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PHAM01 > paediatric OTC > Flashcards

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
Q

When would a vaccine not be given?

A
  • acute illness (delayed by a few weeks)
  • live vaccines not given if immunocompromised
26
Q

What does Rotavirus cause?

A

gastroenteritis (common in infants and children)

27
Q

symptoms of rotavirus

A

diarrhoea
vomiting
can cause severe dehydration

28
Q

How is rotavirus transmitted?

A

faecal roal route

respiratory also possible

29
Q

When is Rotavirus most common?

A

January - March

30
Q

How long do Sx of Rotavirus last?

A

3 - 8 days

31
Q

When and how is Rotavirus vaccine given?

A

8 weeks

via oral route

32
Q

When to postpone Rotavirus vaccine?

A

if child has diarrhoea
- passed through intestine quickly
- won’t be absorbed

33
Q

Target range for Rotavirus to be given?

A

between 6 - 15 weeks

34
Q

When is 2nd Rotavirus vaccine given?

A

4 weeks after the first (3mths of age)

35
Q

When must 2nd Rotavirus dose be given?

A

before 24 weeks

36
Q

Ideally, when should both rotavirus doses be given by?

A

before 16 weeks

37
Q

Rotavirus vaccine and passing it onto parents

A

vaccine is excreted in stools
could be transmitted to close contacts
advice about hand washing

38
Q

vaccination of babies with immunocompormised contacts (Rotavirus)

A

benefits outweigh the risks
- risks from WT virus outweigh risks from vaccine

may protect contacts from the wild type virus

still vaccinate baby

39
Q

When is flu vaccine given to children?

A

from 2-16yrs

40
Q

What is the flu vaccine in children?

A

nasal vaccine

LAIV = live attenuated influenza virus

41
Q

How are the LAIV strains altered?

A
  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
Q

When should child not get the flu vaccine?

A

heavily blocked nose/runny nose

wait until Sx cleared

43
Q

contraindications for the flu vaccine

A

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
Q

How is Men B vaccine given?

A

single injection

into left thigh

45
Q

Brand of Men B vaccine

A

Bexsero

46
Q

risk of Men B vaccine in babies

A

increased risk of fever when given with other vaccines

47
Q

recommendations for Men B vaccine and fever

A

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
Q

paracetamol for Men B and fever and licencing

A

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
Q

risk of fever in children

A

risk of febrile convulsions

50
Q

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?

A

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
Q

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?

A

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
Q

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?

A

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
Q

general issues with immunisations

A

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
Q

When can paracetamol be given for fever in immunisations?

A
  • 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
Q

rare immunisation issues

A

fainting
hyperventiliation
anaphylaxis
MMR - 5-10 days after, mild attack of measels, malaise, fever, rash

PHAM01 (22 decks)

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