paediatrics Flashcards
at what age range is there is a rapid change in new born infants
there is rapid change in body size organ size and function from 0-1
Children have a high gastric PH what does this effect?
This will enhance the BA of basic compounds
reduce the BA of acidic compounds
reduce the BA of prodrugs that need solubilisation or hydrolysis for absorption
How does a childs gastrointestinal motility affect bioavalibility?
it affects physio-chemical properties and interactions with anatomical and physiochemical properties.
how does a child’s gastroinestinal metabolism affect drug absorption.
a child can has an immature bacteria flora which limits the extent of drug absorption as the GI system cannot metabolise compounds
how does a childs first pass effect alter absorption?
Children have. reduced first pass effect and can have an improved bioavalibilty as it immature transporters mean drugs just get through but a reduced BA if an uptake transported is need ed as they are not present
how is distribution affected in a child ?
Infants have a high body water content so drugs that are water soluble have a high volume of distribution.
- drugs that are fat soluble have a low volume of distribution as children have a low proportion of fat
How is plasma binding protein altered in children?
Children have less plasma proteins to bind to so less binding to plasma protein so more free drug available
How is binding affinity to albumin or AA1 affected in children?
children have a lower binding affinity to albumin and AA1
how is hepatic clearance affect in children?
children have reduced enzyme metabolism so a difference in clearnace
there is a difference in glucuronidation, salvation , glutathione conjugation and acetylation
how is renal clearance ?
maturation rates vary for glomerular filtration , tubular secretion and tubular reabsorption
how does elimination rates vary from an adults ?
from the age of 1 the elimination rate for an adult are the same
what does safeguarding mean?
it is to protect peoples mental health , welfare being and human rights allowing them to live freely from harm abuse and neglect.
its fundamental to high quality and social care
what does a venerable adult mean?
any adult over the age of 18 who is at risk of neglect or abuse because of their needs for care or support. they may lack mental capacity
what does a child mean?
anyone 18 years or under
give some examples of a venerable adult?
- mental illness e.g dementia or personality disorder
- elderly or frail
- substance misuser
- homelss
- learning disability
- physical disability
what are the parent career signs of neglect?
- delays seeking medical advice
- reluctant to allow treatment or information
- detachment from the child
- lacks concern for the severity or extent of the issue
- aggressive to child or other venerable person
what are some prescribing similarities between children and adults?
general ward visits drug histories inpatient review TTa's Counselling many use of the same drugs
what are some of the prescribing differences between children and adults?
- some information differs when asking in the drug history
- formulation of drugs
- considerations for medicines at home
- parents rights
what does gestation mean?
time elapsed between the first day of the mothers last menstrual cycle to estimated delivery day
average is 40 weeks
what are some of the short term complications of prematurity ?
- breathing difficulties
- anemia and new bone jaundice
hypoglycaemia
immune system problems
heart problems
what are some of the long term complications of prematurity ?
cereal palsy
impaired learning
dental problems
behavioural and psychological problems
what is patent ductus arteries?
when a baby is born premature and the duct stays open and the baby starts to rely on its own blood supply.
use paracetamol and ibuprofen to close the duct as prostaglandin keeps the duct open
This will increases oxygen saturation
what is hyperplasia left heart valve ?
- when a babies haven’t developed a left vertical and if the patent ductus closes there will be no blood flow
use a prostaglandin analogue as then it will keep the duct open until the baby is a certain weight so a baby can have cardio surgery
