pediatric pharmacology Flashcards
when talking about how the body affects the drug - we talk about
pharmacokinetics
when talking about how the DRUG affects the body - we talk about
pharmacodynamics
risk factors for non-compliance
- polypharmacy
- chronic treatment
- adolescence
describe gut absorption of neonates
- uncoordinated and unpredictable gastric peristalsis
- short intestinal transit time
- Variable Tmax -
- variable absorption
intravascularly what can displace or reduce distribution of a drug
- neonates have 80% of albumin level of adult
- a-1 acid glycoprotei 30% of adult
- interfering substances +++ like bilirubin
INREASED UNBOUND drug
TBW of a neonate vs an adult
ECF
- 75% vs 60%
- 40% vs 20%
drugs distribute more efficiently if they distribute in water
Apparent volume of distribution
- theoretical volume a total drug has to be diluted to give proper concentration in plasma
when do you have a small apparent volume of distribution?
when drug is highly protein-bound
what is hepatic clearance for neonates vs children vs adults?
lowest for neonates, highest for children (2-7 yrs) also have a bigger liver!
middle for adult
excretion in children vs infant
- higher excretion higher clearance - 1-6 yr old
higher GFR
what is the clearance of neonates?
Low!
but have a LARGE volume of distribution
what is the clearance of children?
higher! clearance than neonates
t1/2 of caffeine is 80 hrs in neonate vs 2 hrs in adults
they also clear the drug a lot less
- what should loading dose be?
what should the maintenance dose be?
loading dose IS THE SAME
but maintenance dose will be less frequent!
gentamicin toxicities
nephrotox
ototox
if clearance of a drug is lower but the volume of distribution is higher then
give the same loading dose
but maintenace is less often, and MORE of it, because the volume of distrubtion is higher
