Introduction to pediatric pharmacotherapy

What is considered a pediatric patient?

0-18y

Neonate is any kid between?

0-1 month of age

Infant is any kid between?

1 month to 1 year of age

Child is any kid between?

1 year to 12 years

Adolescent is any kid between?

13-18 years

Full term Neonate

37-42 weeks gestation

Premature Neonate

born before 37 weeks of gestation

The time you were not born yet from conception to the date of birth?

Gestational age

Is from the day you were born to the date that I'm looking at your pharmacotherapy?

Postnatal age

Which of the following best describes the approach to using drugs that are not FDA-approved for certain conditions?

B) Use drugs off-label if supported by reputable literature and clinical evidence.

Which historical event led to the FDA requiring proof of safety for all drugs and their ingredients?

B) The Sulfonamide Incident in 1938

Why is it important for pharmacists to understand the differences in vital signs between children and adults?

B) To assess how a child is responding to treatment and communicate effectively with other healthcare professionals

Question: Why is dosing medication for children more complex than for adults?

A. Children need different doses based on their age and weight.

This is what determines if a drug is going to have an adverse effect, or if it's going to benefit my child?

Ontogeny

Which of the following factors are specifically mentioned as influencing the oral absorption of drugs?

B) Gastric pH and gastric emptying time

Gastrointestinal functions achieve adult values and activity by the age of ____________?

2 years

Question: In premature neonates with a gastric pH of 6-8, which of the following statements is true regarding the oral absorption of drugs?

C. Weak bases are preferentially absorbed.

Question: Which of the following statements is true regarding alpha amylase activity in premature neonates?

B) Low levels of alpha amylase in premature neonates affect the absorption of fat-soluble drugs

Babies born before _____________ have very low levels of alpha amylase for the first month of life.

32 weeks of gestation

Question: Why might premature neonates have difficulty processing the drug chloramphenicol?

C) Low levels of alpha amylase in premature neonates prevent proper breakdown of the drug into its active form.

By the time the baby is about 1 year old, the levels of alpha amylase have matured and are functioning normally true or false?

True

Question: Which of the following statements is true regarding the oral absorption of Penicillin G (PenG) in premature neonates compared to adults?

B. PenG is destroyed by gastric acid in adults, making it less bioavailable.

Question: Why do infants absorb more topical medications compared to adults?

C. Infants have a larger body surface area relative to their body weight.

So if your volume distribution is larger but you're not using a larger dose, you're going to have a subtherapuetic concentration and it will not get better. True or false?

True

What is a potential risk of administering a highly plasma protein-bound drug to a newborn with hyperbilirubinemia?

B. The drug may bind to albumin and displace bilirubin, causing bilirubin to cross the blood-brain barrier.

Are the two drugs that displace bilirubin off

albumin?

Highly acidic drugs and highly plasma protein bound drugs

Creatinine Clearance (Clcr), a measure of kidney function, reaches adult values between?

6-12 months of age

The Modified Schwartz formula is used to estimate kidney function in children aged 1-18 who have chronic kidney disease.

0.413xL/Scr

Question: Why is it important for pharmacists to know the weight of a child when dispensing medication?

B) Weight is necessary to calculate the correct dose per kilogram.

Question: Why is it important to adjust the medication dosage for a child based on their weight?

To ensure the medication remains effective as the child grows and To prevent potential toxicity if the child loses weight.

Question: When prescribing medication for children, why do doctors stop increasing the dose based on weight once the child reaches 40 kilograms?

To ensure the child does not receive more medication than an adult would.

Question: In a case where a patient’s weight exceeds the adult dose, how should the dose be determined?

C. Adjust the dose based on the patient's condition.

Question: Which of the following scenarios can lead to a 10-fold error when dealing with decimals?

trailing zeros and omitting leading zeros

What do you think is the worst age population
For adherence?

adolescence

What is one of the main challenges when administering IV medications to children and infants?

The medications are often too concentrated or in volumes intended for adults.