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Pharma 6th LE > Neonatal And Pedia Pharma > Flashcards

Neonatal And Pedia Pharma Flashcards

0
Q

Phase 2 reactions

A

Conjugation: Glucoronidation, sulfation,acetylation

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1
Q

Phase 1. Reactions

A

Oxidation, reduction, hydrolysis

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2
Q

Drugs that follow zero order kinetics

A

Phenytoin
Salicylate
Alcohol

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3
Q

Saturation kinetics

A

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

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4
Q

Rlative efficacy and safety profile of a drug

A

Therapeutic index

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5
Q

Situations that reduce blood flow

A

CV shock
vasoconstriction
Heart failure
Sick preterm infants

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6
Q

Drugs in which extentof absorption is a determinant of pharmacologic response

A

Cardiac glycoside
Amino glycoside
Anti-convulsant

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7
Q

Gastric acid secretion reaches adult levels by

A

Lower limit: 3 mos

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8
Q

GAstric emptying time in neonates

A

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

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9
Q

Gastric eptying time reaches adult values by

A

6-8 months

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10
Q

Intestinal motility in neonates

A

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

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11
Q

Complete metabolic activity by flora pproaches adult values by

A

4 years

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

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12
Q

Administrred rectally to avoid first pass effect

A

Diazepam

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13
Q

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

A 
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
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14
Q

EXtracellular water of neonate and adult

A

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

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15
Q

Total body fat

A

Neonate 15% of total body weight

Preterm 1% of total body weight

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16
Q

Neonates protein binding

A

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

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17
Q

Drug binding to plasma approaches adult values by

A

10-12 mos

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18
Q

Drug that can cause kernicterus in jaundiced pxs

A

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

19
Q

Drug protein binding

A

Older child/adult: 98%

Neonate: 90%

20
Q

Glucoronide formation reaches adult values by

A

3 or 4 yrs old

21
Q

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

A

1-3 years old(toddlers)

22
Q

Drugs affected by slow renal clearance

A

PCN
Ampicillin
Gentamicin(aminoglycoside)
Digoxin

23
Q

In full term infants. GFR reaches adult values by

A

6-12 mos

24
Q

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

A

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

25
Q

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

A

Adult dose x (wt in kgs/70)

OR

Adult dose x (wt in lbs/150)

26
Q

Formula for pedia dose using body surface area

A

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
27
Q

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

A

Guidlines assume a linear relp between chn and adults

28
Q

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

A

30-60 mins after nursing

3-4 hrs before nursing

29
Q

Drugs with significant effects in nursing infant

A

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

30
Q

Drugs used in lactation that causes drowsinesss on the nursing infant

A

Chloral hydrate

31
Q

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

A

Chloramphenicol

32
Q

Drugs used in lactation that causes sedatiom on the nursing infant

A

Diazepam

33
Q

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

A

Heroin

34
Q

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

A

Iodine(radioactive)

Propylthiouracil

35
Q

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

A

Methadone

36
Q

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

A

Tetracycline

37
Q

Breastfeeding is contraindicated in

A

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

38
Q

Drug used in lactation that causes nephrosclerosis on the nursing infant

A

Furosemide

39
Q

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

A

Aspirin

40
Q

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

A

Phenothiazine

41
Q

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

A

Adrenocorticosteroids

42
Q

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

A

Indomethacin

43
Q

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

A

Phenytoin

44
Q

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

A

Phenobarbital

Pharma 6th LE (3 decks)

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