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Pharmacology Quiz 2 > Pediatrics quiz > Flashcards

Pediatrics quiz Flashcards

1
Q

Problem Areas relating to drugs when treating children?

A

Pharmacokinetics

Pharmacodynamics

Lack of reliable pediatric dosing information

Drug administration

Dosage form alteration

Compliance

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2
Q

Is drug liberation a concern in the pediatric patient?

A

No

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3
Q

Are membranes hydrophilic or hydrophobic?

A

hydrophobic

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4
Q

Drugs need to be _________ to dissolve so they can be transported across membranes at the site of action

A

hydrophillic

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5
Q

How is the pH of of the GI tract affected in a preterm infant?

A

It’s elevated due to immature acid secretion

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6
Q

What is pH of a full term infant at birth and in 24 hours

A

pH in full term infant ranges from 6 to 8 at birth and drops to 1-3 within 24 hours

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7
Q

Why will there be elevated levels of penicillin, ampicillin, and nafcillin if administered to a premature infant?

A

because they are acid-labile and the pH is not as acidic (drug is not degraded as effectively)

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8
Q

Gastric emptying is ________ in the premature infant

A

slower

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9
Q

Is IM injection reliable in premature infants?

A

No - small skeletal muscle mass and subcutaneous fat makes IM absorption unreliable

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10
Q

Is IM injection reliable in older infants / small children?

A

Yes - IM injection effective and usually given in the lateral aspect of a thigh due to insufficient deltoid muscle mass

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11
Q

How is per-cutaneous absorption related to skin thickness and skin hydration?

A

Inversely related to the thickness of the stratum corneum and directly related to skin hydration

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12
Q

A newborns skin is thinner than an adults, will this result in increased or decreased percutaneous absorption?

A

increased

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13
Q

A newborns surface area to body weight ratio may be 2-3 times that of an adult, how will that affect percutaneous absorption?

A

A newborns absorption will be higher

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14
Q

Who will have a higher volume of distribution an infant / small child or adult?

A

Infant/ small child

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15
Q

What affects protein binding in newborns

A

Decreased plasma protein concentrations

Lower binding capacity of protein

Decreased affinity of proteins for binding

Competition by substances such as bilirubin

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16
Q

Drug metabolites are catabolized by?

A

enzymes

17
Q

Where does most drug metabolism occur

A

liver

18
Q

What are the two major metabolic steps in drug metabolism

A

Oxidation and Conjugation

19
Q

Phase 1 reactions add?

A

a polar group to a drug (oxidation)

20
Q

Phase II reactions involve?

A

enzymatic coupling of the polar group to an endogenous substance for greater water solubility

21
Q

Why is drug metabolism slower in infants than adults?

A

Maturation differences

sulfation pathway well developed but glucuronidation not developed in infants

Metabolic pathway is age related; several months to 1 year to develop

22
Q

What are the three major enzymes that neonates have difficulty utilizing in drug metabolism

A

CYP3A4 isoenzyme

CYP1A2

CYP2D6

23
Q

How do you correct the dosage for a neonate who needs a drug that is broken down by a CYP3A4 isoenzyme?

A

On average 2-fold increase in weight-corrected doses over adult doses

24
Q

How do you correct the dosage for a neonate who needs a drug that is broken down by a CYP1A2 isoenzyme?

A

In neonates cut doses by 50%

25
Q

How do you correct the dosage for a 2-10 y/o who needs a drug that is broken down by a CYP1A2 isoenzyme?

A

2-10 years of age need 50% greater weight-corrected dosing

26
Q

How do you correct the dosage for an adolescent who needs a drug that is broken down by a CYP1A2 isoenzyme?

A

Adolescents at adult dosing

27
Q

How do you correct the dosage for a neonate who needs a drug that is broken down by a CYP2D6 isoenzyme?

A

Neonates need decreases weight-adjusted dosing

all other pediatric patients - no change from adult

28
Q

Where does drug elimination mainly occur?

A

through the kidney

29
Q

Renal clearance is governed by?

A

Filtration, Secretion, Reabsorption

30
Q

Whats the most accurate method of drug dosing in pediatrics?

A

Body surface area (BSA)

31
Q

What is the most used drug dosing method in peditrics?

A

Dosing based on body weight.

BSA dosing recommendations not available for most drugs

32
Q

What are some barriers to compliance with pediatric prescribing?

A

Poor communication

Insufficient prescribing information

Lack of understanding

Failure to remember to administer the drug

Fear of side effects

Inconvenient dosage forms/dosing schedules

Palatability of dosage forms

33
Q

What is the current rule that is in effect for pediatric drug testing?

A

Pediatric Final Rule/Pediatric Research Equity Act

Manufacturer- if you have a drug that has any possible use in pediatric patients you will submit data with your NDA

34
Q

At what age is a childs GFR up to an adult rate?

A

About 6 months old

Pharmacology Quiz 2 (4 decks)

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