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Paediatrics > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What factors affect response to medicines in children?

A

Age
Size
Nutrition
Growth

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2
Q

What are the main reasons that drug responses differ in children compared with other children or adults?

A

Altered pharmacokinetics

Altered pharmacodynamics

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3
Q

What must a drug have before marketing?

A

Licensing

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4
Q

What are the unlicensed/off-label prescribing methods used in children?

A
  • Formulation administered via a route not intended
  • Medicines used for an indication not intended
  • Medicines used at a different dose to that recommended
  • Children below stated recommended age limit
  • Medicines without a licence, including those being used in clinical trials
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5
Q

What factors are different in the effect of drugs on children compared to adults?

A
  • Neonates/infants are more sensitive to drugs than adults
  • Neonates/infants are at increased risk for adverse drug reactions
  • Young patients show greater individual variation
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6
Q

What age is categorised as adolescence in pharmacology?

A

12-16/18

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7
Q

What factors affect pharmacological differences in early post natal children?

A
  • Rapid growth
  • Highly variable alterations in drug metabolism and elimination.
  • Lower tolerance to ADRs,
  • Higher incidence of therapeutic errors
  • Difficulty in identifying efficacy and toxicity
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8
Q

What factors affect pharmacological differences in infancy?

A
  • Body weight gain + body water composition changes

- Ratio of bodyweight or surface area to organ size and function

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9
Q

What factors affect pharmacological differences in toddlers?

A
  • Minor illnesses, leading to multiple short courses of therapy.
  • Problems with compliance
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10
Q

What factors affect pharmacological differences in young children?

A
  • Enhanced metabolism and excretion

- Clearance can change significantly during a single dose regimen

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11
Q

What factors affect pharmacological differences in adolescence?

A
  • Sexual development produces major changes in in body size and composition - affects drug metabolism.
  • Psychological changes and peer pressure result in smoking, alcohol and elicit drug use which can alter drug metabolism
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12
Q

What differences can be seen in drug absorption in children?

A 
Oral 
- Reduced gastric acid/delayed gastric emptying
Percutaneous
-Is enhances in infants and children
Intravenous
-Delayed/uncertain delivery
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13
Q

What differences can affect distribution in children?

A
  • High extracellular fluid
  • Total body water high
  • Fat content is low
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14
Q

What needs to be given for initial drug dosage to achieve correct plasma concentration?

A

Larger initial doses on a mg/kg body weight

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15
Q

Following initial dosage, what may need to be adjusted to compensate for decreased hepatic function/renal elimination in children?

A
  • Dosage intervals increased

- Daily dose decreased

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16
Q

What differences in plasma protein binding exist in children?

A
  • Reduced plasma protein binding in neonates

- Greater unbound or active drug

17
Q

What differences in blood brain barrier exist in children?

A
  • Not fully developed at birth
  • Drugs have relatively easy access to the CNS
  • Infants especially sensitive to drugs that affect CNS function = CNS toxicity
18
Q

What differences can affect elimination in children?

A
  • Neonate liver metabolism is immature, thus drugs eliminated by the liver have a longer half life
  • Results in a longer time to reach steady state (4xt1/2), an increase in steady state concentration
  • Applies to drugs eliminated by the kidneys
19
Q

What does decreased albumin proteins in neonates cause in pharmacokinetics?

A

^Free drug

20
Q

What does decreased hepatic metabolism in neonates cause in pharmacokinetics?

A

^Response to drugs

21
Q

What does decreased renal elimination in neonates cause in pharmacokinetics?

A

^Response to drugs

22
Q

What metabolic disturbances increase sensitivity to drugs in children?

A
  • Fever
  • Dehydration (increases the effects of many drugs)
  • Acidosis (decreased cellular penetration of basic drugs)

Paediatrics (18 decks)

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