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Pediatrics > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Variables Affecting GI Absorption

A 
pH
Gastric emptying time
GI motility
Pancreatic enzyme activity
GI surface area
Intestinal microorganisms
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2
Q

pH and GI Absorption

A

More alkaline than adults
Decrease absorption of weakly acidic drugs
Increase absorption of weakly basic drugs

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3
Q

Gastric Emptying Time/GI Motility and GI Absorption

A

Slower than adults

Irregular peristalsis

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4
Q

Pancreatic Enzyme Activity and GI Absorption

A

Decreased for first year of life

Affects drugs that are fat soluble

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5
Q

GI Surface Area and GI Absorption

A

Intestinal size vs. body size

Enhances drug absorption

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6
Q

GI Microorganisms and GI Absorption

A

Intestinal flora depends on diet
More rapid development of flora in breast fed infants
Flora active in breakdown of drugs

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7
Q

Rectal Absorption and GI Absorption

A

Cannot tolerate oral drugs/lack IV access
Absorbed by hemorrhoidal veins
Erratically & incompletely absorbed

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8
Q

IM Absorption Affected by:

A

Muscle mass
Blood flow to muscle
Tone
Activity

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9
Q

IM Absorption in Neonates

A

Decreased muscle mass
Decreased blood flow
Erractic/poor drug absorption

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10
Q

IM Absorption in Infants

A

Greater density of skeletal muscle capillaries

Efficient absorption

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11
Q

Percutaneous Absorption Affected by:

A

Thickness of skin

Body surface area to body mass

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12
Q

Thin Skin + Increased Body Surface Area =

A

Significant percutaneous drug absorption

Watch for toxicity

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13
Q

Factors Affecting Distribution in Pediatric Patients

A 
Vascular perfusion
Body composition
Tissue binding characteristics
Physiochemical properties of the drug
Plasma protein binding
Route of administration
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14
Q

Vascular Perfusion in Distribution

A

Changes in perfusion common

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15
Q

Body Composition in Distribution

A

Higher body water & ECF the larger the volume of distribution
Some drugs need larger doses/kg

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16
Q

Tissue Binding Characteristics in Distribution

A

Drugs bound to tissues exhibit increased free blood levels when the mass of tissues i reduced

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17
Q

Physiochemical Properties in Distribution

A

Lipid solubility

Molecular configuration

18
Q

Plasma Protein Binding in Distribution

A

Decreased alpha1-acid glycoprotein
Decreased albumin
Increased plasma levels of drugs
Larger volume of distribution in neonates

19
Q

Routes of Administration

A

Orally
IV
IM

20
Q

Oral Route of Administration

A

Liver primary distribution site
Hepatic first pass metabolism
Oral doses higher than IV doses

21
Q

IV Route of Administration

A

Heart and lungs primary method of distribution

22
Q

Increased Volume of Distribution of Protein Binding Drugs

A

Theophylline
Ampicillin
Phenobarbital
Phenytoin

23
Q

Increased Uptake and Volume of Distribution of Tissue Uptake

A

Morphine
Fentanyl
Digoxin

24
Q

What is delayed in neonates, infants, and young children?

A

Drug metabolism

Plasma clearance of drugs

25
Q

GFR of Neonates Compared to Adults

A

Decreased until age 2

26
Q

Decreased GFR Leads to:

A

Decreased tubular secretion & reabsorption rates

Proximal tubule decreased ability to concentrate urine

27
Q

What are some common overdoses in children?

A

Iron supplements

Acetaminophen

28
Q

GI and IM Absorption in Pediatric Patients

A

Infants & children absorb medications more rapidly & completely
Younger the human, more permeable the skin
Readily eliminate meds that are cleared renally

29
Q

Drugs to Avoid in Pediatric Patients

A

Propylene glycol

Benzyl alcohol

30
Q

Factors Affecting Pediatric Therapy

A

Liver disease
Renal disease
Cystic Fibrosis
GI disorders

31
Q

Liver & Renal Disease Factors

A

Avoid hepatotoxic drugs

Avoid nephrotoxic drugs

32
Q

Patients with Cystic Fibrosis Require Increased Amounts & Increased Clearance of These Drugs

A

Aminoglycosides
Penicillins
Theophylline

33
Q

GI Disorders that may Require Dosage Adjustments

A

Celiac disease
Gastroenteritis
Severe malabsorption

34
Q

How is Antibiotic Dosing Done in Pediatrics?

A

mg/kg format

35
Q

Equation to determine amount of mL

A

(Desired dose x volume of suspension) / concentration

36
Q

Tylenol Dosing

A

10-15 mg/kg q 4-6 hours

37
Q

Ibuprofen Dosing

A

5-10 mg/kg per dose q6 hours

38
Q

Two Major Drug Classes to NOT Use in a Pediatric Population

A

Fluoroquinolone’s

Tetracycline’s

39
Q

Why can you not use fluoroquinolone’s in a pediatric population?

A

Not studied in children

40
Q

Why can you not use tetracycline’s in a pediatric population?

A

Black teeth

Osteomyelitis

Pediatrics (23 decks)

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