Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What 3 ways we can install dilating drops in patient?

A
  1. Admnister with child’s eyes closed
  2. Spray technique
  3. Ointment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What’s the failure rate of ointments for dilation?

A

10% failure rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 3 ways do topical drugs reach systemic circulation?

A
  1. Through ocular tissues
  2. Spillage on lid and cheek (skin absorption)
  3. Nasolacrimal or Oral absorption/ingestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which type of systemic absorption is absorbed directly and there’s no first pass metabolism through liver

A

Ocular tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is skin absorption more when drugs are spilled on lid and cheek of skin?

A
  • kids have thinner & more porous skin

- Kids up to age 6 absorb drugs better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

For oral absorption, why is a risk of drug toxicity increased in children?

A
  • gastric secretion & peristalsis are reduced

- GI tract is a poor barrier to drug absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Newborns and infants may need higher doses of ______ drugs as expected from weight charts.

A

hydrophillic drugs

- have higher extracellular water compared to adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the BBB in newborns.

A

Incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Newborns younger than 6mo have less protein available which _____ drug binding.

A

decrease

-decreased drug binding increases the amount of unbound drug in the blood, causing toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the primary organ responsible for metabolism?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Children (esp. premature & neonates) have a _____ # of metabolic enzymes.

A

lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does metabolism reaches adult levels at what age?

A

3-4years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In neonates, excretion from the kidney is ____ due to what?

A

Decreased

  • renal blood flow is relative to body size
  • decreased drug elimination, more drug in blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dosing adjustments must be made for renal function for what 2 groups?

A
  • 1-2 yo

- kids with renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the top 3 things needed to determine a pediatric dose?

A
  1. Age
  2. Weight
  3. Surface Area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 ways to manage hyperacute bacterial conjunctivitis?

A
  1. gram stain, culture and sensitivies
  2. Refer to pediatrician
  3. systemic antibiotic (amoxicillin or cephalosporin)
  4. Broad spectrum topical antibiotic (besivance, polysporin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of palpebral conj response is found in hyperacute bac. conj vs. acute?

A
  • hyperacute - mixed response (pap & follicles)

- acute = papillary response only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common cause of post-neonatal conjunctivitis ?

A

Bacterial conjunctivitis (80%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 3 clinical features of bacterial conj?

A
  1. Sticky eyelids
  2. Mucous/purulent discharge
  3. Self-limiting; 8-10 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common pathogen to cause bacterial conj.?

A

H. Influenza (42%, gram negative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the peak incidence of pediatric acute conjunctivitis? What does the child usually also present with?

A
  • 1-3 years old

- otitis media (39%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most common cause of bacterial keratitis in children under 3? from 3-15yo?

A
  • Pseudomonas aeruginosa (gram -)

- Strep pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Polytrim, Sulfacetamide is good for what age?

A

2 mo. +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 3 advantages of aminoglycosides?

A
  • Active against H. Influenzae
  • Bactericidal
  • Most effective against gram negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

There’s a ___% chance of type 4 hypersensitivity reaction with Neomycin. Allergic reactions usually occur if tx lasts longer than __ week.

A

10% chance

longer than 1 week.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What 2 drugs should not be used in kids?

A
  • Chloramphenicol

- Tetracycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the difference between vigamox and moxeza?

A
  • Vigamox is for 1 year +, dosed TID

- Moxeza contains Xanthan gum, 4 mo+, dosed BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What vehicle is found in besifloxacin that enhances ocular surface duration?

A

Durasite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which generation of FQs have the least amount of resistance?

A

4th gen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 4 best treatments and dosing for acute bacterial conj. in a 2mo to 1yo?

A
  1. Polytrim - q3h
  2. Moxeza - BID
  3. Polysporin ung
  4. Tobrex ung, q3-4h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the 2 best treatments and dosing for Acute Bac. Conj. in preschool & school age children?

A
  1. Polysporin ung
  2. Besivance TID
  3. Azasite BIDx2days then QDx5days
  4. Moxeza BID
  5. Vigamox TID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the tx for MRSA?

A
  1. Vancomycin (gold standard)
  2. Polytrim
  3. Bactrim
  4. Bacitracin?
  5. Besivance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the features of blepharokeratoconjunctivitis?

A
  1. Recurrent episodes of chronic red eye
  2. watering
  3. photophobia
  4. blepharitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the symptoms of BKC?

A
  1. irritation

2. constant eye rubbing

35
Q

What are the top 3 associated ocular signs of BKC?

A
  1. Punctate keratitis (55%)
  2. Vascularization (53%)
  3. Corneal scarring (38%)
36
Q

When is the age of onset greatest in BKC? Median age?

A

Age of onset = 2-4yo

Average = 5.4 years

37
Q

BKC is more severe in what ethnic groups?

A
  1. Asian

2. Middle-Eastern

38
Q

What is the tx for BKC?

A
  1. Daily lid hygiene
  2. Warm compresses
  3. Antibiotic ung, hs
  4. Topical steroid (as needed)
39
Q

What is the key in dx neonatal conjunctivitis?

A

Onset!

40
Q

What is the onset of chemical, bacterial, gonoccal and chlamydial conjunctivitis?

A
  1. Chemical - first 24h
  2. Bac - after 24h
  3. Gon - 2-4 days
  4. Chlam - 2 wks after birth
41
Q

What is the proper workup for neonatal conj?

A
  • Conj. Scrapings for 3 slides

- Conj. Cultures

42
Q

What 3 slides do you need for conj. scrapings?

A
  • Gram stain
  • Giemsa stain
  • Chlamydial antibody test
43
Q

What cultures should be used to help dx neonatal conj?

