week 2 pediatrics Flashcards
immaturity of organs puts neonates and infants at risk for what
elevated drug levels/more intense response
delayed elimination/ prolonged response
increased sensitivity in infants d/t immature state of what:
absorption protein binding of drugs blood-brain barrier hepatic metabolism renal drug excretion
neonates and infants gastric emptying time
prolonged and irregular
neonates and infants gastric emptying time reaches adult function by
6 to 8 months
gastric acidity birth
very low 24 hours after birth
gastric acidity reaches adult values
not until 2 years
low gastric acidity causes what
absorption of acid-labile drugs is increased
neonates and infants IM administration
Slow
Erratic
Delayed absorption as a result of low blood flow during the first few days of life
During early infancy, absorption of intramuscular drugs more rapid than in neonates and adults
neonates and infants transdermal absorption
More rapid and complete for infants than for older children and adults
Stratum corneum of infant’s skin is very thin
Blood flow to skin greater in infants than in older patients
Infants at increased risk of toxicity from topical drugs
neonates and infants protein binding
binding of drugs to albumin and other plasma proteins is limited in infant
amount of serum albumin is relatively low
adult protein binding capacity by
10 to 12 months of age
neonates and infants blood brain barrier
Not fully developed at birth
Drugs and other chemicals have relatively easy access to the central nervous system (CNS)
Infants especially sensitive to drugs that affect CNS function
neonates and infants- hepatic metabolism
drug metabolizing capacity of newborns is low
liver’s capacity to metabolize many drugs increases rapidly when
about 1 month after birth
liver’s ability to metabolize drugs at adult level is reached when
a few months after 1 month
complete liver maturation occurs when
by 1 year of age
neonates and infants- renal excretion
significantly reduced at birth
low renal blood flow, glomerular filtration, and active tubular secretion
drugs elimated primarily by renal excretion
must be given in reduced dosage and/or at longer dosing intervals
adult levels of renal function achieved when
by 1 year
pharmacokinetics of children age 1 year and older
most pharmacokinetic parameters are similar to adults
differences in how children 1 year and older vs adult metabolize drugs
markedly faster until age 2, then gradual decline
sharp decline at puberty
may need to increase dosage or decrease interval between doses
growth suppression
caused by glucocorticoids
discoloration of developing teeth
tetracyclines
kernicterus
sulfonamides
