Pediatric Pharmacology Flashcards

1
Q

What aspects regarding drug disposition are impacted by immaturity?

A
  1. absorption
  2. distribution
  3. metabolism
  4. elimination
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2
Q

Factors affecting drug absorption

A
  1. gastric pH- delayed acid prodution in preterms
  2. GI motility- slower motility
  3. rectal anatomy- small size; increases 1st pass clearance
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3
Q

Thin skin does what to absorption?

A

promotes increased absorption

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4
Q

Intramuscular or subcutaneous absorption is decreased when?

A

perfusion is decreased

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5
Q

Factors affecting drug distribution

A
  1. body composition- more water, less fat
  2. protein binding- less protein in sicker infants makes drugs more bioavailable
  3. lower plasma pH
  4. bilirubin
  5. disease states
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6
Q

Factors affecting drug metabolism

A

reduced hepatic enzyme function

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7
Q

Factors affecting drug elimination

A
  1. decreased GI motliity

2. renal immaturity

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8
Q

If you are concerned about possible sepsis, what drug combo do you choose?

A

ampicillin (gram +) and gentamicin (gram -)

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9
Q

Adverse effects of gent?

A

nephrotoxicity and ototoxicity

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10
Q

Importance of monitoring gent levels

A

“peak kills the bug, trough kills the kidney” so monitor trough level carefully

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11
Q

After ampicillin and gent, nosocomial infection suspected, what antibiotic do you use?

A
  1. Add Vancomycin (gram +) because MRSA and staph epidermidis coverage
  2. Add cefotaxime (gram -)
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12
Q

Why monitor vanc levels?

A
  1. high trough is important for clinical effect
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13
Q

For fungal infections such as candida consider what antibiotics?

A
  1. Amp B
  2. Fluconazole
  3. Echinocandins
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14
Q

26 week infant in resp distress requring intubation and mechanical ventilation like needs?

A

Surfactant (curosurf, infasurf, survanta)

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15
Q

What are potential side effects of endotracheal surfactant administration?

A

bradycardia and oxygen desaturation

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16
Q

Is synthetic surfactant more or less effective form of therapy

A

Less

17
Q

Another drug that can be given to mom before delivery of premature to help with lungs?

A

betamethasone

18
Q

Drug to treat patent ductus arteriosus?

A

Indomethacin- prostaglandin synthesis inhibitor

19
Q

Episodes of apnea with bradycardia and desats is apnea of prematurity, how to treat it?

A

Methylxanthine therapy- caffeine citrate, theophylline

20
Q

Bronchopulmonary dysplasia treatment

A
  1. diuretics
  2. corticosteroids
  3. b-agonist aerosols
21
Q

Infant with meconium-stained fluid, resp distress tachypnea, retractions, cyanosis with pulm HTN might benefit from what drug?

A

NO- pulmonary vasodilator contraindicated in infants with right to left shunt

22
Q

Effortless tachypnea (no retraction or grunting) associated with transposition of great vessels treated with

A

Prostaglandin E- dilates ductus arteriosus for ductal shunting with good oxygenation and perfusion until surgery