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CDM 1 Exam 1 > Pediatrics Info > Flashcards

Pediatrics Info Flashcards

1
Q

Infant Age range

A

1-12 months

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2
Q

Young child age range

A

2-5 years

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3
Q

Older child age range

A

6-12 years

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4
Q

Adolescent age range

A

13-17 years

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5
Q

Gestational age divided into 2

A

Preterm ( <37 weeks age)

Fullterm (37-40 weeks age)

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6
Q

Neonate age range

A

0-1 month after birth

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7
Q

What are the 5 rights?

A

Right….

Patient
Drug
Dose
Route
Time
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8
Q

Potential areas for med errors?

A

Prescribing
Dispensing
Administration
Documentation

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9
Q

Why do dose calculation errors occur?

A

usually require conversion and calculations

dosage forms and strengths not always available

dosage recommendations not always available, a lot off label/case study for use

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10
Q

At what age can children usually swallow tablets?

A

around 6 years old

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11
Q

Why is medication adherence difficult in children?

A

Not all medications taste good

Parents are responsible for admin, sometimes forget

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12
Q

Drugs that affect growth and development?

A 
Thalidomide
Fluoroquinolone (Tendon ruptures and brown teeth)
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13
Q

Most common Growth Chart from Birth - 36 months

A

Weight-for-stature for boys and girls (Can stand on own)

Length/weight-for-age for boys and girls (Laying down)

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14
Q

Most common Growth Chart from 2 - 20 years of age

A

BMI-for-age for boys and girls

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15
Q

What is considered overweight (2-20yr old)

A

85th to 95th

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16
Q

What is considered Obese (2-20yr old)

A

> 95th percentile

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17
Q

What is considered Underweight (2-20yr old)

A

<5th percentile

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18
Q

What would 25th percentile mean on a growth chart?

A

BMI is the same or more than 25% of the reference population

BMI is less than 75% of the reference population

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19
Q

Neonates growth info

A

weight decrease ~10% after birth, due to releasing fluids

30g/day target gain for first month

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20
Q

Infant growth info

A

double birth weight by 4 months of life

weight should triple and length should double by 1 yr of life

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21
Q

Children and Adolescents info

A

Weight gain of 2-3kg/yr

Height increases 5-8cm/yr

want to make sure not gaining too quickly

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22
Q

Vital signs - Temp info

A

issue with self-regulation

Might not really have temp, just too bundled

Rectal best way to get temp

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23
Q

How is BP expressed in pediatrics?

A

Expressed as a % based on age, sex and height

Average and UL of Normal go down as get older
Same with Respiratory Rate

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24
Q

Absorption - GI Pediatrics

A

Gastric pH varies between infants and older children/adults

Full term infants pH remains elevated (6-8) at birth and declines to 1-3 after 24hrs….due to amniotic fluid and parietal cells not being matured at first

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25
Q

(Pediatrics) Acid-Labile (Weak Base) drugs will have….

A

increased absorption in peds

Penicillin, erthromycin

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26
Q

(Pediatrics) Weak acid drugs will have….

A

decreased absorption in peds

Phenobarbital, ganciclovir

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27
Q

(Pediatrics) Immature bile acid production causes….

A

decreased absorption of fat soluble vitamins

28
Q

(Pediatrics) Gastric emptying is….

A

slower in pre-term infants and increased during 1st week of life.

have reduced blood flow

Frequent feedings = drug-food interactions

29
Q

IM absorption in infants is….

A

hard to predict due to…

decreased muscle mass
poor perfusion
decreased muscle contractions

30
Q

Skin absorption in newborns can be….

A

greatly increased

this is due to underdeveloped epidermal barrier and increased skin hydration

can experience increased skin irritation from topical mediations

Systemic absorption from topical medications can occur

31
Q

(Pediatrics) The volume of distribution will be….

A

higher in infants/children due to a higher body water-to-lipid ratio

32
Q

Decreased drug binding in newborns is due to….

A

decreased plasma protein conc

lower binding capacity

decreased affinity

competition

33
Q

Decreased drug binding in newborns results in….

A

increased free drug

increased volume of distribution

34
Q

Body fat in infants and neonates is…

A

much lower than adults

highly lipid-soluble drugs are less-widely distributed

35
Q

CYP450 System infants

A

Exceeds adult values at 1yr - 9yr, causing increased metabolization of drugs

Might have to have higher dose or increased frequency compared to adults

36
Q

When do Group 1 enzymes mature?

A

Peak during 2nd and 3rd trimester

37
Q

When do Group 2 enzymes mature?

A

Relatively constant through life

38
Q

When do Group 3 enzymes mature?

A

Little function early life

Expression increases over 1st several years of life

39
Q

Decreased enzyme capacity (Neonates/young infants) will lead to….

