q

Amitryptiline

A

[Tricyclic Antidepressant]

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18
Q

Doxepin

A

[Tricyclic Antidepressant]

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19
Q

Imipramine

A

[Tricyclic Antidepressant]

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20
Q

Nortriptyline

A

[Tricyclic Antidepressant]

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21
Q

Dopamine Reuptake Blockers - MOA

A
  • Structurally different than all other antidepressants
  • MOA not fully understood
  • Dopaminergic & Noradrenergic activity
  • Weak inhibitor of dopamine and norepinephrine (no inhibition of serotonin)
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22
Q

Buproprion (Wellbutrin)

A

[Dopamine Reuptake Blocker]

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23
Q

Nonadrenergic Antagonists - MOA

A
  • Tetracyclic antidepressant
  • Increases release of norepinephrine & serotonin
    (does NOT inhibit reuptake)
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24
Q

Mirtazipine (Remeron)

A

[Noradrenergic Antagonist]

For Major Depressive Disorder

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25
Q

Lithium (Lithobid) - MOA

A

[Mood Stabilizers]

  • Alters transport across cell membrane
  • Prevents reuptake of serotonin & norepinephrine
  • Inhibits postsynaptic D2 receptor
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26
Q

Valproic Acid (Depakote) - MOA

A

[Mood Stabilizers]

  • Increases availability of GABA
  • Enhances effect and mimics effect of GABA at postsynaptic receptor sites
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27
Q

Antipsychotics - MOA

A
  • Prevents binding of serotonin, dopamine, and histamine to receptors
  • Stabilizes mood
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28
Q

Haloperidol (Haldol)

A

[Typical Antipsychotics]

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29
Q

Chlorpromazine (Thorazine)

A

[Typical Antipsychotics]

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30
Q

Aripiprazole (Abilify)

A

[Atypical Antipsychotics]

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31
Q

Olanzapine (Zyprexa)

A

[Atypical Antipsychotics]

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32
Q

Quetiapine (Seroquel)

A

[Atypical Antipsychotics]

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33
Q

Risperidone (Risperidol)

A

[Atypical Antipsychotics]

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34
Q

Stimulants - MOA

A

Blocks the reuptake of dopamine & norepinephrine

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35
Q

Dexmethylphenidate (Focalin)

A

[Stimulants]

for ADD/ADHD

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36
Q

Mixed Amphetamines (Adderall)

A

[Stimulants]

for ADD/ADHD

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37
Q

Methylphenidate (Concerta, Ritalin)

A

[Stimulants]

for ADD/ADHD

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38
Q

Selective Norepinephrine Reuptake Inhibitor - MOA

A

Selectively inhibits reuptake of norepinephrine

for ADD/ADHD

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39
Q

Atomoxetine (Strattera)

A

[Selective Norepinephrine Reuptake Inhibitor]

for ADD/ADHD

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40
Q

Antihypertensives - MOA

A
  • Alpha2 receptor AGONISTS

- Exact mechanism for ADD/ADHD unknown (Regulates prefrontal cortex of brain)

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41
Q

Clonidine (Catapres)

A

[Antihypertensives]

for ADD/ADHD

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42
Q

Guanfacine (Intuniv)

A

[Antihypertensives]

for ADD/ADHD

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43
Q

Triptans - MOA

A
  • Bind to 5-HT 1B & 1D to cause vasoconstriction with reduced inflammation
  • For headaches
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44
Q

Sumitriptan (Imitrex)

Rizatriptan

A

[Triptans]

For headaches

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45
Q

Rapid-Acting Insulin - PK parameters

A 
Onset = 15 mins
Peak = 1-2 hrs
Duration = 3-4 hrs
46
Q 
Insulin Aspart (Novolog)
Insulin Lispro (Humalog)
Insuline Glulisine (Apidra)
A

[Rapid-Acting Insulin]

47
Q

Short-acting Insulin - PK parameters

A 
Onset = 30-60 mins
Peak = 2-4 hrs
Duration = 4-8 hrs
48
Q

Insulin Regular (Novolin R, Humalin R)

A

[Short-acting Insulin]

