Pediatrics - Introduction/PKPD

Question 1

What scales are for children 4 or less? (2)

Answer 1

neonate infant pain scale (NIPS), face legs activity cry consolability (FLACC)

Question 2

What scale is for children 4 or more?

Answer 2

Wong-Baker FACES

Question 3

What scales are for children 10 or more? (2)

Answer 3

visual analog scale, numeric pain scale

Question 4

What is the Bedside Schwartz equation?

Answer 4

CrCl = (0.413 x height in cm)/SCr in mg/dL; must be less than 18

Question 5

What percent of outpatient prescriptions are off-label in pediatrics?

Answer 5

67-96%

Question 6

What percent of inpatient prescriptions are off-label in pediatrics?

Answer 6

79%

Question 7

What are reasons for non-adherence in pediatrics?

Answer 7

apprehension regarding AEs, caregiver inability/unavailability to administer, confusion, inappropriate measurements of medication dose, resistance

Question 8

What are strategies to improve adherence in pediatrics?

Answer 8

caregiver education/reinforcement, ease of administration, decrease child resistance (rewards and positive reinforcement), empowering older children

Question 9

What is the BUD for water containing formulations when refrigerated?

Answer 9

14 days

Question 10

What is the “Ins” units?

Answer 10

mL/kg/day

Question 11

What is the “Outs” units?

Answer 11

mL/kg/hr

Question 12

What is anuria considered? Oliguria? Normal? Polyuria?

Answer 12

zero; < 0.5 - 1 mL/kg/hr ; > 1 mL/kg/hr ; > 4 mL/kg/hr

Question 13

What is first-line for dosing references in pediatrics? (2)

Answer 13

Lexicomp, NeoFax

Question 14

What are the age ranges for taste and smell characteristics? (4)

Answer 14

birth = sweet, by 2 = bitter/salty/sour, by 1-2 texture/temperature, 5-7 odors

Question 15

Is gastric pH higher or lower in early life?

Answer 15

higher (more BASIC)

Question 16

How does gastric emptying affect drug absorption in pediatrics?

Answer 16

increases absorption since emptying rates are increased during first week of life

Question 17

How do rectal contractions affect drug bioavailability in pediatrics?

Answer 17

decrease

Question 18

How do percutaneous differences affect drugs in pediatrics?

Answer 18

enhance drug permeability

Question 19

How does capillary density affect drug bioavailability in pediatrics?

Answer 19

enhance drug permeability

Question 20

How is Vd of drugs affected in pediatric populations?

Answer 20

infants have less muscle/fat (more water): hydrophilic drugs increased Vd, lipophilic drugs decreased Vd

Question 21

How is protein binding affected in pediatric populations?

Answer 21

decreased concentrations of circulating binding proteins and decreased binding affinity

Question 22

What drugs should be avoided in infants 2 months or less? (2) Why?

Answer 22

ceftriaxone and sulfonamides; risk of displacement of bilirubin from albumin binding sites (kernicterus)

Question 23

Which Phase I CYP enzymes are usually present by 1 year of age? (3)

Answer 23

3A4, 2C19, 2E1

Question 24

What Phase II enzymes do children have more of?

Answer 24

sulfates

Question 25

Why are children less than 12 less susceptible to APAP toxicity?

Answer 25

NAPQI, the toxic component from APAP degradation, is the result of glucuronidation which children perform less of

Question 26

What is the major organ of elimination in children?

Answer 26

kidneys

Question 27

In general, dosing is required ______ in pediatrics?

Answer 27

less frequently