Pharmacokinetics Pediatrics 4

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  1. Will neonates have reduced or enhanced clearance of Aminoglycosides, why?
    Reduced, due to decreased renal blood flow, GFR and Tubular filtration
  2. Which increases more in the first week of life, tubular secretion or GFR?
  3. When does Tubular secretion increase in a neonate and how much over that time period?
    Over the first week of life increased 2 fold AND Over the first year of life increased 10 fold
  4. When does Tubular secretion reach adult levels in babies?
    6-7 months Postnatal
  5. When does tubular reabsorption reach adult levels?
    9 months old
  6. At what point can glucose, PO4 and bicarbonate be concentrated into the urine well, why?
    9 months, that is when tubular reabsorption matures
  7. In a baby that is under 9 months, how will Penicillin be eliminated?
    By GFR
  8. In a baby that is over 9 months, how will Penicillin be eliminated?
    By tubular secretion
  9. What is the major pathway of elimination for neonates?
  10. Does a 8 YO, 1MO or Adult on a highly protein bound drug have the most frequent dosing?
    8 YO
  11. Does a 8 YO, 1MO or Adult on a highly protein bound drug have the least frequent dose?
    1 MO
  12. Does a 8 YO, 1MO or Adult on a highly protein bound drug have the highest dose per kg?
    1 MO
  13. Does a 8 YO, 1MO or Adult on a highly protein bound drug have the lowest dose per kilogram?
  14. Adults get larger or smaller doses/kilo compared to peds?
  15. Adults have larger or smaller BW/fat raios compared to peds?
  16. Are peds dosed more or less frequently?
    More frequently as they age due to increasing metabolism, excretion and clearance
  17. Half-life/Clearance in a neonate is _________ compared to a child and a child’s half-life is _____________ compared to an adult.
    Longer Very short
  18. Do pregnant women recive higher or lower doses compared to non-pregnant?
  19. How do Vd and TBW/fat change in pregnant women?
  20. Lactating women receive higher or lower doses than pregnant women?
    A little bit bigger but more like prior to pregnancy doses
  21. What are the major physiological changes in women during pregnancy?
    Increased CO, Renal perfusion, BV and weight, decreased GI motility
  22. What are the pharmacokinetic changes in pregnant women?
    Shorter t 1/2, Larger Vd for lipophilic drugs, Potential decreased rate or extent of oral absorption
  23. Newborns can clear medications quickly (T/F).
  24. Should you promote or avoid medications with long half lives in Newborns, why?
    Avoid, clearance is low at first
  25. Do Fetuses metabolize things in the womb?
    No, dependent on mother
  26. What is the first thing you should look for when evaluating if a lactating mother can have a certain drug?
    Is it even absorbed
  27. Gentamycin oral is unsafe or safe in a lactating mother?
    Safe, because it is not absorbed
  28. Ducosate is unsafe or safe in a lactating mother?
    Safe, because it is not absorbed
  29. How should most drug levels be adjusted in a lactating mom from the doses given during pregnancy?
    Should be made smaller
  30. What are the infant/maternal factors that should be evaluated when deciding on a dose for a lactating mom?
    Disease states, ADME and Age of mom and baby
  31. Lactating doses are different or the same for normal non-pregnant doses?
    About the same
  32. What type of drugs are preferred in women who are lactating and why?
    Shorter t1/2, for baby
  33. Does the fetus/infant receive the same dose of drug that the mom is getting?
    No much lower usually
  34. A drug with what milk:plasma ratio is probably not safe for breast feeding women?
  35. (True/False) pediatric patient have dynamic pharmacokinetics.
  36. (True/False) Drug absorption in pediatrics can be altered by age, feedings and disease states
  37. Children between __________ are super excretes/metabolizers
    2-9 years

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Pharmacokinetics Pediatrics 4
2013-12-10 00:44:25
Pharmacokinetics Pediatrics

Pharmacokinetics Pediatrics 4
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