Pediatric PK/PD- Distribution

Question 1

Total body water in neonates vs. adults

Answer 1

75-85% in neonates

55-60% in adults

Question 2

ECF in neonates vs. adults

Answer 2

35-45% in neonates

20% in adults

Question 3

Infants and muscle/fat

Answer 3

Infants have less muscle/fat than adults

Question 4

Total body water as a patient ages

Answer 4

It decreases

Question 5

Body fat as a patient ages

Answer 5

It increases, then decreases

Question 6

Protein binding: albumin and alpha-1-acid glycoprotein

Answer 6

Decreased concentration of circulating proteins

Question 7

Protein binding: there is decreased binding affinity of ______

Answer 7

fetal albumin

Question 8

Protein binding: there is competitive binding by endogenous substances like ____ and ____

Answer 8

bilirubin and free fatty acids

Question 9

There is an increased Vd of _____

Answer 9

hydrophilic drugs (like aminoglycosides)

Question 10

There is a decreased Vd of

Answer 10

lipophilic drugs

Question 11

There is a ______ free fraction of drugs

Answer 11

increased

Question 12

There is a risk of _______ from ______

Answer 12

Risk of displacement of bilirubin from albumin binding sites

Question 13

Avoid what drugs in infants ≤2 months?

Answer 13

Ceftriaxone and sulfonamides

Question 14

Effect of decreased plasma protein binding

Answer 14

Increase in the free fraction of drug, so there is potential for enhanced pharmacologic effect

Question 15

Binding of drugs to plasma protein effects in newborns

Answer 15

May predispose newborns to ADEs