Brainscape's Knowledge GenomeTM

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


See full index

Pediatrics > Pharmacy > Flashcards

Pharmacy Flashcards

1
Q

TX Colic

A

Medications and CAM havenot shown to be effective and may be harmful

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

TX teething

A

Benzocaine gel w/o alcohol (orajel)

Ibuprofen HS shown to be effective

systemic absorption of Lidocaine

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

TX Diaper Rash

A

Mild, non-candidal: Zinc Oxide Cream

Candida rash: Clotrimazole 1% Cream

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

TX Diarrhea/hydration

A

Maintenance Fluid Requirements:

Less than 10kg 100mL/kg/day
11-20 kg 1,000 mL + 50 mL/kg over 10kg

Greater than 20 kg1,500mL + 20mL/kg over 20kg

Mild Diarrhea
Keep regular diet
Absorb significant protein, fat, CHO

Rehydrate with oral electrolyte solution such as pedialyte

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

TX Otitis Externa

A

Otic Suspensions
Acid to replicate normal ear canal environment

If pt has vent tubes or recent perforation painful then
Ophthalmic Suspensions

Balanced pH and More viscous
Add 2-3 gtts of NSS to 5mL bottle

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

Anti-depressants in Adolescents

A

Causes increased impulsivity, silliness, daring conduct, agitation

Black Box Warning: Antidepressants and increased suicidal ideation/risk:
Initial months of therapy or dose changes

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

Anti-psychotics in Adolescents

A

Susceptible to extrapyramidal symptoms especially dystonias and weight gain use lower doses

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

Acetaminophen-Common Formulations and Dosing

A

Acetaminophen
Formulations:

Infant Drops (80mg/0.8mL)

Liquid (160mg/5mL)

Dosing: 10-15mg/kg/dose Q4-6H Max 65mg/kg/Day

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

Amoxicillin- Dosing

A

Regular 40-45/kg/Day

High dose: 80-90mg/kg/day

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

Why don’t you use Aspirin in children?

A

Reye’s syndrome:

Fatty Liver degeneration, encephalopathy and system failure

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

Why is Benzocaine preferred over Lidocaine?

A

Benzocaine is poorly soluble in water and very slowly absorbed so don’t get toxic levels as easily as lidocaine

Lidocaine
Not for repeated topical application in children due to rapid absorption & toxicity
Very short term use

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

When are fluroquinolones used in children?

A

Have been used in children with cystic fibrosis without significant problems

Fluroquinolones
Such as Ciprofloxacin, levofloxacin, moxifloxacin
May cause joint space crystalization in children

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

Ibuprofen- Common formulations and Dosing

A 
Infant Drops
Children’s Suspension
Children’s Chewable Tablets
Dosing:  
5-10 mg/kg/dose  Q6-8H
Max 40mg/kg/Day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does a childs body metabolize and excrete Erythromycin and Clarithromycin?

A

Primarily hepatic metabolism Biliary excretion

P450 interactions causing nausea, increased gastric motility

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

How does a childs body metabolize and excrete Azithromycian?

A

Minimal hepatic metabolism and is primarily excreted in bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Phenobarbital used for in children?

A

Used in infants with generalized motor seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Who should you avoid using tetracyclines like doxy in and why?

A

Avoid in pregnancy and children under 8 years old because of dental staining

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

Why are vitamin A analogues like Isotretoin dangerous?

A

Isotretoin is teratogenic

Needs 2 forms contraception, regular PG testing and to fill Rx w/in 7 days and max 30 day supply

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

When is zinc oxide used?

A

Barrier protection for diaper irritation used in both Infants and elder in homes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When do glomerular filtrations rates reach adult rate?

A

At adult rates by 6-12 months

End of week 3 at 50-60% adult rates

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

How do toddlers metabolism differ from an adults metabolism?

A

Toddlers metabolism is more rapid and renal elimination than adults

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

What formula can be used to calculate creatinine clearance in children?

A

Schwartz’s Equation (til 18)

CrCl = k x Length (in cm)/ Scr

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

How do neonates P450 activity differ from adults?

A

CYP450 enzymes develop at variable points up to 3 years of age

Phase 1 reactions and enzymes impaired in preterm infants, neonates

less P450 activity
(50-70% adult levels)

Alcohol dehydrogenase may develop late childhood or early adolescence

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

How is the metabolic enzyme activity rate effect in children taking anti-convulsants?

A

Variable rates of hepatic metabolic enzyme activity
2x adult rate @ 6 months persisting to 9-12 years of age

Infants of mothers on drugs that induce hepatic enzymes (phenobarbitol) may have increased metab rates early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Total body water % of a full term infant?

A

70-75% body weight

adult 50-60%

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

Total body water % of a small preterm infant?

A

85% changes after birth day 1-2

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

What type of drug does body water distribution effect ?

A

Impacts water-soluble drugs (aminoglycosides), not lipid-soluble drugs

Effects Immature blood-brain barrier

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

In a preterm infant what type of drug will have more free drug?

A

Low body fat in pre-term infants:

Drugs with lipid affinity will have more free drug

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

When do serum proteins bind to albumin at the same rate in children as they do in adults?

A

Adult albumin levels at age ~1 yr

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

Why do neonates have altered absorption?

A

High gastric pH

Irregular peristalsis

Low levels of pancreatic enzymes

Bile acids can alter absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What can cause a decrease in absorption in children?

A

Diarrheal conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Is Rectal absorption consistent?

A

Nope, highly variable

33
Q

Why is topical absorption higher in neonates and infants?

