Week 3 - Pharmacologic Considerations for Children; Pain Assessment and Management Across Developmental Age Groups Flashcards
What is pain?
Pain is whatever the patient says it is; it is subjective, influenced by family and culture, variable in expression, complex, and treatable with pharmacological and non-pharmacological methods.
What are the key principles of medication safety in pediatrics?
Pay special attention to drugs with narrow therapeutic windows, recognize that drug errors are more common in pediatric patients, and avoid dangerous abbreviations and symbols.
pharmakinetics vs pharmacodynamics
Pharmacokinetics: What the body does with the drug (absorption, distribution, metabolism, excretion).
Pharmacodynamics: What the drug does to the body (mechanism of action).
What are key considerations for drug absorption in pediatrics?
Alkalotic gastric pH until age 2, slow gastric emptying until about 6 months, smaller GI surface area, increased intestinal motility, and high blood flow to the immature liver.
What factors affect drug distribution in children?
Changes in body composition, concentration of available plasma binding proteins, capacity of plasma proteins to bind drugs, and an immature blood-brain barrier.
How do you reconstitute cefotaxime for IV use?
Order: 700 mg cefotaxime IV q6h.
Reconstitution: 1g/vial requires 2.8 mL SWI to yield 300 mg/mL.
Required volume: 700 mg / 300 mg/mL = 2.33 mL.
Safe concentration: 700 mg / 100 mg/mL = 7 mL → 7 mL - 2.33 mL = 4.67 mL diluent required.
What are the excretion considerations for pediatric patients?
Immature renal function, along with excretion through the lungs, GI tract, and skin.
How do you calculate safe dosing for a 20kg child prescribed ampicillin 500 mg IV every 6 hours?
Minimum dose: 100 mg/kg/day → 100 mg x 20 kg = 2000 mg/day / 4 doses = 500 mg/dose.
Maximum dose: 200 mg/kg/day → 200 mg x 20 kg = 4000 mg/day / 4 doses = 1000 mg/dose.
This dose is safe as it falls within the min/max range.
How do you calculate the rate of administration for ondansetron?
Order: 4 mg IV q8h over 30 min.
Rate = Volume / Administration Time (min) x 60 min/hr.
Rate = 4 mL / 30 min x 60 min/hr = 8 mL/hr.
What are daily fluid requirements based on weight?
Daily Formula: (100 mL for the first 10 kg) + (50 mL for each kg 11-20) + (20 mL for each additional kg) / 24 hr = hourly rate.
Holliday-Segar Method: (4 mL for the first 10 kg) + (2 mL for each kg 11-20) + (1 mL for each additional kg) = hourly rate.
What are key components of atraumatic medication administration?
pain assessment tools vary by developmental stage, consider variations in pharmacokinetics, ensure weight-based medication calculations, engage families in education, and implement age-specific atraumatic interventions.
What factors influence drug metabolism in children?
Immature liver function, variations in enzyme activity, developmental changes over time, and differences in the rate of metabolism compared to adults.
What are common causes of fluid volume deficit in pediatric patients?
Dehydration due to vomiting, diarrhea, fever, inadequate intake, and excessive fluid loss through sweating or burns.
What is the significance of the therapeutic window in pediatric medication administration?
The therapeutic window indicates the range between effective and toxic doses; ensuring the prescribed dose falls within this range is crucial to avoid toxicity and ensure effectiveness.
How should drug administration be adjusted for children with a narrow therapeutic window?
Close monitoring of dosing, frequent reassessment of therapeutic levels, and adjustment of doses based on individual response and side effects.