49
Q

Intermediate-acting Insulin - PK parameters

A 
Onset = 1-2 hrs
Peak = 4-10 hrs
Duration = 10-18 hrs
50
Q

Insulin NPH (Novolin N)

A

[Intermediate-acting Insulin]

51
Q

Insulin Detemir (Levemir) - PK parameters

A 
[Long-acting Insulin]
Onset = 6 hrs
Peak = 12-16 hrs
Duration = 2 hrs
Dose freq = q12-24 hrs
52
Q

Insulin Glargine (Lantus) - PK parameters

A 
[Long-acting Insulin]
Onset = 4-5 hrs
Peak = NO PEAK
Duration = 22-24 hrs
Dose freq = q24 hrs (q12)
53
Q

Sulfonylureas - MOA

A
  • Enhancement of insulin secretion
  • Bind to sulfonylurea receptor (SUR) on pancreatic Beta cells
  • Closes ATP-dependent K channels, influx of Ca
  • Suppresses hepatic glucose production
  • Trying to push whatever insulin you’re making out of Beta cells
54
Q

Glipizide

Glyburide

A

[2nd gen Sulfonylureas]

*only ones approved for pediatric use

55
Q

Metformin (Glucophage) - MOA

A
  • Increases insulin sensitivity
  • Decrease hepatic glucose production
  • Decreases intestinal glucose absorption
56
Q

Glucagon (Glucogen) - MOA

A
  • Stimulates adenylate cyclase increasing cAMP & gluconeogenesis
57
Q

Somatotropin (Serostim), aka rGH

A
  • biosynthetic (recombinant) Growth Hormone

- Goal: normalization of height during childhood and attainment of normal adult height

58
Q

Oral Levothyroxine

A
  • Tx of congenital hypothyroidism (CH)
  • Also Acquired Hypothyroidism
  • Dose: 10-15 mcg/kg/day
  • Take on empty stomach
59
Q

Methimazole and Propylthiouracil (PTU) - MOA

A

[Antithyroid Medications]

  • Inhibit synthesis of thyroid hormones by blocking oxidization of iodine in the thyroid gland
  • Dosed every 8-12 hours
60
Q

Antacids - MOA

A
  • Neutralize stomach acid

- Deactivate pepsin & acidity of reflux

61
Q

Calcium Carbonate (Tums, Maalox)

A

[Antacids]

For GERD

62
Q

Aluminum Hydroxide/Magnesium Hydroxide (Mylanta)

A

[Antacids]

For GERD

63
Q

Ranitidine (Zantac)

A

[H2 Receptor Blockers]

  • TID dosing
  • Large dosing range recommendation
64
Q

Famotidine (Pepcid)

A

[H2 Receptor Blockers]

  • Twice daily dosing
  • Standard dosing 1 mg/kg twice daily
65
Q

Proton Pump Inhibitors - MOA

A
  • Blocks acid secretion by inhibiting ATPase enzyme system in parietal cells
  • Causes prolonged decrease in gastric acid secretion
  • Decreases acidity of reflux
66
Q

Esomeprazole (Nexium)

A

[Proton Pump Inhibitors]

For GERD

67
Q

Omeprazole (Prilosec)

A

[Proton Pump Inhibitors]

For GERD

68
Q

Lansoprazole (Prevacid)

A

[Proton Pump Inhibitors]
For GERD
- Only one with liquid formulation, best for enteral tube administration

69
Q

Pantoprazole (Protonix)

A

[Proton Pump Inhibitors]

For GERD

70
Q

Prokinetic Agents - MOA

A
  • Increase gastric emptying

- Increase LES pressure

71
Q

Metoclopramide (Reglan)

A

[Prokinetic Agents]

For GERD

72
Q

Erythromycin

A

[Prokinetic Agents]

For GERD

73
Q

Sucralfate (Carafate) - MOA

A

Forms a paste in the presence of gastric pH to coat the lining of the esophagus & stomach.
For GERD

74
Q

Aminosalicylates - MOA

A

For IBD

  • unknown MOA
  • Works typically to inhibit pro-inflammatory cytokines
  • Inhibits inflammatory transcription of NF-kB to block prostaglandin and leukotriene production
75
Q

