Pharmacotherapeutics Flashcards
how should a child be positioned when administrating medication?
- standing or at least propped up to 45 degrees
- will reduce choking and gagging
how to administer medication for young infants and toddlers?
- take syringe and deliver towards back and side of the mouth
- Otherwise, if in “cheek pouch,” it will get spit out
how to administer a dissolvable tablet to a pediatric pt?
- place on back of tongue
- Less likely to get spit out
what are ways you can alter a medication to make administration easier?
- applesauce, peanut butter, chocolate pudding, apple juice, chocolate milk, marshmallow cream
- Purchase flavoried meds
- Refrigerate meds
things/strategies to help with administering medication
environment, communication, routes, etc
- Put them in a relaxing environment
- Give them power of choice
- Play “doctor” w/ stuffed animals
- Tell them it will make them feel better
- Don’t lie
- Star charts with rewards
- Make sure to praise them if/when they do
- Injection option
- Consider other routes - suppository
- If all else fails, have someone hold them and give medication
- Don’t negotiate though, they have to take it
if a pt refuses a pill and wants an injection instead, what two options could they have?
Rocephin; bicillin
as a provider, what are strategies to better the adherence of medication
- Meds dosed once daily
- Clearly written instructions for parents and children
- indo about common SE and ways to deal w/ them
- Incorporate into daily routine - Ex) ADHD meds
American Academy of Pediatrics discourages children of what age from taking OTC medications for colds?
< 6 y/o
Current FDA guidelines discourage children from taking OTC cough and cold medications at what age? why?
< 2 y/o
* No evidence of being safe and effective
* Have potential for enhanced toxicity in young children b/c metabolism, clearance, and drug effects may vary according to age
what are the potential SE of OTC cough/cold meds if given to a pt < 2 y/o?
Tachycardia, convulsions, decreased LOC
The AAP recommends using what as a standard dosing method (in place of tsp)
mL with a syringe
Every medicine has an ___ ___, which treats the symptoms
active ingredient
Do not give aspirin or aspirin-containing products to pts what age? why?
- kids under 18
- Reye’s Syndrome
MOA of Sudafed
- Main ingredient: pseudoephedrine
- Decongestant
- Sympathomimetic
- Produces vasoconstriction by stimulating alpha receptors in mucosa of respiratory tract
SE of sudafed
Dizziness, nervousness, difficulty sleeping, tachycardia, irritability, hypertension
alternative of sudafed
Topical decongestant - Phenylephrine / oxymetazoline (Afrin)
Topical decongestant has less systemic effects, however, can cause ?
rebound congestion
MOA of Dextromethorphan
Robitussin / Delsym
- Acts on the cough center of the medulla to suppress cough
- Isomer of codeine
SE of Dextromethorphan
Nausea, sedation, dizziness, abdominal pain
MOA of Guaifenesin
Mucinex
- Increases rsp tract fluid secretions and helps loosen bronchial secretions by reducing viscosity, therefore increasing mucociliary clearance
- Nonproductive cough becomes more productive, less frequent, less irritating
Other Cough & Cold Remedies
not Rx
- Honey - Over age 1
- Nasal saline
- Keeps nasal passages moist and helps avoid stuffiness
- Bulb suction will help suck out mucus - Elevate head of the bed
- Cool mist vaporizer / humidifier
- Helps nasal passages shrink and allow easier breathing - Antihistamines
- Tylenol / acetaminophen - q4h for fever
- Motrin / ibuprofen
- F, aches and pains
- Every 6-8 hours for fever
- Pts has to be > 6 mos old
- alternate Tylenol w/ Motrin q3h prn - Keep hydrated with water / pedialyte
- Hand washing
- Education on expected course - EXTREMELY IMPORTANT!
differences between peditric vs adult population in terms of medication
- Pediatric - dosage is by wt & age - wt specifically w/ liquid meds
- Adult - fixed dosing
- Compliance
- Body composition and organ function changes over time, which effects dosage
- Common disorders are different
- stage of development can alter action of, and response to, a drug - a truly age-dependent difference in pharmacodynamics
- Tetracyclines staining developing tooth enamel - Different ADME
- Developmental PK
- ↓GI but ↑IM absorption
- ↑body H2O but ↓lipids
- Limited protein binding
- ↑liver/body wt ratio
- Immature enzymes
- ↑brain/body wt ratio; ↑blood brain barrier permeability
- Immature renal function
Utilize 3 key items for pediatric dosing:
- Mostly dosed by wt in kg (wt in pounds divided by 2.2) - Liquids
- All dosage amounts in mg / kg / day
- All med amounts in mg / ml
6 steps on how to do pediatric dosing
- Find mg/kg dosing amount, along w/ mg/mL amount
- Convert pt’s wt and to kg (lbs / 2.2)
- Multiply dosage amount by kg (mg times kg)
- Divide by how many times the med is taken per day
- gives how many mg of med the pt will need - Convert to mL by dividing mg dose by amount of med in each 5 mL of med
- Dispense amount
- (mL / day) x (# of days med is given)
