pediatrics 1 Flashcards
what is considered as a neonate?
< 1 month
what is considered as a preterm baby?
< 36 weeks gestation
what is considered a term baby?
> /= 36 weeks gestation
what is considered an infant?
1 month to 1 year
what is considered a child?
1-11 years
what is considered an adolescent?
12-18 years
what is considered low birth weight?
1500 g to < 2500 g
what is considered a very low birth weight/
<1500 g
what are 3 unique things of pediatric pharmacy?
- difficulty in conducting research
- diverse patient population
- lack of adequate dosage forms
when should you not give aspirin to a patient?
< 20 years old unless prescribed by a doctor
what age should tetracyclines be avoided?
children less than or equal to 8
the use of medications outside its FDA approved labeled indication(s) include what 3 things?
- age range
- disease or illness it treats
- route of admin.
when is off label drug use legal and well accepted?
if based on appropriate clinical judgement
what are 2 limitations to off label drug use?
- liability
- denied insurance coverage
what act provided financial incentives for companies to voluntary study drugs in the pediatric population?
FDAMA
what act extended the patent exclusivity of FDAMA through 2007 and was reauthorized in 2007 and 2012 permanently?
Best pharmaceuticals for children act (BPCA)
what act requires studies on indications under review; minimum assessment is PK/PD and safety and requires phramaceutical companies to test in the pediatric population a new drug likely to be used in children?
Pediatric research equity act (PREA)
___ is more variable than anrticipated
PK
higher doses of what drug were required to control seizures in those younger than age 5?
gabapentin
what drug recommends higher doses in adolescents than were previously indicated, with the exception of girls aged 8-11 who may require lower doses because the drug can make them drowsy?
fluvoxamine
what adverse reaction of gabapentin was seen in children < 12?
aggression and hostility
what was experienced in children who were taking fluoxetine?
limited growth
how is the pulse measured in young babies?
listening to the heart, palpating peripheral pulse or observing the anterior fontanel
when is the circadian rhythm in the heart observed?
at 2 yrs
hearts beats ____ as the child ages
decreases
respiratory rate ____ as the child ages
decreases
at what age should children have their BP monitored?
> /= 3 yo
what is considered normal BP?
SBP and DBP <90th percentile
what is considered prehypertension?
SBP or DBP >/=90th but <95th percentile
what is considered as stage 1 HTN?
SBP or DBP in the 95th percentile to 5 mmHg above the 99th%
what is considered as stage 2 HTN?
SBP or DBP > 5 mmHg above 99th%
what is considered a fever with a rectal temperature?
> 100.4 °F
how should you measure temperature in infants and children up to 3-4 yrs of age?
rectally
which thermometer is close to the core temoerature?
tympanic
what thermometer is 1° lower than the core temperature?
oral
what thermometer is 2° lower than the core temperature?
axillary
when is the circadian rhythm of the body well developed?
at 5 yrs
what temperatures are considered a low grade fever?
100-102°F
what temperature is considered as a high fever?
104 °F
when should children with a fever be evaluated by a health care provider?
- <3 months who have a temp of >/= 100.4°F
- > 3 months who have a temp >/= 100.4°F for more than 3 days or who appear ill
- infants and children 3 mo-3 yrs who have a temp of >/= 102°F
- children of any age with a temp. >/=104°F
-febrile seizure
- recurrent fevers
- fever + chronic medical problem
- fever + new skin rash
what are 2 treatments for fever?
- drink fluids
- APAP
when should APAP be given to neonates 28-32 weeks?
every 6-8 hours
when should APAP be given to neonates 33-37 weeks?
every 6 hours
when should APAP be given to term neonates?
every 4-6 hours
what is the APAP dose for infants and children?
10-15 mg/kg/dose every 4-6 hours as needed (do not exceed 5 doses in one day)
ibuprofen should not be used in children at what age?
<6 months
what is the pediatric dose for iubuprofen?
7.5 mg/kg every 6 to 8 hours as needed
what BMI chart should be used for children <2?
WHO chart
what BMI chart should be used for children >/= 2?
CDC chart
what BMI is considered overweight for children?
BMI >/= 85th % to <95th%
what BMI is considered obese for children?
BMI >/= 95th%
what BMI is considered underweight for children?
BMI <15th%
when do the most dramatic PK changes in children occur?
in the first 2 years of life
what is the GI pH in premature infants?
6-8
when is the extent of fat absorption the lowest?
early in the neonatal period
the concentration of bile salts within the intestinal lumen is lower through the first ___ months of life
6
why is the rectal route useful in older infants or children? 3
- IV drug choices are lacking
- IV access problems
- oral route is impractical
what route, other than rectal can be used in place of IV?
IM
to decrease IM pain what should you limit the volume of the solution to in young children?
0.5 mL
to decrease IM pain what should you limit the volume of the solution to in school age children?
1 mL
to decrease IM pain what should you limit the volume of the solution to in adolescents/adults?
3-5 mL