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Pediatrics > Pharm > Flashcards

Pharm Flashcards

1
Q

What acne cream do you not want to give PG women?

A

Isotretinoin (accutane!)

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2
Q

What don’t you want to give a febrile child?

A

ASA

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3
Q

Why don’t you want to give kids ASA?

A

Reyes syndrome! (fatty liver, encephalopathy)

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4
Q

What should you give to help a child who has a fever?

A

acetaminophen

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5
Q

What can you give for teething pain?

A

benzocaine gel or ibuprofen

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6
Q

What do you not want to give?

A

lidocaine, alcohol

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7
Q

What do you rx for bacterial pharyngitis?

A

ampicillin

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8
Q

What do you give a child with AOM with 5% local resistance to S. pneumoniae?

A

amoxicillin

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9
Q

What do you give 17 yo for depression?

A

SSRI (fluoextine)

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10
Q

What is the black box warning of SSRIs?

A

increased suicidality (esp. under 24yo)

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11
Q

What do antipsychotics do more in adolesctents?

A

More extrapyrimadal effects, esp. tardive dyskinesia

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12
Q

What do you give a 2yo with bilateral AOM who has not responded to amoxicillin?

A

Augmentin

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13
Q

What anti-htn med is safe for PG women?

A

HCTZ

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14
Q

What class of anti-htn meds do you want to avoid?

A

ACEI, ARBs

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15
Q

What do you prescribe for absence seizures?

A

ethosuximide

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16
Q

What do you not want to use for measureing medications in children?

A

teaspoon/tablespoon

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17
Q

What is a more accurate way to measure medications for children?

A

syringe

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18
Q

How is the metabolism of anti-seizure meds different in children than adults?

A

Children metabolize anti-seizure drugs faster

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19
Q

What age can you start giving nebulizer?

A

3yo

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20
Q

What age can you start giving MDI?

A

5yo

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21
Q

What do you have to be careful of when giving a medication rectally?

A

variable absorption (the further in, the more absorption)

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22
Q

What route of admin do you want to avoid in children?

A

IM (not well tolerated, variable muscle mass, variable flow to muscle)

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23
Q

What do you give for a fungal diaper rash?

A

clotrimazole

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24
Q

What do you not give for a fungal diaper rash due to resistance?

A

nystatin

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25
Q

What do you give for protection/barrier from diaper rash?

A

zinc oxide

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26
Q

What medication is super poisonous to children?

A

Benzonatate (coma, convulsions, cardiac arrest)

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27
Q

Why do you have to be careful with opioids and children?

A

They cross BBB more quickly in kids, can cause respiratory distress more easily

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28
Q

What diet is outdated for children with diarrhea?

A

BRAT diet (just eat regular diet instead)

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29
Q

How much of an increased risk is a child at for having another seizure after having their first febrile seizure?

A

30 percent increase

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30
Q

What else do adolescents experience more with antispychotics?

A

increased weight gain

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31
Q

What do you prescribe for sinusitis?

A

amoxicillin

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32
Q

What is Clark’s rule?

A

use body weight to calculate dosage

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33
Q

What is the problem with Clarks rule

A

slightly under doses, outdated

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34
Q

What is the most accurate way to calculate dosing in children?

A

BSA (usually only used for chemo drugs?)

35
Q

What do you rx for cellulitis?

A

cephalexin

36
Q

10yo with complex focal seizures not controlled by valproic acid. What do you do?

A

add lamictal (lamotrigine)

37
Q

What do you give a child with asthma exacerbation for rapid control of sxs?

A

dexamathasone

38
Q

What is an elixir?

A

liquid medication that has alcohol

39
Q

What do you have to be careful about with elixirs?

A

If not stored correctly, may evaporate

40
Q

What is unique about research studies in terms of ped pharm?

A

Not a lot of research studies

41
Q

What percent of drugs are not FDA approved for children? What percent of drugs are missing dosing efficacy and safety in children?

A
  1. 60 percent not approved by FDA

2. 75 percent missing efficacy

42
Q

What is not regulated by FDA?

A

CAM (complementary alternative medications)

43
Q

What changes were made recently to OTC drugs?

A

Changed from “not for use for under 4yo” to “not for use for under 2yo”

44
Q

How do you avoid decimals in children dosing?

A

round UP (no more than 10 percent of total dose)

45
Q

What is a suspension?