Mesalamine

A

[Aminosalicylates] For IBD

  • Ascacol
  • Pentasa
  • Rowasa
76
Q

Sulfasalazine

A

[Aminosalicylates]

For IBD

77
Q

Balsalazine

A

[Aminosalicylates]

For IBD

78
Q

Corticosteroids - MOA

A

For IBD

  • Unknown MOA
  • Decreases transcription of proinflammatory cytokines
  • Prevents nuclear translocation of NF-kB
  • Inhibits inflammatory response
79
Q

Hydrocortisone

A

[Corticosteroids]

For IBD

80
Q

Prednisone/Prednisolone

A

[Corticosteroids]

For IBD

81
Q

Budesonide (Enterocort)

A

[Corticosteroids]

For IBD

82
Q

Metronidazole

A

[Antibiotics]
For IBD
- Active CD
- UC maintenance

83
Q

Ciprofloxacin

A

[Antibiotics]
For IBD
- CD (perineum)
- UC

84
Q

Azathioprine (Imuran) & Mercaptopruine (6MP)

A

[Immunomodulators] For IBD

- inhibit inflammatory response (protein synthesis, nucleic acid metabolism, clonal expansion of lymphocytes)

85
Q

Methotrexate

A

[Immunomodulators] For IBD

  • MOA unknown
  • Inhibits proinflammatory cytokines and down-regulates activate T cells and neutrophils
86
Q

Calcineurin Inhibitors

A

[Immunosuppressants] For IBD

  • Tacrolimus & Cyclosporine
  • MOA: Inhibit production of Interleukin 2 (IL 2) and cytokines
87
Q

Antimetabolites

A

[Immunosuppressants] For IBD

  • Mycophenolate mofetil (Cellcept)
  • Suppresses T and B cell proliferation
  • Used in conjunction w/ other agents
88
Q

Biologics - MOA

A

For IBD

  • Neutralizes proinflammatory cytokine TNF
  • Activates complement-mediated cytolysis of TNF-producting monocytes
  • Monoclonal antibodies targeting a specific immune response, using a more targeted therapy compared to methotrexate or calcineurin inhibitors whcih ahve a larger ADE profile)
89
Q

Humira (Adalimumab)

A

[Biologics] For IBD

- Only subcutaneous injection

90
Q

Remicade (Infliximab)

A

[Biologics] For IBD

- Only intravenous infusion

91
Q

5-HT3 Receptor Antagonists - MOA

A

For N/V

  • Effects occur at CTZ (potentiality at peripheral sites as well)
  • Block binding of Serotonin
92
Q

Ondansetron (Zofran)
Granisetron (Kyrtril)
Palenosetron
Dolasetron

A

[5-HT3 Receptor Antagonists]

For N/V

93
Q

Antihistamine & Anticholinergic Agents - MOA

A
  • For N/V

- Weak antiemetic properties but work by competing with histamine on H1-receptors or M1 (scopolamine)

94
Q 
Diphenhydramine (Benadryl)
Hydoxyzine (Vistril)
Medizine (Dramamine)
Dimenhyrinate (Gravasol)
Scopolamine
A

[Antihistamine & Anticholinergic Agents]

For N/V

95
Q

Dopamine Receptor Antagonists - MOA

A

For N/V

Work primarily affecting DA receptors but also bind to M1 and H1

96
Q

Prochlorperazine
Promethazine
Metoclopramide

A

[Dopamine Receptor Antagonists]

For N/V

97
Q

Dronabinol (Marinol)

A

For N/V

  • Synthetic delta-9-tetrahydrocannabinol (delta-THC)
  • CIII medication (controlled)
  • No DDI except w/ highly protein-bound drugs (Warfarin)
98
Q

Dexamethasone

A 
[Corticosteroid]
For BPD
- 0.25 mg/kg/dose IV BID x 3 days
- Gradually taper by 10% every 3 days
- Taper over 12-21 days, total of 42 days is possible
99
Q

Furosemide (Lasix)

A

[Diuretics]
For BPD
- IV (0.5-1 mg/kg/dose), max 2 mg/kg/dose q24 (or q12)
- PO (1-2 mg/kg/dose)

100
Q

Chlorothiazide (Diuril)

