Introduction & PK/PD Clinical Pearls

Question 1

Preterm Neonate

Answer 1

< 37 weeks gestation

Question 2

Neonate

Answer 2

Age < 28 days

Question 3

Infant

Answer 3

Age 29 days to < 12 mo

Question 4

Child

Answer 4

Age > 12 mo to 12 yrs

Question 5

Adolescent

Answer 5

Age 13 to 17 yr

Question 6

Pediatric Dosing

Answer 6

Units/kg/DOSE or Units/kg/DAY

Question 7

Pediatric dosing based on age classification

Answer 7

PNA < 7 days: 100 mg/kg/dose every 8 hours
PNA 8 – 60 days: 75 mg/kg/dose every 6 hours

Question 8

GI absorption

Answer 8

Prolonged and irregular
Adult function at 6 – 8 months

Question 9

Peds Gastric acidity

Answer 9

High pH for neonates

Question 10

Transdermal/Topical Pediatric Absorption differences?

Answer 10

Infant’s skin is THIN
Skin is HIGHLY hydrated
Larger surface area
Erratic Absorption

Question 11

Pediatric Distribution differences?

Answer 11

Bags of water
Increased volume of distribution
Hydrophilic drugs need higher dosing (aminoglycosides)

Question 12

Pediatric Protein Binding differences?

Answer 12

LOW serum albumin
INCREASED free drug concentrations
Potential INCREASE in toxicity

Question 13

Pediatric Metabolism differences?

Answer 13

Impaired drug metabolism

Question 14

Pediatric Elimination differences?

Answer 14

Pediatric patient has INCREASED renal clearance!

Question 15

time from birth to date of assessment (today)?

Answer 15

Chronological Age