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AAA-PEDIATRICS Y3S2 > SPECIALIZED PEDIATRIC CARE (PPT UPLOADED) > Flashcards

SPECIALIZED PEDIATRIC CARE (PPT UPLOADED) Flashcards

1
Q

What are the three sectors in the practice of pediatrics?

A

Professional sector. Popular sector. Folk sector

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2
Q

What routes are involved in pediatric drug absorption?

A

Oral route. Rectal route. Percutaneous route. Intramuscular route. Aerosol or inhalation

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3
Q

What factors can alter the rate and extent of drug absorption in children?

A

Developmental differences in the physiologic composition and function of barriers

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4
Q

What organ is often overlooked but important for systemic drug absorption in pediatrics?

A

Skin

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5
Q

In neonates, how much of the bodyweight is total body water?

A

80–90%

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6
Q

In neonates, how much of the bodyweight is fat content?

A

10–15%

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7
Q

At what age does total body water decrease to 55–60%?

A

By adulthood

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8
Q

What is the extracellular water content in neonates?

A

0.45

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9
Q

What drugs have a larger volume of distribution in neonates?

A

Gentamicin. Linezolid

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10
Q

Which organ is primarily responsible for drug excretion?

A

Kidney

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11
Q

When does GFR reach adult values?

A

8–12 months

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12
Q

What can hypoxic–ischemic events in neonates cause?

A

Decrease in drug absorption and impaired renal function

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13
Q

What effect does a patent ductus arteriosus have on drug distribution and elimination?

A

Major impact on volume of distribution and elimination

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14
Q

How is oral drug absorption influenced in pediatrics?

A

Passive diffusion. Motility of stomach. Peristalsis of intestines

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15
Q

How is gastric pH at birth and how does it change?

A

Practically neutral at birth. Decreases to around 3 within 48 hours. Returns to neutral over next 24 hours. Remains for 10 days

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16
Q

When does gastric pH reach adult values?

A

About 2 years of age

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17
Q

How is gastric emptying in neonates?

A

Delayed. Approaches adult values in 6–8 months

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18
Q

What factors can increase intestinal permeability in neonates?

A

Immaturity of intestinal mucosa

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19
Q

What factors influence drug absorption in the intestines?

A

High Beta-glucuronidase activity. Reduced first-pass metabolism. Maturation of carrier mechanisms. Variable microbial colonization

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20
Q

What happens to acid labile drugs like Penicillin G and Erythromycin in neonates?

A

More efficiently absorbed

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21
Q

How does gastric pH change impact absorption of weak organic acids?

A

Decreases absorption of Phenobarbital and Phenytoin

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22
Q

How is drug absorption rate generally in neonates?

A

Slower. Prolonged time to maximum plasma concentrations

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23
Q

When is the rectal route convenient in pediatrics?

A

No central or peripheral access. Convulsions. Vomiting. Induction of anesthesia. Drugs with large first pass effects

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24
Q

Why does the rectal route improve bioavailability?

