W13_05 pediatric pharmacology Flashcards
what affects absorption in neonates?
gastric peristalsis is unpredictable, and there’s a short intestinal transit time
what affects drug distribution in neonates?
there’s only 80% of albumin in a kid than an adult;
a1 glycoprotein is only 30# of adult levels;
interfering substances, like high bilirubin, which can displace bound drug to free, active drug
what’s the apparent volume of distribution of a highly protein-bound drug?
low
what’s the apparent volume of distribution of a drug that’s extensively taken up by tissues?
high
note: children are 80% water, as opposed to adults, who are 60% water (volume of distribution calculations)
ok
note: children clear drugs faster thru liver and kidneys than adults do
liver is proportionally larger in a child
note: neonates clear drugs more slowly than children and adults
give same loading dose;
give smaller maintenance dose;
recall the caffeine’s effects on the baby
name some of the drugs that can easily kill a child
CCBs;
camphor;
narcotics;
aspirin/oil of wintergreen;
antidepressants;
patches/drops/sprays;
diabetes meds;
shot of alcohol
why not give tetracycline to kids under 8?
causes brown stripes across teeth
what risk does valproic acid cause in children?
liver failure;
developmental delay in kids taking multiple drugs
what does ethanol do to infants?
hypoglycemia, secondary to inhibition of gluconeogenesis and low glycogen stores
what do sulfonamides do to neonates?
displaces bilirubin and causes kernicterus
what’s Reye syndrome?
liver failure in children given aspirin. (children who had varicella)
note: digoxin levels are inaccurate in children
ok
what’s gasping syndrome?
benzyl alcohol incipient solution causes metabolic acidosis in neonates