A

Thin stratum corneum, increased cutaneous perfusion, higher surface to weight ratio

34
Q

What drugs in neonates and young children are dangerous due to their less effective blood brain barrier?

A

Greater opioid impact; bilirubin

35
Q

How do you calculate dosing by body surface area?

A

BSA: Ped Dose = Dose A

BSAPed)/BSAA (More accurate
BSA (m2)= Ht (cm) x Wt (kg)
3600

36
Q

How do you calculate dosing by weight?

A

Clark’s Rule (Tends to under dose slightly)

Dose=Adult dose x Weight (kg)/ 70 kg

Dose=Adult dose x Weight (lb)/ 150 lbs

37
Q

How do you calculate dosing by age?

A 
Young’s Rule (Tends to under dose slightly)
Adult dose x Age (years)
				Age + 12
1 to 18 years  
 IBW= (Ht2 x 1.65) / 1000
38
Q

How does the accuracy of BSA, Weight and Age calculations relate to each other?

A

Body surface area dosing > weight dosing > age dosing

39
Q

Best place to find child dosages?

A

On the package but it’s often not there

40
Q

What reduced ER toxicity visits by 50% in children under age 2?

A

OTC cough and cold medications were taken off the market for infants, now labeled only for those 4+,

41
Q

What can happen after 1 or 2 caps of Benzoate?

A

Can put child in a coma/seizure/cardiac arrest

42
Q

How much iron does a child have to be symptomatic and what are the symptoms?

A

60+ mg/kg can cause severe GI distress and shock/death in extreme

43
Q

What percentage of dosing errors occur in children?

A

70%

44
Q

How is IM administration tolerated in children?

A

Not well tolerated:

low muscle mass

blood flow to muscles is variable in kids

45
Q

How is reliable is rectal route administration?

A

Variable absorption makes concentration difficult to predict
**First pass is dependent on position in rectum

46
Q

What age can kids start using nebulizers/MDI?

A

Nebulizer: age 3+
MDI: age 5+

47
Q

What are elixirs?

A

Elixirs: drug dissolved and evenly distributed in alcohol; caution evaporation

48
Q

What are suspensions?

A

Un-dissolved particles of drug suspended in solution

need distribution by shaking; caution variable dosing if not distributed

49
Q

What can crushed tablets be mixed with?

A

Suspending agents

No honey in infants

50
Q

Around what age can capsules/tablets be taken?

A

~age 6

51
Q

What should you educate parents with dosing?

A

Educate on what a “teaspoon” is – 5mL, using an actual spoon may vary 2-8mL

Syringes or other calibrated devices are best for measuring and administering

52
Q

Whats concerning about OTC and CAM drugs?

A

CAM drugs are not FDA regulated and have limited data on efficacy and safety

OTC drugs are FDA regulated but efficacy data has not been demonstrated, most offer a safety guideline of not using in children under 2

53
Q

Whats concerning about using off label drugs?

A

Off Label Drug Use: 60% of drugs are NOT FDA approved for children and 75% of drugs do not have data on dosing, efficacy and safety for children

54
Q

Pregnancy category of isotrenytoin?

A

X

55
Q

Pregnancy category of tetracyclines?

A

D

56
Q

What happens when you give aspirin to kids?

A

Reye Syndrome

57
Q

What is the fatality rate of Reye Syndrome?

A

30-40%

58
Q

What is the pediatric dosage for Tylenol?

A

10-15 mg/kg/dose

No more than 5 doses per day

59
Q

What is the topical anesthetic used for teething?

A

topical benzocaine

60
Q

What can lidocaine toxicity cause?

A

+/- Cardiac issues

61
Q

What can SSRI’s cause in adolescents?

A

Increased risk of suicide

62
Q

When should you follow up when rxing SSRI’s to adolescents?

A

Within first 2 weeks

63
Q

Are ACE inhibitors safe to use in pregnancy?

A

Nope

64
Q

Why shouldn’t you use ACE inhibitors in pregnant women?

A

Newborn Renal Abnormalities, HTN, growth retardation, Still birth

65
Q

Can you rx thiazide diuretics to pregnant women?

A

Yup

66
Q

Is ethosuxamide metabolized by the CYP enzyme shit?

A

Yup

67
Q

What is the best method to treat an infant with asthma?

A

Nebulizer

68
Q

What age can you use an MDI to treat asthma?

A

5+

69
Q

Paige said something about rectal tylenol

A

no idea if she was joking or not but just in case maybe have some rectal tylenol on you

70
Q

In terms of the back door, where are you going to have the highest absorption rate?

A

The further up you go in the a-hole

71
Q

Can you give IM injections to babies?

A

Nope, muscles are very little

72
Q

What cream can prevent diaper rashes when a baby has diarrhea?

A

Zinc Oxide Cream

73
Q

Why are opiods and benzonatate potent in young kids?

A

Crosses the Blood Brain Barrier and can cause respiratory depression

74
Q

A child is having a febrile seizure, what do you do?

A

Don’t treat

75
Q

What are the side effects of risperadone?

A

extra pyramidal side effects, suicidal, weight gain

76
Q

What do elixir drugs contain?

A

ETOH

77
Q

According to Paige what drug is most likely an Elixir?

A

dexamethasone

78
Q

How do beta agonist receptors differ in kids and adults?

A

Kids have fewer Beta receptors

Infants have only 10-15% of alveoli compared to adults
adult by age 8

79
Q

What type of reaction do kids have to metochlopromide?

A

Increased dyostonic reactions

Pediatrics (3 decks)

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