A
  • blood and chocolate agar
  • thayer martern for gonorrhea
  • viral culture
44
Q

What is the most common cause of chemical conjunctivitis? How do you tx it?

A
  • Silver nitrate
  • No tx is necessary
  • used non-preserved ATs
45
Q

How do we tx gonococcal conj?

A
  1. Hospitalize
  2. IV Ceftriaone for 7 days
  3. Bacitracin, ung
46
Q

How do we tx chlamydial neonatal infections?

A
  1. Erythromycin syrup
  2. Erythro. ung
  3. Tx mom and sexual partners
47
Q

Poorly tx chlamydial conj. in a newborn can lead to what 2 things?

A
  1. Chlamydial pneumonia

2. Otitis media

48
Q

Neonates with suspected herpes simplex infectin should be treated with systemic ____ to reduce risk or systemic infection.

A

acyclovir, 60mg/kd/day, TID for 14 days

49
Q

What is the best treatment for VKC?

A

Antihistamine/mast cell stabilizer

50
Q

How many americans have allergies?

A

50 million

51
Q

What are the top 2 goals in allergic kids?

A
  • to stop the itching

- stop the rubbing

52
Q

What is a good first treatment for allergies?

A

Decongestant-antihistamine drops (Visine).

53
Q

Naphazoline is contraindicated in who?

A
  • low birth weight and premature infants
54
Q

Naphcon A and Vasocon A are approved for what age?

A

6 years +

55
Q

Long-termuse of decongestant antihistamine drops should not be used chronically in children bc they’ll cause what 2 SE?

A
  1. drowsiness

2. bradycardia

56
Q

Emadine is an antihistamine drop that targets what receptor?

A

H1 receptor antagonist

57
Q

What is the age and dosing of Emadine?

A

3+, QID

- good for mild allergies, not really used for allergic conj.

58
Q

What is the mainstay treatment for chronic allergies?

A

Mast Cell Stabilizers

59
Q

What is the age and dosing of Alomide, Cromolyn sodium and Alocril?

A
  1. Alomide - 2y+, QIDx3mo
  2. Cro. S- 4y+, QID-6x a day
    Alocril - 3y+, BID
60
Q

What drug acts as a MCS and Eosinophil chemotaxis inhibitor?

A

Alamast

  • 3y +
  • QID
61
Q

What is the age and dosing of BEZPOP>

A
  1. Bepreve: 2+, BID
  2. Elestat: 3+, BID
  3. Zatidor: OTC, 3+, BID
  4. Pazeo: 2+, QD
  5. Pataday: 3+, QD
  6. Latacaft: 2+, QD
62
Q

What drug is a MCS/AH combo and eosinophil chemotaxis inhibitor?

A

optivar

3+, BID

63
Q

What corticosteroid is approved for the ages of 2+?

A

FML

64
Q

What NSAID is approved for ages 3+?

A

Acular LS (less stinging than regular Acular)

65
Q

What are the 5 supportive allergy therapy options?

A
  1. Sunglasses
  2. Stay inside in am
  3. Wash hands after being outside
  4. Shower before bed
  5. Air conditioner in house, bedroom, car
66
Q

What test is performed to dx viral conj.?

A

RPS - Rapid pathogen screening Adeno Detector

67
Q

How do we tx. viral conj? Is it contagious?

A
  1. ATs 4-8 times/day

2. Very contagious

68
Q

How do we decrease the risk of sprading viral conj?

A
  • frequent hand washing
  • don’t share anything
  • don’t touch eyes
  • don’t shake hands
69
Q

Timolol is approved for what age?

A

Children over 10yo

70
Q

Brinzolamide is contraindicated in what type of kids?

A

Kids with sulfa allergies

71
Q

PGAs are only allowed to be used in __?

A

older children

72
Q

There should be no atropine refractions until 3 mo old due to what?

A
  • sensitive period of vision development

- may induce amblyopia

73
Q

Atropine and Cyclogyl are contraindicated in what 3 groups?

A
  1. Down Syndrom children
  2. Kids w/ neurological disorders (brain damage, seizure, etc)
  3. Albinos
  • use tropic and phenyl instead of atropine
74
Q

Atropine and Cyclogyl should be used with CAUTION in who?

A

Lightly pigmented children

75
Q

A 1-5yo with light irides should be dilated using what?

A
  • tropicamide
  • phenylephrine
  • tropicamide again (prn)
  • separate drops by several minutes
76
Q

A 1-5yo with dark irides should be dilated using what?

A
  • tropic + phenyl, use punctal occlusion
  • hold lids apart for 30secs
  • wipe excess liquid after lids are closed
77
Q

A normal kid with light iridies should get what drops for a dilated refraction?

A
  • cyclopentolate (1gttp)

- phenyl (1 gttp)

78
Q

A normal kid with dark iridies should get what drops for a dilated refraction?

A
  • cyclopentolate (1gttp)
  • tropicamide
  • phenyl (1 gttp)
79
Q

What is the DOC for cycloplgic refraction for accommodative esotropia?

A

Atropine

- 2 to 3 drops per day for 3 days before exam

80
Q

What is it called when atropine is used in the tx of amblyopia?

A

Pharmacologic penalization

- alternative to occlusion therapy

81
Q

Pharm. Penalization is used for what type of amblyopia?

A

Moderate ambly: 20/40 to 20/100

82
Q

What are the main 3 adverse reactions of atropine?

A
  • light sensitivity (18%)
  • Lid/Conj irritation (4%)
  • Eye pain/HA (2%)
83
Q

If severe CNS reaction to atropine, what drug should be used?

A

Physostigmine

Pediatrics (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions