Pharmacokinetics Pediatrics 3

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kyleannkelsey
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251833
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Pharmacokinetics Pediatrics 3
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2013-12-09 19:43:56
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Pharmacokinetics Pediatrics
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Pharmacokinetics Pediatrics 3
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  1. What drugs are of most concern due to billirubin/protein binding effects in neonates?
    Sulfonamides, Contrast medium, Analgesics and anti-inflammatory drugs
  2. You are a hospital pharmacist. You have the following 3 pharmacokinetic consults for the day on gentamicin (H20 soluble), Rank in order of who will receive the larges t dose per kg: 28 wk premature infant in NICU, 4yr child w/ sepsis, 35 yr adult w/ pneumonia
    28 wk premature > 4yr child > 35 yr adult w/ pneumonia
  3. Is a full term babies liver mature?
    No
  4. Liver Biotransformation ability increases with age in what group?
    1-5 years
  5. Liver Biotransformation ability decreases with age in what group?
    Puberty throughout life
  6. Do neonates have the same enzyme pathways?
    No, some that we don’t have and vice versa
  7. Young children have an increased or decreased enzyme capacity?
    Increased
  8. A drug in a young child would have and increased or decreased clearance rate and half-life?
    Increased clearance and decreased half life
  9. A baby with a 30 week gestational age or a 30 week postnatal age born 2 weeks ago will have better liver function?
    30 week postnatal age born 2 weeks
  10. Phase I Metabolism is directly related to what variables?
    Gestational and Postnatal age
  11. At what age is the adult phase I metabolism patter for phase I reactions attained?
    7-9 months
  12. At what age do children exceed adult phase I metabolism?
    2-9 years
  13. How old must a baby be to begin phase II metabolism at a reasonable rate?
    A couple of months old
  14. What are phase II metabolic reactions?
    Sulfonation, Acetylation ,Amino acid conjugation, Glucuronidation
  15. What are phase I metabolic reactions?
    Oxidation, Reduction and Hydrolysis
  16. At what age do children have adult level equivalent Phase II metabolic abilities?
    1.5- 4 years of life
  17. (True/False) Babies have CYP pathways that adults don’t.
    True
  18. A neonate metabolizes Theophylline into what?
    Caffeine
  19. Can Theophylline be metabolized to caffeine in older children?
    No, only babies
  20. You are designing a new cardiac drug for Congenital heart failure, what are the top priorities for dosing in the 0-18 year old range?
    Low protein binding and water soluble
  21. You are designing a new cardiac drug for Congenital heart failure for 0-18 YO, What age group will need least frequent dosing?
    Premature infants
  22. You are designing a new cardiac drug for Congenital heart failure, what age group will need the lowest dose?
    Adolescents
  23. The rate of maturation in the kidney happens in what way?
    Different for each function (filtration, reabsorption and secretion)
  24. The kidney’s at birth receive how much of CO?
    5-6%
  25. The kidney’s of adults receive how much of CO?
    15-25%
  26. At what age do children exceed adult kidney filtration values?
    2 years
  27. Elimination through the kidney’s is better or worse in neonates than adults?
    Worse
  28. Elimination through the kidney’s is better or worse in 2 YOs than adults?
    Better
  29. Does tubular filtration and reabsorption mature slowly or rapidly?
    Slowly
  30. Renal elimination is altered by what things?
    Hypoxemia, nephrotic drugs and underperfusion
  31. When does GFR accelerate?
    With birth, over first 7 days
  32. GFR accelerates in what period rapidly?
    The first 7 days
  33. What factors contribute to GFR?
    Protein binding, renal blood flow, and nature of glomerular membrane
  34. GFR is directly proportional to what?
    Gestational age
  35. A preterm infant will have fast or slower GFR than a term infant?
    Slower
  36. When do babies hit adult levels of GFR?
    2.5 – 5 months of life
  37. What percent of adult values are GFR levels in neonates?
    30-50%
  38. How low can GFR be in preterm infants compared to adults?
    5%

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