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Therapeutics IV > Peds GI > Flashcards

Peds GI Flashcards

1
Q

Age of a neonate?

A

0-28 days (Plus days premature if premie)

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2
Q

Age of an infant?

A

1 to 12 months

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3
Q

Age of a child?

A

1 to 12 years

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4
Q

1 oz = __mL

A

30mL

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5
Q

How to measure doses?

A

Syringes - not tablespoon/teaspoon

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6
Q

Estimating renal function in a child

A 
Schwartz Equation:
0.413 * (ht in cm/SCr)
or
Urine output
>1mL/kg/hr
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7
Q

GER v. GERD

A

GERD is pathological - GER is normal reflux

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8
Q

Regurgitation v. vomiting

A

Regurgitation is no effort

Vomiting is effort

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9
Q

When does GER peak?

A

4 months

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10
Q

What are GERD risk factors?

A 
Genetic predisposition
Esophageal atresia
Obesity
Prematurity
Neurological impairment
Lung disease (CF)
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11
Q

GER is caused by ______ of _____

A

relaxation of lower esophageal sphincter (LES)

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12
Q

GI Symptoms of GERD in infants

A

Regurgitation
Feeding difficults
Hematemesis

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13
Q

Extra-intestinal symptoms of GERD in infants

A

Failure to thrive
Wheezing/Stridor/Cough/Apnea
Irritability
Back arching

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14
Q

GI symptoms of GERD in kiddos

A 
Hearturn
feeding difficulties
Hematemessis
Vomiting
Regurgitation
Dysphagia
Chest pain
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15
Q

Extra-intestinal symptoms of GERD in kiddos

A 
Cough/wheezing/stridor
Asthma
Recurrent pneumonia
Dental erosions
Anemia
Laryngitis
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16
Q

When to refer for infants

A 
Bile/projectile vomiting
GI bleeding/vomiting blood
Failure to thrive
Emesis begins after 6 months old
Difficulty swallowing
Fever
Diarrhea/constipation
Lethargy
Hepatosplenomegaly
17
Q

Non-pharma GERD treatment in kiddos

A

Feeding changes - thicker, higher caloric density, hypoallergenic, transpyloric (feeding tube)
Positoning - supine position
Lifestyle - diet, weight, smoke/alcohol

18
Q

Pharma GERD treatment in kiddos

A

H2RAs
PPIs
Prokinetics (2nd line)
Antacids (older patients)

19
Q

How long to trial GERD therapy before reassessing?

A

8-12 weeks

20
Q

2 main H2RAs?

A

ranitidine

famotidine

21
Q

Ranitidine pediatric dose for GERD

A

PO: 4-8mg/kg/day divided BID

max 300

22
Q

Famotidine pediatric dose for GERD

A

PO: 1mg/kg/day BID

max 40

23
Q

Do H2RAs or PPIs cause tachyphylaxis?

A

H2RAs

24
Q

Most peds data on PPIs for which PPIs?

A

Omeprazole

Lansoprazole

25
Q

DFs of lansopraole?

A

PO, ODT, suspension

26
Q

DFs of omeprazole, pantoprazole, esomeprazole, rabeprozole?

A

Granules (and pO)

27
Q

Peds dosing of lansoprazole and omeprazole?

A

1mg/kg/day (not to exceed adult max doses)

28
Q

Risks of chronic use of acid suppressants?

A

Increased fractures
Gastric tumors
Increased pneumonia risk
Altered gastric flora

29
Q

Prokinetic agents for kiddos

A

Metoclopramide

Erythromycin

30
Q

Metoclopramide AEs

A

Neurologic, tardive dyskinesia, lactation/gynecomastia (neonates)

31
Q

Erythromycin ADEs

A 
Pyloric stenosis
QT prolongation (arrhythmias)
Drug interactions
32
Q

QT Prolonging medications

A 
Antipsychotics (haloperidol)
Fluoroquinolones
Macrolides
azoles
methadone
Ondansetron
antiarrhythmics (sotolol, dofetilide)

Therapeutics IV (5 decks)

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