Pharmacotherapeutics Flashcards
Adalimumab (Humira)
Treats plaque psoriasis and psoriatic arthritis
SQ
Etanercept (Enbrel)
Treats plaque psoriasis and psoriatic arthritis
SQ
Infliximab (Remicade)
Treat plaque psoriasis and psoriatic arthritis
IV
Golimumab (Simponi)
arthritis only, not plaque psoriasis
SQ
Ustekinumab (stelara)
Interfere with IL-12 and IL-23
SQ
Mycophenolate Mofetil (CellCept)
used in combination with other therapies for moderate to severe
oral
category D
Hydroxyurea
antimetabolite for hematologic malignancies
psoriasis only
for pt with liver dx who would be at risk of ADRs with other antipsoriatic agents, less effective
Oral
pediatrics
0-18 years
premature
<37 weeks gestation age
normal is 40 weeks
neonate
1 day to 1 month
infant
1 month to 1 year
children
1-12 years
adolescent
12 - 18 years
chloramphenicol
gray baby syndrome
could not metabolize drug & accumulated in body & turned grey
thalidomide
accutane
phocomelia
flipper like limb syndrome
sulfonamides
kernicterus
displace bilirubin and accumulates = jaundice = cross BBB & lodge brain = permanent brain damage.
tablets and capsules for children <6
cannot swallow so use liquids, oral disintegrating tables, cheweable tablets
subcutaneous in neonates
unpredictable, more viable than intramuscular injections, absorption increased in neonates, should inject in abdomen = less risk of injecting into muscle/bone.
intramuscular
not ideal in neonatal due to absorption issues
IV bags for neonates
used for maintenance fluids only
syringe pump
most common technique in pediatrics
allows med to be administered over a set time at specific rate
concentrated solution is slowly dripped into the maintenance fluid for dilute administration
volumetric set
Buretrol or Metriset
allows for administration of a set volume of medication into a specific volume of diluent to create a patient specific concentration
allows for tubing to the flushed to ensure entire dose is given
intraosseous infusion
when IV access cannot be gained
should not be used if pt is over 6 years old
can infuse most meds & fluids w exception of lipid based products
pediatric chief complaint
presented same as in adults but states who is giving the information
past medical history
adult chart + prenatal & birth history.
NVSD = normal spontaneous vaginal delivery
pediatric social history/family history
child’s primary living environment, daycare, genetic illnesses in family
diet history
important for infants
document types of food & amts.
pediatric heart rate
starts high prior to birth, dips slightly at birth, slowly decreases until age 14 when adult normals are reached
pediatric respiratory rate
highest at birth, declines until normal adult at 15 years
pediatric blood pressure
starts low and increases with age.
pediatric serum creatinine
for the first 10 days of life, the value obtained is indicative of the mother’s renal health, not the child’s renal health
levels are dependent on muscle mass and don’t reach adult normals until adolescence
pediatric creatinine clearance
maturation occurs btw 6 mo-3 years
pediatric bilirubin
total bilirubin peaks at 3-7 days of life and decreases as the liver’s ability to conjugate matures. conjugated bilirubin should remain the same throughout a health childhood since body will excrete any excess.
pediatric fluids, electrolytes, nutrition (FEN) for non-dehydrated pediatrics patients
100 ml/kg for the first 10kg
50 ml/kg for the 2nd 10 kg
20 ml/kg for each extra kg over 20 kg
3 years = D5/.45 NaCl + 20 mEq KCl/L
divide by 24 to get ml/hr rate
nelson’s textbook of pediatrics
widely available, general reference, req some medical terminology knowledge, a “dipro’s for pediatrics”
pediatric dosage handbook by lexicomp
excellent drug reference, nothing on diagnosis or treatment plans, FDA information
Current Concepts in Pediatric Diagnosis and Therapy
UTD std of care, assume you know background on dx staet
Harriet Lane Handbook
good section on dx & testing, some difficulties w drug section, designed for physicians, questionable drug reference
Nelson’s Essentials of Pediatrics
handbook on common pediatric dx states
Teddy Bear Book
peds specific compatibility info of IV for each conc used in children, found very rarely in other resources
Neofax
limited to medications in neonatal pop
