Pharmacology

Question 1

Kg to Lbs conversion

Answer 1

1kg = 2.2lbs

Question 2

PK and PD are necessary in order to

Answer 2

Determine the behavior of the drug to find the appropriate dose and predict what to expect in certain age groups. Determined through bioavailability/absorption, volume of distribution, metabolism, elimination, clearance of drugs. Liver and kidneys are immature, metabolizes differently than adults

Question 3

Bioavailability

Answer 3

Extent the drug is absorbed once it enters the body. Influenced by the rate of absorption. Listed as a percent, oral meds are not 100 percent absorbed due to gastric acid being acidic and the stomach pH. Liquid absorbed diff than solids. Food changes, take it w a bottle? Empty stomach?

Question 4

Drug absorption

Answer 4

Translocation of the drug from its site of administration to the blood stream. Stomach pH is 1/2 normal by 6mo, takes 1 year to be the same as an adult. PO meds are made a higher dose because of this.

Question 5

Fat soluble meds not well absorbed because of

Answer 5

immature amylase and lipase from an immature liver

Question 6

Rectal meds ok when

Answer 6

cant do any other route, good if seizing or N/V but immature GI system, no control of rectal sphincter can expel it, erratic large intestine absorption – not recommended – avoid in neonates

Question 7

IM route

Answer 7

decrease muscle mass and decreased muscle activity can cause erratic muscle absorption. Adults use muscles more than kids so they absorb better, kid are slower

Question 8

Intraosseous Route

Answer 8

Used in pediatric emergencies when IV cant be accessed. in the leg during circulatory failure through long bone marrow quick absorption w rich vascular bed/noncollapsable/low fat. As quick as IV Route. Any IV med can be given at same dosage as adult even IV fluids

Question 9

Absorption skin

Answer 9

Skin is 13% of infants body weight compared to 3% of adults. More at risk for toxic concentration, thin skin immature epidermis more drug is being absorbed. Have more fat cells than adults who have more muscle cells.

Question 10

Lidocaines, EMLA, silvadene burn creams can lead to

Answer 10

arrhythmias

Question 11

Drug distribution

Answer 11

Movement of drug from the systemic circulation to areas of the body. Depends on age dependent factors – 45 extracellular 35intracellular compared to adults 15 extracellular so need higher dose of water soluble. Protein binding capacity, body compartment size, cardiac output, membrane permeability

Question 12

Kernicterus

Answer 12

Med absorption can displace billirubin leading to the billi going to the brain causing this, excess billi in blood, yellow skin, jaundice, backs up into brain tissue causing mental delays

Question 13

Metabolism

Answer 13

liver is the primary site of metabolism, superfamily called cytochrome P450 account for 75% metabolism in the liver. drugs can inhibit the CYP enzyme or induce the biosynthesis

Question 14

Elimination

Answer 14

Monitor serum cr. an increase of 0.2 to 0.4 is significant. 1st week uses moms but after 1 week GFR will increase. Goes from 40 to 12 or 13 eventually like an adult. Monitor urine output may need to use dipsticks poor excretion of a drug –> toxicity

Question 15

Bactrim not given in what age

Question 16

Ceftriaxone causes

Answer 16

due to metabolism in liver can lead to billiary slude and gallstones

Question 17

Opiods lead to

Answer 17

resp depression

Question 18

Reglan

Answer 18

crosses blood brain barrier leads to dystonias and central nervous system toxicity that cannot be reversed - was being used to GERD in infants

Question 19

ADHD drugs

Answer 19

impede growth

Question 20

Tetracycline

Answer 20

not

Question 21

Erythromycin

Answer 21

damages teeth and stains them

Question 22

Flouroquinolones

Answer 22

Toxic to growing cartilage

Question 23

Tylenol dose

Answer 23

15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of acetaminophen of 75 mg/kg per day. Give every 4-6 hours, as needed, and not more than five times in 24 hours unless directed by a health care professional. 80mg/0.8ml infants. Children 160mg/5ml.

Question 24

Ibuprophen dose

Answer 24

50mg/1.25ml infants. Children 100mg/5ml. Give every 6-8 hours, as needed, and not more than four times in 24 hours unless directed by a health care professional. When possible, calculate ibuprofen dose based on weight using 4-10 mg/kg/dose. Give PO every 6-8 hours. Maximum single dose is 400 mg/dose, and maximum daily dose is 40 mg/kg/day up to 1200 mg/day.