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paediatric OTC Flashcards

1
Q

if med doesn’t have licence for use in a child what is it known as

A

off label use

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2
Q

examples of off-label medicines in children

A

salbutamol in children <2yrs

paracetamol <2mths

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3
Q

routes to give medicines to children

A

oral liquids
oral solids
inhaled + spacer
ear/eye/nose
skin
injection
rectal

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4
Q

How to give child med from syringe?

A

give it drop by drop

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5
Q

should you mix medicined in bottle?

A

no

could be interactions with Ca
don’t know how much of dose baby had if they don’t finish bottle

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6
Q

tablets and capsule considerations in children

A

not usually for under 5-7yrs

some can be crushed/open capsules and sprinkle onto soft food/mix with yoghurt

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7
Q

What can not be crushed?

A

enteric coated tablets
or
sustained release

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8
Q

soluble preparations in children?

A

avoid in children

because of high salt content

(not paracetamol soluble tabs)

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9
Q

How long after opening msut eye drops be discarded?

A

4 weeks - preservative

7 days - unpreserved

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10
Q

when are rectal formulations suitable

A

for young children
- glycerol for constipaiton
- safe in babies too

less acceptable in older children

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11
Q

what are child’s doses usually calculated by

A

weight or BSA

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12
Q

Why can child have a higher dose per kg than an adult?

A

due to higher metabolic rate

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13
Q

problems with calculating doses in children

A

using body weight in overweight children can result in much higher doses being given than necessary

  • use ideal body weight in these cases
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14
Q

counselling for the parent

A
  • how to give - on the label and explained/shown
  • what it is used for
  • what happens if dose is missed
  • frequency of dosing and waking hours/school
  • how long taken for
  • further supplies?
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15
Q

storage of meds for children

A
  • keep out of reach of children
  • child resistant containers
  • fridge?
  • don’t mix meds in same bottle
  • keep in oiginal container
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16
Q

medicines at school

A

varies depending if short/long term med

depends on age of child

meds must be labelled with full details

could change dosing to avoid admin in school

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17
Q

immunisations at 8 weeks

A
  • 6 in 1 vaccine: diphtheria, tetanus, whooping cough (pertussis), polio, haemophilius influenza type b (Bib), hepatitis B
  • rotavirous vaccine (oral)
  • Men B (meningitis)
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18
Q

vaccinations at 12 weeks

A
  • 6 in 1 (2nd dose)
  • Rotavirus (2nd)
  • Pneumococcal vacine (PCV)
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19
Q

vaccinations at 16 weeks

A
  • 6 in 1 vaccine (3rd dose)
  • Men B (2nd)
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20
Q

vaccinations at 1 year

A
  • Hib/Men C (single jab, 1st Hib, 4th Hib)
  • MMR (measels, mumps and rubella)
  • Pneumococcal (PCV, 2nd)
  • Men B (3rd)
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21
Q

vaccines from 2-10yrs

A
  • flu vaccine
  • every year
  • nasal
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22
Q

vaccinations at 3yrs, 4 months

A
  • MMR (2nd)
  • 4 in 1 pre-school booster: diphtheria, tetanus, pertussis, polio
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23
Q

vaccinations at 12-13yrs

A

HPV vaccine (girls and boys)

