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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
(Pediatrics) Acid-Labile (Weak Base) drugs will have....
increased absorption in peds Penicillin, erthromycin
26
(Pediatrics) Weak acid drugs will have....
decreased absorption in peds Phenobarbital, ganciclovir
27
(Pediatrics) Immature bile acid production causes....
decreased absorption of fat soluble vitamins
28
(Pediatrics) Gastric emptying is....
slower in pre-term infants and increased during 1st week of life. have reduced blood flow Frequent feedings = drug-food interactions
29
IM absorption in infants is....
hard to predict due to... decreased muscle mass poor perfusion decreased muscle contractions
30
Skin absorption in newborns can be....
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
(Pediatrics) The volume of distribution will be....
higher in infants/children due to a higher body water-to-lipid ratio
32
Decreased drug binding in newborns is due to....
decreased plasma protein conc lower binding capacity decreased affinity competition
33
Decreased drug binding in newborns results in....
increased free drug increased volume of distribution
34
Body fat in infants and neonates is...
much lower than adults highly lipid-soluble drugs are less-widely distributed
35
CYP450 System infants
Exceeds adult values at 1yr - 9yr, causing increased metabolization of drugs Might have to have higher dose or increased frequency compared to adults
36
When do Group 1 enzymes mature?
Peak during 2nd and 3rd trimester
37
When do Group 2 enzymes mature?
Relatively constant through life
38
When do Group 3 enzymes mature?
Little function early life Expression increases over 1st several years of life
39
Decreased enzyme capacity (Neonates/young infants) will lead to....
increased 1/2 life and decreased clearance
40
Increased enzyme capacity (Children) will lead to....
Decreased 1/2 life and increased clearance
41
Which pathway is well developed in infants? underdeveloped?
Sulfation = well developed Glucuronidation = underdeveloped
42
Grey Baby Syndrome
Related to Chloramphenicol, due to Glucuronidation underdeveloped Rapid progression to death, CV instability
43
Is GFR lower or higher in infants?
Much lower in infants when compared to older children and adults Reach approximate adult values within 1 year of life
44
Decreased GFR (neonates/infants) leads to.....
increased 1/2 life and reduced clearance
45
Decreased tubular secretion (Neonates/infants) leads to....
increased 1/2 life and reduced clearance
46
3 Types of dosing for pediatrics
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
Pediatric resources.....
Lexicomp Pediatric Dosage Handbook Micromedex Respective guidelines
48
Medication Administration concerns
adherence is difficult, and children have trouble with admin many meds not available in proper dosage/strength bad taste
49
Steps pharmacist should take to reduce error
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
Counseling Pediatric Patients
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
Common Pediatric conditions
``` Common cold AOM Pharyngitis Type 1 DM Eczema Asthma Hand,Foot,Mouth disease ```
52
Reasons to immunize?
Vaccines have reduced or eliminated many devastating infectious disease Herd Immunity Endorsed by a bunch of health organizations
53
Passive immunity
Person given antibodies to a disease Get immediate protection, also few weeks or months Via mother-to-baby or IVIG
54
Active immunity
Via infection, or Vaccine Long acting, sometimes life long immunity Takes several weeks to develop Disease organism triggers immune system to produce antibodies
55
Types of vaccines
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
How do vaccines work simplified?
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
Some diseases Vaccines are used for....
``` Polio Rubella Influenza Pertussis/Diphtheria/Tetanus Pneumococcus Varicella Measles, mumps, rubella HPV ```
58
Risk vs Benefit of Vaccines
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
Vaccine Misconceptions
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
Common Adverse Reactions to vaccines
At injection site: Soreness, redness, swelling Fussiness, low grade fever
61
Vaccine Contraindications
Sever allergies (anaphylaxis) to prior vaccine or component Having moderate to sever illness, defer until resolved
62
Contraindicated Vaccines immunocompromised patients?
Live vaccines: MMR, Varicella, Rotavirus
63
Contraindicated Vaccines in Pregnancy?
Live Vaccines: MMR, Varicella, Flumist
64
Vaccine components that can cause anaphylactic reaction?
``` Egg product Neomycin Streptomycin Polymixin B Baker's Yeast Gelatin ```
65
Questions to ask prior vaccine admin?
Any allergies Any reactions to previous immunizations Any unlisted medical conditions

CDM 1 Exam 1 (14 decks)

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