Pediatrics Part 3

Question 1

concern with erythromycin in infants

what is an alternative agent?

Answer 1

when given PO, can cause IHPS (INFANTILE hypertrophic pyloric stenosis) in infants less than 1 month

pyloris overgrows and causes vomiting

azithromycin preferred for pertussis

Question 2

2 concerns with ceftriaxone in NEONATES

Answer 2

ceftriaxone and calcium - can cause calcium crystal deposits in kidneys – leads to deaths

ceftriaxone also has plasma protein binding - can displace bilirubin (only concern in less than 2 months)

Question 3

ceftriaxone and calcium cannot be administered within ________ of each other in neonates due to concern of calcium crystal deposits in their kidneys

Answer 3

48 hours

Question 4

fluroquinolones issue in peds

Answer 4

musculoskeletal/cartilage abnormalities

LAST LINE OF DRUGS in kids up to 18

Question 5

therapeutic misadventure: Vitamin E

what was the cause? what happened to the kids?

Answer 5

cause was NOT vitamin E – it was the solvents used (polysorbate 80 and 20)

resulted in low birth weight infants

drug marketed too quickly before safety studies

Question 6

MVI-12 misadventure

Answer 6

it was a IV multivitamin marketed for adults – causes premature infants (due tp PPG)

solution is to use IV PEDIATRIC multivitamins in parenteral nutrition

Question 7

therapeutic misadventures: benzyl alcohol

Answer 7

used as preservative and to flush IV lines

resulted in gasping syndrome in neonates. premature neonates at risk

BENZYL ALCOHOL AVOIDED IN PREMATURE NEONATES

Question 8

a 1 month old is considered a neonate or infant?

Answer 8

infant

Question 9

true or false

an infant with a 102 temp is not considered to have a fever

Answer 9

false - they do.
defs are the same for peds and adults

Question 10

how can we minimize IM pain

Answer 10

use the highest concentration of drug in the LOWEST VOLUME possible

Question 11

is bilirubin displacement a concern in neonates, infants, or both

Answer 11

neonates

Question 12

mg/kg/day

vs

mg/kg/dose

when to use each

Answer 12

use “per day” when the dose is SCHEDULED

use “per dose” when the dose is as needed

Question 13

recommendation to help reduce pain of IM injection

Answer 13

move around

Question 14

peds may need a _____ pump when getting an IV to ensure the med is getting in in a timely manner

Answer 14

syringe pump

Question 15

how can we minimize risk of infection from giving IV’s

Answer 15

try to find a drug that can be dosed x1 a day - the less # of times you go into a vein, the better

Question 16

what are some questions to ask a parent when they state their baby threw up after getting an oral medication

Answer 16

what color was it?
how much?
when was the last time they were fed?

look at therapeutic range of drug – if we were already giving on the lower end, maybe administer half of another dose

Question 17

how is ampicillin eliminated from the body

Answer 17

renal

Question 18

true or false

if a patient’s creatinine clearance is within the range for the age group, no dose adjustment is needed

Answer 18

trueq

Question 19

a 5 year old child metabolizes drugs like midazolam through CYP3A4 more rapidly than adults

what does this say about the dosing and frequency?

Answer 19

give higher doses and more frequently