Peds Flashcards
What are PREGB category drugs?
no problem in animals, not tested in humans
acetaminophen B- analgesic antipyreitc
OD serious fetal mother, liver failure
oxycodone B
Fetal addiction
ceftriaxone B
20x dose in animals was stll ok
lidocaine B
cross PBB
Do typical results of a clinical trial reference age <18? ,
notice age ranges, no children NO ideal drug formulations Incomplete RX Dose calculation errors immune response diff from adults, ADR unanticipated
How do we ensure Compliance with pediatric dosing
requires special attention training- use of plastic syringes for oral (po) dosing
follow complete dosing
Are spaces and periods BEXT practice for writing RX?
YES
use zeros before
NEVER abbreviate units or drug name
EBM- 43% of RX to children were errors, broncho benzo, opioids
Where is the most reliable dosage info?
1st LIne Podiatric dose calculation
Age (Young’s rule)
Weight (Clark’s rule)
Body surface area
Product insert- but rare liability
PDR 2nd line
Tarascon Pocket Pharmacopeia
Codeine-do not use iv in children due to large histamine release
what is Lamotrigine ADRs in pediatric vs adult patients?
anticonvulsant drug.
ADR***life-threatening dermatitis
childre 1-2%
What are PREG A drugs?
no evidence of harm
levothyroxine,
liothyronine,
folic acid
What are PREG D?
oxazepam D IBUPROFEN . D pre-op sedative growth retardation lisinopril, losartan, alprazolam, clonazepam, lorazepam
What PRED C drugs?
EBM of animal fetus damage aspirin C Bleeding in fetus codeine C opioid W/D pain,
What drugs NEVER give a PREG?
atorvastatin, simvastatin, warfarin, methotrexate, finasteride (inhibits testosterone activation)
What are pharmocology defenition of aes
Infant
1 month to 1 year
Child
1 – 12 years
Adolescent
13- 18 years
Adult
> 18 years
Types of pediatric dosage forms
suspension (phenytoin) - undissovled needs shaking
HOspital train parents
elixir is a drug dissolved in ethanol and ***never used in children
What is more potent cortisone or dexamethosone?
DEXA-.75 vs 25mg cortisone ALLERGY & IMMUNOLOGY: prednisone diphenhydramine methylprednisone- UNAPPROVED DOSE
cetirizine
montelukast
Bone growth retardation
CNS-ACTING DRUGS:
acetaminophen midazolam morphine fentanyl ondansetron
INFECTIOUS DISEASES:
cefazolin ampicillin gentamicin amoxicillin clindamycin- ADR-c.diff, anaerobes, G+
What is black box warning for SSRI and fluroquninon
SSRI- sucide
FQ- tendon rupture, overused uneccessary
NO APPROVED <18
What drug is local anestheic, never used topically or IV?
BUPIVACAINE
ADR CV risk
What should not be mixed with asprin? WhY
possible additive effects on platelets.
Antipyretic, anti-inflammatory and analgesic.
Non-selective COX enzyme inhibitor,
Available PO, IV, topical creams and gels.
Chronic -hyperkalemia and renal failure.
What is not FDA approved for children?
TERbinafine
Indomethacin
Colchincine
Companies use drugs off label bc RX manufacture have less money to use drug for legal multiple dz. What are requirements
LEGAL BUT
inc. ADR risk
injury no malpractice
1- well-informed use based on FDA product insert
- based on sound evidence based medicine. Peer-reviewed article should be kept on file vs. a placebo.
- Patient response, use and efficacy must be kept in the patient chart.
- Patient must be informed written consent. A pre-printed form with information as to off-label use is sufficient.
What is ILLEGAL regarding drugs?
DRUG rep. stating it can be used for another condition w/ trials
GABAPENTIN- peripheral neuropathy
What was used for HTN, but men were growing hair?
Minoxidil Rogaine
What was used or stomach acid but now wart removal?
Cimetidine
