Pharmacology In Pediatrics Flashcards
Preterm or premature
<36 week gestational age
Neonate
<30 days old
Infant
Age 1 month until 1 year old
Child
Age 1 until 12 yr old
Adolescent
Age 12-18
Drug ____ is related to gastric acidity, gastric emptying time, GI motility, pancreatic enzyme activity, GI surface area, and skin permeability
Durg absorption
Drug distribution is related to
The blood brain barrier and plasma proteins
Drug metabolism is related to
The liver
Drug elimination is related to
Renal blood flow
Glomerular filtration
Tubular function
In premature neonates, gastric acidity is
Lessened
In premature neonates, gastric emptying time is
Slower
In premature neonates GI motility is
Lower
In premature neonates pancreatic enzyme activity is
MUCH lower
In premature neonates, GI surface are is
Greater
In premature neonates skin permeability is
MUCH higher
In premature neonates, there is a ______ distribution across the blood brain barrier
Increased
In the premature neonate, the number of plasma proteins is
Decreased
In the premature neonate liver metabolism
Is lower, with a decrease in bile acid synthesis
In premature neonates, renal blood flow, glomerular filtration and tubular function is…
Lessened
In neonates, gastric acidity, gastric emptying time, GI motility and pancreatic enzyme activity are ___
Lower
In neonates, GI surface area and skin permeability are
Greater
In neonates, the blood brain barrier is
Less developed
In neonates, plasma proteins are
Less present
In neonates, drug metabolism in the liver is
Lower
In neonates, renal blood flow, glomerular filtration, and tubular function are
Lower
In infants, gastric acidity is
Less
In infants, gastric emptying time is
Equal
In infants, GI motility is
Lower
In infants, pancreatic enzyme activity is
Lower
In infants, GI surface area is
Greater
In infants, skin permeability is
Equal
In infants, distribution across the blood brain barrier is
The same
In infants, the amount of plasma proteins is
The same
In infants, liver metabolism is
Less than
In infants, renal blood flow, glomerular filtration and tubular function are
Lower than
In children, gastric acidity is
The same
In children, gastric emptying time is
The same
In children, GI motility is
the same
In children, pancreatic enzyme activity is
Equal to
In children, GI surface area is
Greater than
In children, skin permeability is
Equal to
In children, distribution accross the blood brain barrier is
Equal
In children, the amount of plasma proteins is
equal
In children, metabolism by the liver is
equal or greater
In children, elimination by the kidney is
the same
In the adolescent, drug absorption, distribution, metabolism, and elimination is
equal; closely monitor during this time
In rectal absorption, _____ is avoided because the drug is absorbed by the _____ which are not a part of
first-pass hepatic elimination
hemorrhoidal veins
which are not part of the portal circulation
Pulmonary absorption and drug delivery are ____ in infants and children because ____
decreased
infants and children have lower tidal volumes and increased respiratory rates (especially when crying)
Metabolic enzymes that have been identified as important in human drug metabolism, include
cytochrome P-450 (CYP450) CYP1 CYP2 and CYP3 families pronounced "sip"
Codeine is metabolized to ____ via the enzyme ____
morphine
Cytochrome P450 2D6 (CYP2D6)
Ultrarapid metabolizers of ____ are at risk of high levels of morphine after the metabolism of ___
cytochrome p450 2D6 (CYP2D6)
Codeine
The enzyme ____ metabolizes caffeine and theophylline
CYP1A2
Cytochrome P4520 1A2
CYP1A2, responsible for the metabolism of __________, is _____ at birth
caffeine and theophylline
reduced
Cytochrome P450 1A2 (CYP1A2) is ____ at birth, reaches adult levels at ___, and ____ throughout childhood. Therefore, when prescribing theophylline to neonates, ____ doses administered___ frequently than in older infants and children.
reduced 4 months exceeds adult levels lower doses less frequently
In adults, acetaminophen (Tylenol) is a substrate for ____
glucuronosyltransferase 1A6 and 1A9
In adults, acetaminophen is metabolized by a _____ reaction
by a phase II glucuronidation reaction
phase II biotransformation reactions ___
produce a much more water-soluble compound that can be excreted more easily
phase I biotransformation reactions
modifies a compound to reveal a reactive group to which a conjugation molecule can react