Test 1 Therapy Considering for Pediatrics

Question 1

define neonate

Answer 1

less than a month of age

Question 2

define premature

Answer 2

less than a month of age born less than 37 weeks of gestation

Question 3

define infant

Answer 3

1-12 months

Question 4

define child

Answer 4

2-11 years

Question 5

define adolescent

Answer 5

12-16 years

Question 6

physiologic differences between infants/children and adults: gastric pH

Answer 6

• pH is neutral in premature neonates
• this causes increased absorption of acid-labile medications
• this causes decreased absorption of weak acids

Question 7

physiologic differences between infants/children and adults: gastric emptying time

Answer 7

• babies have prolonged gastric emptying time (matures @ 6-8 months)
• this causes delayed and decreased peak concentration

Question 8

physiologic differences between infants/children and adults: gastric transit time

Answer 8

• babies have increased gastric emptying time

- this causes increased absorption of some medications

Question 9

physiologic differences between infants/children and adults: muscle mass

Answer 9

• babies have decreased muscle mass

- leads to poor perfusion and decreased muscular contractions

Question 10

physiologic differences between infants/children and adults: skin surface area to body weight ratio

Answer 10

• babies have greater skin surface area to body weight ratio
• this causes increased absorption

Question 11

physiologic differences between infants/children and adults: skin fat

Answer 11

• neonates have decreased skin fat

- this causes increased absorption

Question 12

TBW% and ECF% in pre-term neonate

Answer 12

• TBW%: 85

- ECF%: 50

Question 13

TBW% and ECF% in term neonate

Answer 13

• TBW%: 78

- ECF%: 45

Question 14

TBW% and ECF% in 1 year old

Answer 14

• TBW%: 60

- ECF%: 25

Question 15

TBW% and ECF% in adults

Answer 15

• TBW%: 60

- ECF%: 19

Question 16

How does total body water as percent of total body weight affects drug distribution?

Answer 16

• Hydrophilic medications will have a higher volume of distribution in an infant compared to an adult
• Lipophilic medications have lower volume of distribution in neonate compared to an adult due to their decreased body fat

Question 17

neonates’ plasma proteins

Answer 17

• decreased quantity and quality of plasma proteins which increases the % of free drug => more drug to be eliminated
• if neonate is given high protein binding drug, it will knock off bilirubin => increased bilirubin concentration

Question 18

Which medication should be avoided in neonates and why?

Answer 18

• sulfonamides (ex. Bactrim) and ceftriaxone

- increases the risk of kernicterus

Question 19

Which metabolic pathways are immature at birth?

Answer 19

Phase I 
- oxidation
- reduction
- hydrolysis
- demethylation
Phase II 
- glucuronidation

Question 20

Which metabolic pathways are developed at birth?

Answer 20

• sulfation

- methylation

Question 21

What causes grey baby syndrome?

Answer 21

• decreased glucuronidation with administration of chloramphenicol

Question 22

What causes gasping baby syndrome?

Answer 22

benzyl alcohol