A

Blood supply drains directly into inferior vena cava

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25
What factors influence percutaneous absorption in neonates?
Degree of skin hydration. Relative absorptive surface area. Thickness of stratum corneum
26
Why is topical therapy risky in neonates?
Higher surface area to body weight ratio. Greater drug absorption
27
How is intramuscular absorption in neonates?
Less predictable. Variability in peripheral perfusion. Limited muscle mass
28
What factors affect inhalation drug delivery in neonates?
Preferential nasal breathing. Small airway. Low tidal volume. Higher respiratory rate
29
What are minimum requirements for drug labeling?
Formulation. Indications. Contraindications. Precautions. Warnings. Mode of administration. Directions for use
30
When is a drug considered off-label?
Different dose. Another indication. Different route. Outside licensed age. Contraindicated in label
31
When is off-label use justified?
High quality evidence for efficacy. Sufficient safety evidence. Benefits outweigh risks
32
What are goals of pediatric anesthesia?
Analgesia. Amnesia. Hypnosis. Akinesia. Maintenance of physiologic homeostasis. Vigilance
33
What characterizes conscious sedation?
Sleepy. Comfortable. Cooperative. Maintains airway protective reflexes
34
What characterizes deep sedation?
Unarousability to voice. May respond purposefully to painful stimulus
35
What characterizes general anesthesia?
Complete loss of consciousness. Suppresses response to noxious stimuli
36
What are components of pre-anesthetic evaluation?
Medical history. Multiorgan system assessment. Physical exam. Ancillary testing. Risk factors. Allergies. Reactions to anesthetics. Family history
37
What respiratory conditions increase anesthetic risk?
Respiratory illness with fever. Mucopurulent discharge. Productive cough. Lower respiratory symptoms
38
What conditions increase intraoperative respiratory risk?
Bronchopulmonary dysplasia. Cystic fibrosis
39
What cardiovascular assessments are needed pre-anesthesia?
Room-air pulse oximetry. CXR. ECG. Echocardiogram. Cardiac catheterization
40
What hematologic assessments are important pre-anesthesia?
Platelet count. Fibrinogen. PT. aPTT. Correct pre-op anemia. Vitamin K administration
41
What is the importance of neurologic assessment pre-anesthesia?
Ensure perioperative AED. VP shunt patency
42
What is the psychological consideration before pediatric anesthesia?
Parental presence during induction (PPI). Maladaptive behavior responses
43
What are common vascular access routes in pediatrics?
Peripheral venous. Peripheral arterial. Central umbilical catheterization. Intraosseous
44
What are uses of IV lines?
Hydration. IV medications. Total parenteral nutrition. Blood products. Chemotherapeutics. Anesthetic agents. Blood extraction
45
What influences drug distribution in children?
Drug-specific physiochemical factors. Drug transporters. Blood or tissue protein binding. Blood and tissue pH. Perfusion
46
What causes a larger volume of distribution for hydrophilic drugs in neonates?
Higher extracellular water content
47
What happens to GFR in the first 2 weeks of life?
Rapid increase due to increased renal blood flow
48
How does hypoxic-ischemic injury in neonates affect drug pharmacokinetics?
Decreases absorption rate and impairs renal function
49
How does a patent ductus arteriosus affect ceftazidime pharmacokinetics?
Decreases GFR. Increases volume of distribution
50
What drugs have improved absorption with high gastric pH in neonates?
Penicillin G. Erythromycin
51
What drugs have decreased absorption with high gastric pH in neonates?
Phenobarbital. Phenytoin
52
What is the pH trend in premature infants' stomachs?
Little or no free acid during first 14 days of life
53
What impacts intraluminal pH influence on drug absorption?
Drug stability. Degree of ionization
54
Why is rectal drug administration preferred during convulsions or vomiting?
Convenient when oral or IV routes are not available
55
What factors increase percutaneous absorption toxicity risk in neonates?
High skin hydration. Large surface area to weight ratio. Thin stratum corneum
56
Why are neonates at risk for higher drug exposure through the skin?
Higher ratio of surface area to body weight
57
Why is caution necessary with percutaneous route in newborns?
Efficient absorption. Risk of higher toxicity
58
Why is intramuscular absorption unpredictable in neonates?
Limited muscle mass. Variable peripheral perfusion
59
Why is inhalation route challenging in neonates?
Small airway. Low tidal volume. High respiratory rate
60
What are common inhaled drugs in pediatrics?
Corticosteroids. Beta-adrenergics. Anticholinergics. Prophylactic anti-asthma agents
61
What defines off-label drug use?
Use not included in the approved label
62
What evidence is necessary to justify off-label use?
High-quality efficacy evidence. Sufficient safety evidence
63
What are examples of sedatives causing deep sedation?
Obtund painful responses. Possible reflex suppression
64
What does vigilant monitoring during pediatric anesthesia aim to maintain?
Physiologic homeostasis
65
What pre-anesthetic finding does not increase anesthetic risk?
Clear rhinorrhea without fever
66
What pre-anesthetic finding increases anesthetic risk?
Fever. Mucopurulent discharge. Productive cough. Lower respiratory symptoms
67
What is important for anesthetic assessment in children with VP shunts?
Checking shunt patency and function
68
What hematologic problems must be corrected pre-operatively?
Bleeding disorders. Anticoagulant use. Anemia
69
What psychological strategies reduce pediatric anesthesia anxiety?
Parental presence during induction
70
What are the uses of intraosseous access?
Hydration. Emergency drug delivery
71
Where does the umbilical vein catheter go?
Into the inferior vena cava via the umbilical vein
72
What are the parts of an IV catheter?
Needle. Catheter tube. Hub
73
Why secure IV sites properly in children?
Prevent dislodgement. Prevent infection
74
What are uses of orogastric or nasogastric tubes?
Feeding. Medication delivery. Decompression
75
What is the purpose of a Foley catheter in children?
Urinary drainage

AAA-PEDIATRICS Y3S2 (55 decks)

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