Peds

Question 1

What are PREGB category drugs?

Answer 1

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

Question 2

Do typical results of a clinical trial reference age <18? ,

Answer 2

notice age ranges, no children
NO ideal drug formulations
Incomplete RX
Dose calculation errors
immune response diff from adults, ADR unanticipated

Question 3

How do we ensure Compliance with pediatric dosing

Answer 3

requires special attention training- use of plastic syringes for oral (po) dosing
follow complete dosing

Question 4

Are spaces and periods BEXT practice for writing RX?

Answer 4

YES
use zeros before
NEVER abbreviate units or drug name
EBM- 43% of RX to children were errors, broncho benzo, opioids

Question 5

Where is the most reliable dosage info?

Answer 5

1st LIne Podiatric dose calculation
Age (Young’s rule)
Weight (Clark’s rule)
Body surface area

Product insert- but rare liability

PDR 2nd line

Question 6

Tarascon Pocket Pharmacopeia

Answer 6

Codeine-do not use iv in children due to large histamine release

Question 7

what is Lamotrigine ADRs in pediatric vs adult patients?

Answer 7

anticonvulsant drug.
ADR***life-threatening dermatitis
childre 1-2%

Question 8

What are PREG A drugs?

Answer 8

no evidence of harm
levothyroxine,
liothyronine,
folic acid

Question 9

What are PREG D?

Answer 9

oxazepam		D
IBUPROFEN .         D
pre-op sedative
growth retardation
lisinopril, losartan, alprazolam, clonazepam, lorazepam

Question 10

What PRED C drugs?

Answer 10

EBM of animal fetus damage
aspirin			C
Bleeding in fetus
codeine		C
opioid W/D pain,

Question 11

What drugs NEVER give a PREG?

Answer 11

atorvastatin,
simvastatin, 
warfarin, 
methotrexate, 
finasteride (inhibits testosterone activation)

Question 12

What are pharmocology defenition of aes

Answer 12

Infant
1 month to 1 year

Child
1 – 12 years

Adolescent
13- 18 years

Adult
> 18 years

Question 13

Types of pediatric dosage forms

Answer 13

suspension (phenytoin) - undissovled needs shaking
HOspital train parents

elixir is a drug dissolved in ethanol and ***never used in children

Question 14

What is more potent cortisone or dexamethosone?

Answer 14

DEXA-.75 vs 25mg cortisone
ALLERGY & IMMUNOLOGY:
prednisone
diphenhydramine
methylprednisone- UNAPPROVED DOSE

cetirizine
montelukast

Bone growth retardation

Question 15

CNS-ACTING DRUGS:

Answer 15

acetaminophen
midazolam
morphine
fentanyl
ondansetron

Question 16

INFECTIOUS DISEASES:

Answer 16

cefazolin
ampicillin
gentamicin
amoxicillin
clindamycin- ADR-c.diff, anaerobes, G+

Question 17

What is black box warning for SSRI and fluroquninon

Answer 17

SSRI- sucide
FQ- tendon rupture, overused uneccessary
NO APPROVED <18

Question 18

What drug is local anestheic, never used topically or IV?

Answer 18

BUPIVACAINE

ADR CV risk

Question 19

What should not be mixed with asprin? WhY

Answer 19

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.

Question 20

What is not FDA approved for children?

Answer 20

TERbinafine
Indomethacin
Colchincine

Question 21

Companies use drugs off label bc RX manufacture have less money to use drug for legal multiple dz. What are requirements

Answer 21

LEGAL BUT
inc. ADR risk
injury no malpractice
1- well-informed use based on FDA product insert

2. based on sound evidence based medicine. Peer-reviewed article should be kept on file vs. a placebo.
3. Patient response, use and efficacy must be kept in the patient chart.
4. Patient must be informed written consent. A pre-printed form with information as to off-label use is sufficient.

Question 22

What is ILLEGAL regarding drugs?

Answer 22

DRUG rep. stating it can be used for another condition w/ trials
GABAPENTIN- peripheral neuropathy

Question 23

What was used for HTN, but men were growing hair?

Answer 23

Minoxidil Rogaine

Question 24

What was used or stomach acid but now wart removal?

Answer 24

Cimetidine

Question 25

What is topical Nsaid for ACtnic Keratosis is not used for foot pain?

Answer 25

Diclofenac