24
Q

vaccinations at 14yrs

A
  • 3 in 1 teenage booster (tetanus, diphtheria, polio)
  • Men ACWY (meningitis)
25
When would a vaccine not be given?
* acute illness (delayed by a few weeks) * live vaccines not given if immunocompromised
26
What does Rotavirus cause?
gastroenteritis (common in infants and children)
27
symptoms of rotavirus
diarrhoea vomiting can cause severe dehydration
28
How is rotavirus transmitted?
faecal roal route respiratory also possible
29
When is Rotavirus most common?
January - March
30
How long do Sx of Rotavirus last?
3 - 8 days
31
When and how is Rotavirus vaccine given?
8 weeks via oral route
32
When to postpone Rotavirus vaccine?
if child has diarrhoea - passed through intestine quickly - won't be absorbed
33
Target range for Rotavirus to be given?
between 6 - 15 weeks
34
When is 2nd Rotavirus vaccine given?
4 weeks after the first (3mths of age)
35
When must 2nd Rotavirus dose be given?
before 24 weeks
36
Ideally, when should both rotavirus doses be given by?
before 16 weeks
37
Rotavirus vaccine and passing it onto parents
vaccine is excreted in stools could be transmitted to close contacts advice about hand washing
38
vaccination of babies with immunocompormised contacts (Rotavirus)
benefits outweigh the risks - risks from WT virus outweigh risks from vaccine may protect contacts from the wild type virus still vaccinate baby
39
When is flu vaccine given to children?
from 2-16yrs
40
What is the flu vaccine in children?
nasal vaccine LAIV = live attenuated influenza virus
41
How are the LAIV strains altered?
1. cold adapted to stimulate immune system in the nose where cooler temps found 2. temp sensitive so can't infect the lungs (if inhaled) or warmer nasal passages 3. attenuated - replicates to provoke a full immune response without clinical Sx
42
When should child not get the flu vaccine?
heavily blocked nose/runny nose wait until Sx cleared
43
contraindications for the flu vaccine
immunocmopromised (Leukaemia, lymphoma, untreated HIV, high dose steroids) under 2yrs receiving aspirin/salicylates (inc risk of Reyes) - rare that child will be taking aspirin, unlicenced U16yrs egg or gelatin allergy pregnancy (some exceptions - flu/wooping cough) children actively wheezing or severe asthma
44
How is Men B vaccine given?
single injection into left thigh
45
Brand of Men B vaccine
Bexsero
46
risk of Men B vaccine in babies
increased risk of fever when given with other vaccines
47
recommendations for Men B vaccine and fever
give 3 doses of paracetamol prophylactically against fever - 1 dose at time of vaccination or shortly afterwards - 2 further doses in 4-6hr intervals
48
paracetamol for Men B and fever and licencing
this overrides the licencing for infant paracetamol (what is written on the bottle/PIL) says can only give 2 doses post immunisation in babies aged 2-4mths tell parent
49
risk of fever in children
risk of febrile convulsions
50
CASE: child (30mths), has 5yr old sister who has leukaemia, at 12mths had an anaphylactic reaction after eating an omlette Can he have scheduled flu vaccine?
NO - egg allergy - risk of transmitting LAIV to sister (LAIV contains LIVE VIRUS, risk of transmitting 1-2 weeks after vaccine, low risk but immunocmompromised higher risk) -> offer inactivated vaccine (injection)
51
CASE: 3yrs, has eczema treated with topical clobetasol and emollients, recently been Rx salbutamol for night cough and beclomethasone inhaler, suspected childhood asthma Can she receive annual flu vaccine?
YES - not c/i in patients with topical/inhaled corticosteroids or low dose systemic steroids - asthma not severe - flu vaccine well tolerated - main s/e is nasal congestion - reasure patient dose very quickly absorbed and if child sneezes/nose drips vaccine still effective
52
CASE: 8 weeks, due to receive all scheduled vaccines, mother asks if he can take paracetmaol 120mg/5ml straight after received oral Rotavirus vaccine Recommend?
prophylactic antipyretic Tx not recommended as routine with any vaccine - exception of Men B Men B would be given at 8 weeks, guidance on 3 doses Rotavirus and paracetamol should be given at separate times, but vaccine not affected, small volume of fluid in gut, won't prevent the vaccine from replicating, ok to give
53
general issues with immunisations
adverse reactions - most not serious localised pain and swelling - within 3-4hrs - resolves within 24hrs - prolonged swelling needs medical attention fever - prophylactic paracetamol NOT recommended unless Men B
54
When can paracetamol be given for fever in immunisations?
* with Men B * give 3 doses of infant paracetamol as a prophylactic measure against fever * 1 dose at the time of vaccination or shortly afterwards, 2 further doses in 4-6 hour intervals * if fever persists, med attention
55
rare immunisation issues
fainting hyperventiliation anaphylaxis MMR - 5-10 days after, mild attack of measels, malaise, fever, rash

PHAM01 (22 decks)

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