Neonatal And Pedia Pharma

Question 0

Phase 2 reactions

Answer 0

Conjugation: Glucoronidation, sulfation,acetylation

Question 1

Phase 1. Reactions

Answer 1

Oxidation, reduction, hydrolysis

Question 2

Drugs that follow zero order kinetics

Answer 2

Phenytoin
Salicylate
Alcohol

Question 3

Saturation kinetics

Answer 3

Michaelis menten knetics
-in lower doses curve is linear bur somewhere along the line, elimination pathways become saturated and drug conc becomes disproportionate to dose administered

Question 4

Rlative efficacy and safety profile of a drug

Answer 4

Therapeutic index

Question 5

Situations that reduce blood flow

Answer 5

CV shock
vasoconstriction
Heart failure
Sick preterm infants

Question 6

Drugs in which extentof absorption is a determinant of pharmacologic response

Answer 6

Cardiac glycoside
Amino glycoside
Anti-convulsant

Question 7

Gastric acid secretion reaches adult levels by

Answer 7

Lower limit: 3 mos

Question 8

GAstric emptying time in neonates

Answer 8

Increased, so if drug is maximally absorbed ins tomach it leads to greater absorption

Question 9

Gastric eptying time reaches adult values by

Answer 9

6-8 months

Question 10

Intestinal motility in neonates

Answer 10

Slow and irregular, decreased-> drugs exposed for a longer time to the absorptive surface of the intestine

Question 11

Complete metabolic activity by flora pproaches adult values by

Answer 11

4 years

Digoxin has increased BA for young children d/t dec bacterial flora

Question 12

Administrred rectally to avoid first pass effect

Answer 12

Diazepam

Question 13

Body water composition of neonate , full term, preterm, adult

Answer 13

Neonate: 70-75% of body wt
Full term-70%
Preterm-85%
Adult: 59-60% of body wt
Absorption of water soluble drugs: PT>FT>adult

Question 14

EXtracellular water of neonate and adult

Answer 14

Neonate:40% of body wt
Adult:20% of body wt

Question 15

Total body fat

Answer 15

Neonate 15% of total body weight

Preterm 1% of total body weight

Question 16

Neonates protein binding

Answer 16

Decreaed protein binding seen in diazepam, pheytoin, ampicillin, phenobarbital

Question 17

Drug binding to plasma approaches adult values by

Answer 17

10-12 mos

Question 18

Drug that can cause kernicterus in jaundiced pxs

Answer 18

Sulfonamide antibiotics-> drug displaces bilirubin, free bilirubin crosses BBB-> kernicterus

Question 19

Drug protein binding

Answer 19

Older child/adult: 98%

Neonate: 90%

Question 20

Glucoronide formation reaches adult values by

Answer 20

3 or 4 yrs old

Question 21

Metabolic rate of many drugs is greater than that of adults in this age grp

Answer 21

1-3 years old(toddlers)

Question 22

Drugs affected by slow renal clearance

Answer 22

PCN
Ampicillin
Gentamicin(aminoglycoside)
Digoxin

Question 23

In full term infants. GFR reaches adult values by

Answer 23

6-12 mos

Question 24

Formula for Pedia dose young's rule (based on age)

Answer 24

Adult dose= (adult dose)x (age in yrs/age+12)

Question 25

Formula for pedia dose clark's rule(based on weight)

Answer 25

Adult dose x (wt in kgs/70) OR Adult dose x (wt in lbs/150)

Question 26

Formula for pedia dose using body surface area

Answer 26

Dose= adult dose x percentage of adult dose ``` *percentage of adult dose(table) Newborn= 0.12 3 mos=0.18 1 year= 0.28 5.5 yrs= 0.48 9 yrs= 0.60 12 yrs=0.78 14 yrs= 0.90 ```

Question 27

Pitfall of using adult dosage as basis on finding out pedia dose

Answer 27

Guidlines assume a linear relp between chn and adults

Question 28

Guideline for drug intake in breastfeeding mothers(mins/hrs before and after breastfeeding)

Answer 28

30-60 mins after nursing | 3-4 hrs before nursing

Question 29

Drugs with significant effects in nursing infant

Answer 29

Sedatives and hypnotics(barbiturates, chloral hydrate, diazepam) Opioids(heroin, methadone, morphine)

Question 30

Drugs used in lactation that causes drowsinesss on the nursing infant

Answer 30

Chloral hydrate

Question 31

Drugs used in lactation that causes gray baby syndrome on the nursing infant

Answer 31

Chloramphenicol

Question 32

Drugs used in lactation that causes sedatiom on the nursing infant

Answer 32

Diazepam

Question 33

Drugs used in lactation that causes prolonged neonatal narcotic dependence on the nursing infant

Answer 33

Heroin

Question 34

Drug used in lactation that causes thyroid suppression on the nursing infant

Answer 34

Iodine(radioactive) | Propylthiouracil

Question 35

Drug used in lactation that can cause signs of opioid withdrawal on the nursing infant if mother stops taking or abruptly stops breastfeeding

Answer 35

Methadone

Question 36

Drug used in lactation that causes permanent staining of developing teeth on the nursing infant

Answer 36

Tetracycline

Question 37

Breastfeeding is contraindicated in

Answer 37

Mothers undergoing cancer chemotheraphy or being treated with immunomodulatory agents( pxs with SLE) Mothers with: HIV and HTLV Active TB infxn Active herpetic lesions in herpes simplex infxn

Question 38

Drug used in lactation that causes nephrosclerosis on the nursing infant

Answer 38

Furosemide

Question 39

Drug used in lactation that causes REYE's syndrome on the nursing infant

Answer 39

Aspirin

Question 40

Drug used in lactation that causes extrapyramidal reactions on the nursing infant

Answer 40

Phenothiazine

Question 41

Drug used in lactation that causes devlptal delay, growth suppression on the nursing infant

Answer 41

Adrenocorticosteroids

Question 42

Drug used in lactation that causes renal failure on the nursing infant

Answer 42

Indomethacin

Question 43

Drug used in lactation that causes thick skull, coarse features on the nursing infant

Answer 43

Phenytoin

Question 44

Drug used in lactation that causes hyperactivity, impaired intellectual devlpt on the nursing infant

Answer 44

Phenobarbital