Pharm

Question 1

What percentage of drugs are not FDA approved for children?

Answer 1

60 percent

Question 2

We often round doses up to avoid decimals. What is the limit we can round up?

Answer 2

10% of dose

Question 3

What is our best option for a measuring device?

Answer 3

Syringe

Avoid using measuring cups and teaspoons – too much variation.

Question 4

What would administering medications IM in children be a bad idea?

Answer 4

1. Not well tolerated
2. Variable muscle mass in infants and young children
3. Variable blood flow to muscle, SQ tissue

Question 5

What do we call drugs that are dissolved and even distributed in alcohol?

Answer 5

Elixirs

Question 6

What can’t we give honey in infants

Answer 6

Clostridium botulism

Question 7

Because honey is a bad idea to use as a suspending agent, what are some other good options?

Answer 7

Apple sauce, pudding, chocolate syrup

Question 8

Tell me about the first pass effect when administering drugs rectally?

Answer 8

First past effect depends on location in rectum

Question 9

At what age can we start using metered dose inhalers?

Answer 9

5!

Use nebulizers before age 5

Question 10

What percentage of dosing errors occur in children?

Answer 10

70 percent

Question 11

When prescribing SMX/TMP, what component of the drug do we dose off of?

Answer 11

TMP

Question 12

When prescribing Amoxicillin/Clavulanate, what component of the drug of do we dose off of?

Answer 12

Amoxicillin

Question 13

What drug did we talk about that can cause coma, convulsions, cardiac arrest in children?

Answer 13

Benzonatate

Question 14

Rank the following from most accurate to least accurate for dosing medication in children.

1. Weight dosing
2. Age dosing
3. Body surface area dosing

Answer 14

1. Body surface area dosing
2. Weight dosing
3. Age dosing

Question 15

Topical absorption is higher in this population

Answer 15

Neonates/infants

Question 16

GI tract in neonates…

They have low or high gastric pH?

Regular or irregular peristalsis?

High or low levels of pancreatic enzymes?

Answer 16

High gastric pH

Irregular peristalsis

Low levels of pancreatic enzymes

Question 17

What percentage of body weight is water in a full term infant?

Answer 17

70-75%

Question 18

Neonates have more or less P450 activity than adults?

Answer 18

Less, 50-70% of adult levels

Question 19

At what age do babies have the same glomerular filtration rates as adults?

Answer 19

6-12 months

Question 20

What do toddlers metabolism and renal elimination rates look like?

Answer 20

Rapid!

Question 21

Is the blood brain barrier more or less effective in neonates and young children?

Answer 21

Less

Question 22

At what age do children have adult levels of alveoli?

Answer 22

Eight

Infants only have 10-15% of adult number

Question 23

What OTC drug interacts with SSRI’s to increase 5HT levels, decrease effect of anticonvulsants, warfarin, digoxin, and protease inhibitors?

Answer 23

St John’s Wort

Question 24

Whats the problem with using Lidocaine to relieve teething pain?

Answer 24

Systemically absorbed

Question 25

What medication should we use for teething pain?

Answer 25

Benzocaine gel without alcohol

Question 26

What drug should we use for diaper rash?

Answer 26

Zinc oxide cream

Question 27

What's the issue with using Nystatin for diaper rash?

Answer 27

Resistance issues

Question 28

When a child has mild diarrhea, do we recommend a regular diet or the BRAT diet?

Answer 28

Regular

Question 29

What's the difference between otic and ophthalmic suspensions?

Answer 29

Otic have an acid pH to replicate a normal ear environment -- this can be painful if a patient has a perforation or vent tubes Ophthalmic suspensions are more viscous and a neutral pH

Question 30

What drugs increase impulsivity, silliness, daring conduct, and agitation in adolescents?

Answer 30

SSRI's

Question 31

Children and adolescents are more susceptible to extrapyramidal symptoms, especially dystonias, and weight gain when taking this medication.

Answer 31

Antipsychotics

Question 32

Why is benzocaine better than lidocaine?

Answer 32

Benzocaine is poorly absorbed in water and is very slowly absorbed -- don't get toxic levels as easy as lidocaine.

Question 33

What drugs can cause joint space crystallization in children?

Answer 33

Fluoroquinolones

Question 34

Does alternating tylenol and ibuprofen work for reducing fevers?

Answer 34

NO.

Question 35

What medication can cause generalized motor seizures in infants?

Answer 35

Phenobarbitol

Question 36

What do we need to avoid Tetracyclines in pregnancy and in children

Answer 36

Dental staining

Question 37

Is Isotretinoin bad for babies?

Answer 37

Like really bad -- increases risk of malformed fetus 25 times