A

undissolved particles of drug suspended in solution

46
Q

What do you need to do with a suspension before distribution?

A

SHAKE IT!

47
Q

What suspending agent for chweable tablets do you not want to use in children under 1yo?

A

honey! (clostriudium botulinum)

48
Q

When can kids start using capsules/tablets?

A

6yo

49
Q

What percent of dosing errors are made in kids?

A

70

50
Q

What part of SMP/TMP do you want to calculate the dose for?

A

TMP component

51
Q

What part of amox/clavunate so you want to calculate the dose for?

A

amoxicillin

52
Q

What are crucial measurements that need to be accurate for dosing in children?

A

height, weight

53
Q

What OTC drugs cause poisoning in children frequently?

A

cough and cold medicines

54
Q

Other than benzonotate, what else can be poisonous in children?

A

elemental iron

55
Q

What is youngs rule?

A

using age to calculate dose

56
Q

How is absorption different in neonates?

A

higher gastric ph, irregular peristalsis, decreased pancreatic enzymes, bile acids alter absorption

57
Q

How does diarrhea in children alter absorption?

A

decreases absorption

58
Q

How is topical absorption different in neonate/children?

A

topical absorption is higher in neonate/infants

59
Q

How is body water different in infants?

A

adults are 50-60 percent water

full term infants are 70-75

pre term infants are 85

60
Q

How does having more body water affect distribution?

A

Impacts water soluble drugs (does not impact lipid-soluble drugs)

61
Q

How does having low body fat in infants affect drug distribution?

A

drugs w/lipid affinity will have more free drug

62
Q

What is different about serum proteins in infants?

A

less bound to albumin in infants (adult albumin level at 1yo)

63
Q

What is different in neonates in regards to their metabolism?

A

Less P450 activity (phase 1 reactions impaired)

64
Q

What is different about hepatic metabolism in neonates?

A

2x the adult rate @6 months, lasting until 9-12yo (anticonvulsants)

65
Q

If a mother is taking phenobarbitol, how would that affect the baby?

A

phenobarbital induces hepatic enzymes, the child may have increased rates early after delivery

66
Q

How do golumerular filtration rates compare in adults vs infants?

A

Infants reach adults rates by 6-12 months old

67
Q

At what age can you start using the Cockroft-Gault equation?

A

18yo

68
Q

What equation do you use to calculate childrens CrCl?

A

schwartz equation

69
Q

What effect does having a less effective BBB have in young children?

A
  1. greater opioid impact

2. bilirubin passes through

70
Q

What affect does having variable rates of development of receptors in various tissues have on children?

A

They have less B-Receptors until 8yo, so B-agonists affected

-also increased dystonic reactions to metoclopramide

71
Q

How do you treat otitis externa?

A
  1. otic suspensions (are acidic to replicate ear canal– will be PAINFUL if vent tubes or perforation present)
  2. If vent tubes/perf use ophthalamic suspensions because they have a balanced pH and are more viscous
72
Q

Why is benzocaine preferable to lidocaine?

A
  • preferable for topical mucosal admin

- it is poorly soluble in water and very slowly absorbed so doesn’t reach toxic levels as early as lidocaine

73
Q

What do you have to be careful with when it comes to fluoroquinolones?

A

joint space crystallization

74
Q

What are examples of fluoroquinolones?

A

ciprofloxacin, levofloxacin, moxifloxacin

75
Q

What should not be used for repeated application in children due to rapid absorption and potential toxicity?

A

lidocaine

76
Q

What are macrolide abx?

A

erythromycin, clarithrymycin, azithromyin

77
Q

What are erythromycin and clrithromycin metabolized/excreted?

A

primarily hepatic concentration/metabolism

biliary excretion

78
Q

What effects do clarithro and erythro have?

A

P450 interactions, nausea, increased gastric motility

79
Q

What is azithromycin metabolized/excreted?

A

tissue and macrophage concentration, minimal hepatic metabolism

excreted via bile

80
Q

What do you give for generalized motor seizure in children?

A

phenobarbitol

81
Q

What class of abx do you want to avoid in PG ladies and kids under 8yo?

A

tetracyclines

82
Q

What is a SE of tetracyclines

A

dental staining

83
Q

What is a Vit A analogue?

A

itsotretinoin (accutane)

84
Q

How many forms of BC do you need when on accutaine?

A

2

Pediatrics (3 decks)

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