Lecture 1: Pharmacotherapeutics

Question 1

What age range is the most difficult to administer medication?

Answer 1

Birth to 4

Question 2

What is the ideal administration method for peds pts?

Answer 2

• Prop them 45deg to prevent choking
• Go past the cheek so they can spit it out
• Place tablet on the back of tongue to dissolve
• Cover taste (esp. Augmentin and steroids)
• Refrigerate meds

Question 3

When are OTC cold meds not recommended for children?

Answer 3

Under the age of 6!

AAP recommendation

FDA is under 2 for both cough and cold.

Question 4

Why are OTC cold/cough meds not recommended in young children?

Answer 4

• ONly treats S/S
• Combo meds may cause an OD
• Risk of enhanced toxicity

Question 5

Who monitors OTC Cough/Cold meds for pediatrics?

Answer 5

Pediatric cough and cold surveillance system

Most adverse med effects were due to med errors or accidental ingestion

Question 6

What does the AAP recommend to measure doses of meds?

Answer 6

Syringes with a mL measurement

Better than using tsp.

Question 7

Describe sudafed/pseudoephedrine’s drug class, MOA and main SEs.

Answer 7

• Drug class: Decongestant
• MOA: Sympathomimetic with vasoconstriction of alpha receptors in mucosa of respiratory tract
• SE: dizzy, nervous, insomnia, tachy, htn, irritable

Question 8

Who is robitussin/delsym NOT to be used in?

Answer 8

• Productive cough
• Asthma

Question 9

What is the MOA in robitussin/DXM and its SE?

Cough suppressant

Answer 9

• Dextromethorphan (DXM): codeine isomer that suppresses cough center.
• SEs: Nausea, sedation, dizzy, abd pain

Question 10

What does guanfenesin/mucinex do?

Expectorant

Answer 10

• Increases respiratory tract fluid production while lowering viscosity, increasing clearance of mucus.
• Causes a nonproductive cough to become more productive but less frequent.

Mainly used for productive coughs!

OK in asthma

Question 11

Why is honey not recommended in children under 1y/o?

Answer 11

Risk of botulism due to immature digestive system

Ok after age 1 to help with cough

Question 12

What is the minimum age to use motrin/ibuprofen for children and how often?

Answer 12

• 6-8 hours
• 6 months

Question 13

How often is tylenol given for children?

Answer 13

Q4h

Question 14

What are the 3 key items to pediatric dosing?

Answer 14

1. Wt in kg (lbs/2.2) for liquids
2. All dosing is in mL/kg/day
3. All med amts are in mg/mL

5 mL = 1 tsp

Question 15

Calculate the dispense amt for a 10d rx of amoxcillin for a children with AOM.
Wt: 22lbs
Amoxicillin: 80mg/kg/d, 400mg/5mL

Answer 15

1. Wt: 10kg
2. Required amount daily is 10kg * 80mg/kg/d = 800mg/d.
3. 800mg/400mg/5mL = 10mL/day
4. 10d rx therefore is 100 mL.
5. Dispense 100mL of amoxicillin and give 5mL BID.