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Pharm 2 > Final, Pedo > Flashcards

Final, Pedo Flashcards

1
Q

Child physiology differs from adults in these ways

A

Metabolism
Cardiovascular response
Airway anatomy

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2
Q

Child emergencies most often involve what?

A

Respiratory compromise- AIRWAY!

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3
Q

Child’s airway anatomy

A

Larynx is more superior and anterior and has immature cartilage
Tongue is larger, and higher in mouth
Tonsils are more prominent
Head is larger proportionally

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4
Q

Oxygenation DEF

A

Transport of oxygen to metabolically active tissues

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5
Q

Children ventilation

A

Children breath faster and have smaller tidal volumes - overall take in less oxygen

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6
Q

Brodsky Scale

A

If tonsils are greater than half the airway, likelihood of blockage inc dramatically
Do NOT sedate with chloral hydrate or meperedine if kissing tonsils

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7
Q

If have kissing tonsils, don’t sedate with these drugs!!!

A

Chloral hydrate or Meperidine

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8
Q

Mallampati Scale

A

View for intubation- quality of peritonsillar tissue

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9
Q

Respiratory Problems

A

Prematurity
Early Life Intubation/Apnea
Respiratory Syncitial Virus
Asthma

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10
Q

Premature Birth

A

Delayed development of airway–> reduced levels of surfactant
Usually have early life intubation–> will have inc post-extubation scarring
Can have impact on muscle tone, reflex arc, laryngospasm tolerance level

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11
Q

Early Life Intubation

A

Post-intubation tracheal stenosis
Hyperoxgenation - bronchopulmonary dysplasia- pulmonary scarring, chronic inflammation, rt side heart failure, subglottic stenosis

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12
Q

RSV

A

Virus infecting >90% but only 2% are symptomatic

Affects up to 125k in US each year

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13
Q

RSV Risk factors

A

Male
Household crowding
Daycare
Gestational age

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14
Q

Most common cause of bronchiolitis and pneumonia in children

A

RSV

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15
Q

RSV and oral sedation

A

Inc reactivity to airway–> resp depression

Can predispose to asthma hyper reactivity too

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16
Q

Asthma

A

Affects over 6 mil children

2nd most common chronic illness

17
Q

Asthma meds

A

Controllers: B agonists and Leukotriene inhibitors
Rescue Meds: Albuterol
Steroid

18
Q

Aspiration Risk Assessment

A

Lower esophageal pressure
Floppy sphincters
Reflexes not intact
Acidity and volume of gastric contents

19
Q

Guidelines for eating drinking before Sedation

A

Good - 8 hours
Formula- 6 hrs
Breastmilk - 4 hrs
Clear liquid - 2 hrs

20
Q

N2O

A

Can be truly titrated
Can have potentiating effect with other sedatives
Can produce suppression or airway reflexes (swalloing) at 50% concentration

21
Q

Chloral Hydrate: class, dose, effects

A

Hypnotic
Dose: 20-50 mg/kg
Effects: at 20-35mg - disinhibition, giddiness, irritability, anger, somnolence?
35-50mg - no giddiness, more somnolence
Are hyperactive first 20 min, then somnolence till 90 min

22
Q

Chloral Hydrate Adverse Effects

A 
Dec resp rate
inc airway blockage
inc cardiac arrythmias
inc mucosal irritation
inc vomiting
inc drug-interactive effects
NO reversal agent
23
Q

Meperidine: class, dose, effects

A 
Narcotic
1-2 mg/kg
Euphoria/dysphoria
Analgesia
Mood depression
irritability
obtunded responsiveness
Takes about 20 min and last till 90
24
Q

Meperidine Adverse Effects

A 
Dec resp rate
Inc myocardial depression
Inc seizures
Inc vomiting
Inc drug-interactive effects
25
Q

Midazolam: class, dose, effects

A 
Benzodiazepine
0.2-1.0 mg/kg
Mood change
relaxation
less reactive to stimuli
QUICK onset (5 min)
SHORT duration (20 min)
26
Q

Drugs interactions with Midazolam

A

Narcotics inc adverse effects

Antihistamine - prolong effects

27
Q

Midazolam administration

A

Oral 0.2-1.0 mg/kg oral

Intranasal - faster onset and recovery

28
Q

Midazolam adverse effects

A

Resp rate decrease
Inc hiccups
Inc cardiac arrest
Inc interactive drug effects

29
Q

Doses and Max amounts:

Meperidine

A

1-2 mg/kg

50 mg

30
Q

Doses and Max amounts:

Chloral Hydrate

A

20-50 mg/kg

1 g

31
Q

Doses and Max amounts:

Hydroxyzine

A

1-2 mg/kg

50 mg

32
Q

Doses and Max amounts:

Diazepam

A

0.25-0.5 mg/kg

15 mg

33
Q

Doses and Max amounts:

Midazolam

A

0.3-1.0 mg/kg

15 mg

34
Q 
Sedation med flavors
Phenergan
Versed
Demerol
Atarax
A

Phenergan - lime
Versed- cherry
Demerol - vomit
Atarax- lime

35
Q

Agents for Easy procedures

A

Midazolam

36
Q

For more difficult procedures

A

Midazolam + demerol

37
Q

For difficult and long cases agents

A

GA

Pharm 2 (11 decks)

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