Pediatric Stuff Flashcards
Pediatric PK: Alteration in Absorption
- Gastric pH more neutral
- Less effective GI motility
- Reduced intestinal integrity
Pediatric PK: Alteration in Distribution
Inc water, reduced adipose
Hydrophilic rx will require larger dose; lipophilic require smaller dose
Pediatric PK: Alteration in Metabolism
Reduced hepatic metabolism; up to 1 year of age to develop CYP fully
Pediatric PK: Alteration in Elimination
Reduce kidney fxn until 3-5 mo of age
How to calculate GFR in pediatrics
Modified Scwartz
GFR=(0.413*ht)/SCr
Usual tacro dose in peds
0.05-0.15 mg/kg BID
Usual cyclo dose in peds
2-5 mg/kg BID
Usual MMF dose in peds
300-600 mg/m2 BID
OR
15-25 mg/kg BID (~equiv to 1000 mg PO BID in adults)
Usual AZA dose in peds
1-2 mg/kg daily
Usual everolimus dose in peds
0.8 mg/m2 BID
Usual sirolimus dose in peds
0.5-1 mg/m2 per day, divided into 1 - 2 doses
Consider load of 2-3 mg/m2
What (& quantity) can tacrolimus granules be mixed with to make the suspension?
Only water at room temp
15-30 mL x2 (to get all medication)
What (& quantity) can sirolimus solution be mixed with to make the suspension?
Water or orange juice only
At least 2 oz x2(to get all medication)
Valganciclovir dose for pediatrics
Dose=7BSACrCl
BSA=sqrt(htwt/3600)
CrCl via Schwartz = kht/SCr (max 150)
Alt: 15-18 mg/kg/day
Max isohemagglutinin titers for pediatric liver txp
None
- However, high titer (1:32) consider PP, IVIG, ritux, triple IS
Max isohemagglutinin titers for ABOi pediatric thoracic txp
<1 year old: no max
>1 year old: max 1:16
- Consider intraop plasma exchange, induction, triple IS
Palivizumab for RSV prophy: dosing & who it is indicated for
Immunocompromised peds <24 months
Give at beginning of RSV season
15 mg/kg IM Qmonth x5 months
Peds diphtheria, tetanus, and pertussis (DTaP) vaccination: How early & schedule
Minimum age: 6 weeks
Schedule: 5-dose series over 4-6 years (can be accelerated to go over ~1 year)
Peds Hep A vaccination: How early & schedule
Minimum age: 6 months (accelerated; normal = 12 mo)
Schedule: 2 doses over 6 months
Peds Hep B vaccination: How early & schedule
Minimum age: Birth
Schedule: 3 doses over 6-18 months
Peds Hib vaccination: How early & schedule
Minimum age: 6 weeks
Schedule: 4-dose series over 12-15 months (also combo with DTaP)
Peds influenza vaccination: How early & schedule
Minimum age: 6 months
Schedule: 2 doses separated by at least 4 weeks if < 8 years old and less than 2 influenza vaccine doses before July 1, 2020,
Peds MenACWY vaccination: How early & schedule
Minimum age: 2 to 9 months (accelerated for high risk; normal=11-12 years)
Schedule: Varies widely depending on age
Peds MenB vaccination: How early & schedule
Minimum age: 10 years (accelerated; normal=16-18 years)
Schedule: 2 or 3 dose series over 1-6 months
Peds PCV13 vaccination: How early & schedule
Minimum age: 6 weeks
Schedule: 4-dose series that may be accelerated to 4-5 months (normal: 12 - 15 months)
UNLESS >5 years old –> just need 1 dose
Peds PPSV23 vaccination: How early & schedule
Minimum age: 2 years (accelerated; normal age 19)
Schedule: Repeat in 5 years
Peds Rotavirus vaccination: How early & schedule
Minimum age: 6 weeks (NOT TO BE GIVEN IF 14w6d)
Schedule: 2-3 doses over 2-4 months
Peds Varicella vaccination: How early & schedule
Minimum age: 6 months (accelerated; normal age 12 months)
Schedule: 2 doses as close as 3 months together
Peds MMR dose
Minimum age: 12 months
Schedule: 2 doses as soon as 4 weeks apart (usually repeat after 5 years)
