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Peds Flashcards

1
Q

Premature neonate age?

A

Born at <36 was gestational age

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2
Q

Term neonate age?

A

Born at >36 was gestational age

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3
Q

Neonate age?

A

Birth to 1 month

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4
Q

Infant age?

A

I month to 1 yr

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5
Q

Child age?

A

1 to 11 yrs

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6
Q

Adolescent age?

A

12-16 yrs

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7
Q

Acidity in first 2-3 yrs?

A

Less

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8
Q

Gastric emptying in neonates compared to infants?

A

Slower in neonates

Increase in infants

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9
Q

Stratum corneum in preterm neonates?

A

Underdeveloped

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10
Q

Transdermal absorption compared to adults in peds?

A

Faster

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11
Q

IM absorption compared to adults in peds?

A

Less or erratic

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12
Q

Inhalation onset compared to adults in peds?

A

More rapid

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13
Q

Percent of BW is water in premature infant?

A

85%

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14
Q

When do peds come close to adult body water competition (55-60%)?

A

1 yr but ECF to ICF is nearly equal

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15
Q

Volume of distribution of water soluble drugs in peds?

A

Higher Vd

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16
Q

Dosing requirements for drugs such a NMBs in peds?

A

Higher

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17
Q

Duration of action of lipid soluble drugs like propofol and fent?

A

Longer (less redistribution effect)

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18
Q

What drug types can displace bilirubin in neonates and cause CNS adverse effects?

A

Highly protein drugs

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19
Q

Reduced metabolism of some agents include (3):

A

Benzodiazepines, barbiturates, amide local anesthetics

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20
Q

What kind of clearance of morphine in neonate to 6 months?

A

Reduced

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21
Q

GFR status in neonates?

A

Underdeveloped

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22
Q

Does peds elimination often impact antibiotic dosing?

A

Yes

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23
Q

Nicotine can cholinergic receptors is what kind of channel and when is it that form?

A

Ligand gated ion channel

Felt and adult

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24
Q

Fetal receptors have what kind of response to depolarizing agent and non depolarizing agent?

A

Enhanced to depolarizing

Relative resistance to non depolarizing

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25
Stroke volume is what in neonates and infants?
Fixed because immature, non compliant L ventricle
26
CO is most sensitive to changes in what?
HR
27
Normal HR at neonate?
140 bpm
28
Normal HR for 1 yr?
120
29
Normal HR for 3 yr
100
30
Normal HR for 12 yrs
80
31
Sympathetic nervous system in infants?
Immature so don’t get baroreceptor reflex response in hypotension (less compensatory vasoconstriction) and blunted response to exogenous catecholamines
32
IV volume depletion in neonates and infants may present as what?
Hypotension without tachycardia
33
What do you need to know for Schwartz equation to estimate peds CrCl? (2)
1. Length or height | 2. Serum creatinine
34
When is the most danger of overdosing or toxicity in pts age?
<1 yrs due to immaturity of organs and enzyme systems
35
6 goals for premedication?
1. Minimal sedation to allay anxiety and facilitate induction 2. Block autonomic (vagal) reflexes 3. Reduce airway secretions 4. Produce amnesia 5. Provide prophylaxis against aspiration of gastric contents 6. Provide analgesia
36
Sux dosing for <1 yr and >1 yr?
<1 yr: 2-3mg/kg | >1yr: 1-2mg/kg
37
IM dosing of sux for infant and child?
Infant: 5mg/kg Child: 4mg/kg
38
Larygospasm dose of sux for IV and IM?
IV: .5-1mg/kg IM: 3-5mg/kg
39
Sux adverse effect?
Bradycardia
40
More susceptible depolarizing agent (4)
1. Severe hyperkalemia 2. Rhabdomyolysis 3. Masseter muscle spasm 4. MH
41
When is Sux mostly used? (3)
1. Emergency intubation 2. Rapid sequence intubation for full stomach 3. Laryngospasm unresponsive to positive pressure ventilation
42
3 overall ped differences compared to adults?
1. Neonate differences include immature NMJ 2. Increase ECF 3. Less hepatic metabolism may prolong duration of action
43
Nondepolarizing agents need higher dosing in who and why?
Neonate > infant > adult | Due to increase ECF
44
MOA of ketamine?
NMDA
45
Monitoring and potential adverse effects of dexmedetomidine (2)?
Bradycardia | Hypotension
46
Advantage of propofol (2)?
Reduces PONV and emergence delirium
47
How much propofol should be used?
More the younger pt is
48
Opioids are what in neonates than older children and adults?
More potent and can have rigid chest effect
49
Should you use morphine in neonates?
NO
50
Why beware of ambient temp IV fluids in peds?
Due to increased risk for hypothermia
51
Maintenance glucose requirements for newborns to 8yrs is what?
6 mg/kg/min
52
Maintenance glucose requirements for premature neonates is what?
6-8 mg/kg/min
53
Water loss is a function of what?
Caloric expenditure
54
Approximating IV fluid requirements is based on what?
Holliday-segar nomogram
55
Maintenance fluid should include what for peds and neonates?
Peds: dext 5%/.45 NS with 20 mEq KCL Neonates: dext5%/.25% NS (limited ability to manage Na load)
56
Estimate deficit based on what?
421 rule x time
57
Dehydrated infants will become hypotensive without what?
Tachycardia
58
Replace with what if kidneys unable to handle the Na load? (2)
1. LR | 2. .45 NS
59
What to avoid if kidneys are unable to handle the Na load?
.9% NS
60
POV rarely occurs in children of what age? (2)
< 3yrs | Puberty
61
Risk factors of POV for types of procedure? (4)
Strabismus ** Adenotonsillectomy Inguinal scrotal Penile procedures
62
Main 4 risk factors for PONV for children?
Surgery >30min Age >3hrs Strabismus surgery History of POV or family history of PONV
63
Which antiemetic drug is FDA black box warning?
Droperidol
64
Most commonly involved agents for periop anaphylaxis? (3)
NMB agents Latex (30-60min into procedure) Antibiotics
65
7 things to manage periop anaphylaxis:
``` O2 Epi Fluid bolus Phenylephrine Hydrocortisone Diphenhydramine Ranitidine ```

Pharm 3 (me) (7 decks)

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