Pediatrics lec 1

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Questions and Answers

What is the primary objective of therapeutic drug monitoring (TDM) in pediatrics?

To diagnose sepsis in neonates

To identify potential drug-drug interactions

To monitor the pharmacokinetics of medications in pediatric patients (correct)

To determine the optimal dosage of antibiotics

How do the pharmacokinetics of absorption, distribution, metabolism, and elimination differ between children and adults?

Children have slower absorption and faster elimination rates compared to adults

Children have similar pharmacokinetic profiles to adults

Pharmacokinetics are unaffected by age

Children have faster absorption and slower elimination rates compared to adults (correct)

What is the correct dose of tobramycin for a 4 kg neonatal patient based on the adult dose of 1mg/kg IV q8h?

1 mg IV q8h

2 mg IV q8h (correct)

4 mg IV q8h

0.5 mg IV q8h

Why is it crucial to consider age when determining the dosage of medications in pediatric patients?

To minimize the risk of adverse effects and optimize therapeutic outcomes Signup and view all the answers

What additional information is necessary to determine the correct dose of tobramycin for the 8-day-old neonatal patient?

The patient's kidney function Signup and view all the answers

Why might the adult resident's suggested dose of tobramycin (4 mg IV q8h) be incorrect for the 4 kg neonatal patient?

The dose is too high for the patient's age Signup and view all the answers

Why would neonates require a higher dose of tobramycin to achieve similar peaks as adults?

Due to their higher volume of distribution Signup and view all the answers

What is the primary reason why the MD's suggested dose of tobramycin for the neonate is incorrect?

The dose is too low Signup and view all the answers

What is a key principle in pediatric drug dosing?

Children are not little adults Signup and view all the answers

What is an important consideration when dosing antibiotics in neonates?

The antibiotic's volume of distribution Signup and view all the answers

Why is Therapeutic Drug Monitoring (TDM) important in pediatric patients?

To ensure optimal drug concentrations Signup and view all the answers

What is a challenge in pediatric drug dosing?

Dosing is complex and needs to account for age-related changes Signup and view all the answers

Why is it important to use pediatric-specific dosing guidelines?

Because pediatric patients have different pharmacokinetics Signup and view all the answers

What is a key difference between adult and neonatal pharmacology?

Neonates have a lower body fat content Signup and view all the answers

What is the primary reason for using different dosing categories in pediatrics?

Because children have different pharmacokinetics than adults Signup and view all the answers

What is the age range for a preschool child?

2-5 years Signup and view all the answers

What is the correct calculation for post-menstrual age (PMA)?

PMA = GA + PNA Signup and view all the answers

What is the primary concern with using the adult dose of tobramycin for an 8-day-old neonate?

The dose is based on weight, but not adjusted for age Signup and view all the answers

What is the correct category for an 8-day-old baby?

Neonate Signup and view all the answers

What additional information is needed to determine the correct dose of tobramycin for an 8-day-old neonate?

The baby's gestational age and postnatal age Signup and view all the answers

Why is it important to consider prematurity in pediatric dosing?

Because premature babies have different pharmacokinetics Signup and view all the answers

What is the correct dose of tobramycin for an 8-day-old neonate based on the adult dose of 1mg/kg IV q8h?

The dose cannot be determined from the information provided Signup and view all the answers

Study Notes

Pediatrics: Age Definitions

Neonate: 0-1 month
Infant: 1 month-1 year
Child: 1-11 years
Child can be further categorized as:
- Toddler: >12 months-23 months
- Preschool child: 2-5 years
- School age child: 6-11 years
Adolescent: 12-18 years

Dosing in Pediatrics

Dosing can be based on:
- Weight
- Age
- Prematurity (post-menstrual age)
- Body surface area
- A combination of the above

Importance of Age Definitions

Dosing in pediatrics is complex and needs to account for drug disposition changes with age
Children are not little adults

Volume of Distribution (Vd)

Adults: fat content ~13%
Neonates: lower body fat content, need a higher dose to achieve similar peaks

Pharmacokinetic Considerations

Differences in pharmacokinetics between children and adults:
- Absorption
- Distribution
- Metabolism
- Elimination

Therapeutic Drug Monitoring (TDM)

Role of TDM in pediatrics: important for optimal dosing and patient care

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Description

Learn about the different age categories in pediatrics, including neonate, infant, child, toddler, and adolescent. Understand the specific age ranges for each category.