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On a mg/kg basis are pediatric doses larger or smaller?
Larger
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The Volume of distribution are larger or smaller per kg in pediatrics?
Larger
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Total body water/fat ratio is different in what way for pediatrics?
Larger total body water and fat stores
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Are pediatric patients dosed less or more frequently?
Usually more, less for pre-mes
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What age group of pediatrics gets the highest dose most frequently?
2-9
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What age group are “super metabolizers”?
2-9
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What is antenatal?
Before birth
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What is Perinatal?
12th week of gestation to the 28th day of life after birth
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What is a Pediatric?
<18 years
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What is a Neonate?
Within first month of life
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What is an infant?
1-17 months
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What is a Toddler?
18 mo – 3 years
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What is a Preschooler?
3-5 years
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What is a Child?
6-12 years
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What is an Adolescent?
13-18 years
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What is a young adult?
18-24 years
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What is a premature baby?
< or = to 37 weeks gestation
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What is a full term baby?
38-42 weeks gestational age
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What is a Post-term baby?
> or = 42 weeks of gestation
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How do children’s stomach acid differ from adults?
Elevated Gastric pH due to immature Parietal cells
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What is the biggest issue with IM injections in pediatric patients?
Pain
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Enteral absorption is often reliable or unreliable?
Unreliable
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If a baby is born by C-section, what will be their gut pH?
Greater than normal, which is 5-6
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Why is absorption in the intestine more reliable than in the stomach in pediatrics?
Because of the immature parietal cells in pediatrics
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What type of drugs do pediatrics not absorb as well due to their higher stomach pH?
Acidic drugs like Phenytoin, Phenobarbitol, APAP and riboflavin
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What type of drugs are absorbed better in pediatrics due to higher stomach pH?
Acid labile drugs like antibiotics
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Why might pediatrics not need as large of a dose of antibiotics as you would think?
Because many antibiotics are acid labile and so are better absorbed in their elevated gastric pH
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Do pediatrics absorb fat well?
No
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Will fat be in the intestines longer or shorter times in pediatrics?
Longer
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Neonates have an increased capacity of what enzymes in the gut?
B-glucoronidase and UDP-glucorinyl transferase
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Describe the difference in pediatrics in terms of Bile and pancreatic enzymes?
Immature, not as prolific
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How are pediatrics different in terms of bacterial flora of the gut?
Dependent on diet
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Why do babies get a Vitamin K shot at birth?
Because they could bleed out otherwise
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What has a high impact of gastric flora of pediatrics?
Breast or Bottle fed
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What things can increased gastric emptying rate in pediatrics?
Feeding Human milk, Hypocaloric feeding
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What things can decrease gastric emptying in Pediatrics?
Prematurity, GI reflux, Respiratory distress, congenital heart disease, Long chain fatty acids
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What effect does Osmolality and Posture have on gastric emptying rate of pediatrics?
None
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IM absorption is directly proportional to what?
Blood flow, Surface area of drug deposited in the muscle, sick or hypothermic conditions
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Is IM or Enteral considered more reliable?
IM if the infant is healthy
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