A

increased 1/2 life and decreased clearance

40
Q

Increased enzyme capacity (Children) will lead to….

A

Decreased 1/2 life and increased clearance

41
Q

Which pathway is well developed in infants? underdeveloped?

A

Sulfation = well developed

Glucuronidation = underdeveloped

42
Q

Grey Baby Syndrome

A

Related to Chloramphenicol, due to Glucuronidation underdeveloped

Rapid progression to death, CV instability

43
Q

Is GFR lower or higher in infants?

A

Much lower in infants when compared to older children and adults

Reach approximate adult values within 1 year of life

44
Q

Decreased GFR (neonates/infants) leads to…..

A

increased 1/2 life and reduced clearance

45
Q

Decreased tubular secretion (Neonates/infants) leads to….

A

increased 1/2 life and reduced clearance

46
Q

3 Types of dosing for pediatrics

A

Weight-based dosing (Most common, max dose not established so don’t surpass adult)

Age-based dosing (easy to use, assume same ADME all patients)

Body-surface-area dosing (Precise, used for drugs requiring exact dosage calc and narrow TI)

47
Q

Pediatric resources…..

A

Lexicomp Pediatric Dosage Handbook

Micromedex

Respective guidelines

48
Q

Medication Administration concerns

A

adherence is difficult, and children have trouble with admin

many meds not available in proper dosage/strength

bad taste

49
Q

Steps pharmacist should take to reduce error

A

Obtain weigh/age/sex and diagnosis if possible

Verify allergies

Calculate dosage with known info

compare dose with pediatric dosing refernce

Make sure dose and form appropriate

dispense with proper materials

50
Q

Counseling Pediatric Patients

A

show how to measure proper dose

Explain medication

Explain what to do if symptoms do/don’t improve

make yourself available for future questions

51
Q

Common Pediatric conditions

A 
Common cold
AOM
Pharyngitis
Type 1 DM
Eczema
Asthma
Hand,Foot,Mouth disease
52
Q

Reasons to immunize?

A

Vaccines have reduced or eliminated many devastating infectious disease

Herd Immunity

Endorsed by a bunch of health organizations

53
Q

Passive immunity

A

Person given antibodies to a disease

Get immediate protection, also few weeks or months

Via mother-to-baby or IVIG

54
Q

Active immunity

A

Via infection, or Vaccine

Long acting, sometimes life long immunity

Takes several weeks to develop

Disease organism triggers immune system to produce antibodies

55
Q

Types of vaccines

A

Made using same components (antigens) of bacteria or viruses that cause disease

Killed = inactivated
Live but weakened = attenuated
Part of bacteria/virus = conjugated/subunit
Inactivated toxin= toxoid
Messager RNA = mRNA
56
Q

How do vaccines work simplified?

A

Vaccine with antigens injected into body

immune system produces antibodies to fight antigens off

Memory cells will remember how to produce antibodies again

When actual bacteria/virus enter body the memory cells can produce the same antibodies quicker to fight off disease

57
Q

Some diseases Vaccines are used for….

A 
Polio
Rubella
Influenza
Pertussis/Diphtheria/Tetanus
Pneumococcus
Varicella
Measles, mumps, rubella
HPV
58
Q

Risk vs Benefit of Vaccines

A

No vaccine is 100% safe or effective

Vaccines associated with milder form of disease

Risk of risk is far greater than risk of vaccine

59
Q

Vaccine Misconceptions

A

Chicken pox not fatal? = no true, can be older age

Disease eliminated? = no, because vaccination rates reduced and disease reemerging

Vaccines have mercury? = have different kind, Ethyl mercury not methyl mercury. also moving away from

Cause autism? = paper discredited and not peer reviewed

More than 1 at a time is dangerous? = not really, maybe sore arm

60
Q

Common Adverse Reactions to vaccines

A

At injection site: Soreness, redness, swelling

Fussiness, low grade fever

61
Q

Vaccine Contraindications

A

Sever allergies (anaphylaxis) to prior vaccine or component

Having moderate to sever illness, defer until resolved

62
Q

Contraindicated Vaccines immunocompromised patients?

A

Live vaccines: MMR, Varicella, Rotavirus

63
Q

Contraindicated Vaccines in Pregnancy?

A

Live Vaccines: MMR, Varicella, Flumist

64
Q

Vaccine components that can cause anaphylactic reaction?

A 
Egg product
Neomycin
Streptomycin
Polymixin B
Baker's Yeast
Gelatin
65
Q

Questions to ask prior vaccine admin?

A

Any allergies

Any reactions to previous immunizations

Any unlisted medical conditions

CDM 1 Exam 1 (14 decks)

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