A

[Diuretics]
For BPD
- <6 months: 20-40 mg/kg/day, divided q12
- >6 months: 20 mg/kg/day po divided q12 (max 1g)

101
Q

Spironolactone (Aldactone)

A

[Diuretics]
For BPD
- Potassium sparing diuretic
- 1-3mg/kg/day po q24 hours - 2mg/kg/day typical

102
Q

Albuterol

A

[Bronchodilators]
For BPD
- Nebulizer 2.5 mg every 2-6 hours PRN

103
Q

Indomethacin (Indocin)

A

[Prostaglandin Inhibitor]
For PDA
- Prophylactic dose (0.1 mg/kg/dose) IV over 20 min Q24 hours for the first 6 days of life
- All <1250 grams BW who have received surfactant for RDS
- Early symptomatic dose (0.2 mg/kg/dose) IV over 20 min, 2nd and 3rd doses (0.1 mg/kg/dose if <1250 grams and <7 days old) given 12 and 36 hours after first dose
- If >1250 grams and >7 days old 0.2 mg/kg/dose
- TYPICALLY THIS IS DAYS 2-4 of life when symptoms appear!

104
Q

Ibuprofen

A

[Nonselective cyclooxygenase inhibitor]

  • Studies show as effective as Indocin for PDA
  • Advantage: does not reduce the mesenteric and renal artery blood flow..so fewer renal side effects
  • DOSE (10mg/kg/dose followed by 2 doses of 5 mg/kg) each after 24 and 48 hours within 1st week of life
  • Due to change in PK, higher doses (18 mg/kg and 9 mg/kg) after the 2nd week of life
105
Q

Caffeine Citrate (CAFCIT)

A

[Methylxanthine]
For Apnea of Prematurity
- Loading dose: 20-25 mg/kg IV or PO
- Maintenance dose: 5-10 mg/kg/day IV or PO Q24 hours
- Therapeutic levels: 5-25 mcg/ml trough, draw on day 5 of life if needed

106
Q

Ampicillin

A

[Antibiotic]
For Neonatal Sepsis
- <2kg = 100 mg/kg/day IV divided every 12 hours
- May see 50 mg/kg/day IV divided every 12 hours
- >2kg = divided every 8 hours (75-150mg/kg/day)
- GBS meningitis: 200-300 mg/kg/day divided every 8 hours IV

107
Q

Gentamicin

A

[Antibiotic]
For Neonatal Sepsis
- = 29 weeks PMA: 4.5mg/kg/dose ever 36-48 hours (5mg and 48 hours if in first 7 days of life)
- 30-40 weeks PMA: 4-4.5mg/kg/dose every 24-36 hours (4.5 and 36 hours if in first 7 days of life)
- >/= 35 weeks PMA: 4mg/kg/dose IV every 24 hours
- OTOTOXICITY WITH HIGH LEVELS
- Trough: 0.5-2mcg/ml; if trough high adjust the interval

108
Q

Vancomycin

A

[Antibiotic]
For Neonatal Sepsis
- Gram positive activity
- Streptococci, Staph, MRSA, Listeria
- 15 mg/kg/day IV every 8 (>2kg and >7 days)
- MRSA DOSING: 15 mg/kg/dose every 6 hours for 2-6 wks

109
Q

Cefotaxime

A

[Antibiotic]
For Neonatal Sepsis
- Gram negative
- Pseudomonas, E-coli, Klebsiella, Serratia, H. influenzae
- 100 mg/kg/day divided every 12 hours (up to 1 mo of age) IV
- 1/2 life 1-4 hours
- Excreted in the urine

110
Q

Clindamycin

A

[Antibiotic]
For Neonatal Sepsis
- NEC anaerobic coverage for suspected perforation
- 10-15 mg/kg/day IV divided every 8-12 hours
- Does not cross BBB so not used to treat meningitis

111
Q

Ranitidine (Zantac) - Neonatal GERD

A
  • DOSE Neonatal: 2-4 mg/kg/day divided every 8-12 hours PO (max is 6 mg/kg/day)
  • DOSE Infants >1 month: 5-10 mg/kg/day divided 2-3x daily

Neonatal/Ped Pharm (1 decks)

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