Pediatric Pharmacology: Dosing Considerations

Play an AI-generated podcast conversation about this lesson

Which factor is NOT typically used to determine the initial drug dose for obese children?

Actual Body Weight
Age
Disease severity
Ideal Body Weight (correct)

Plasma drug level monitoring is generally discouraged in obese pediatric patients due to its potential to complicate dosing adjustments.

False (B)

What characteristic of adipose tissue affects the distribution of hydrophilic antibiotics in obese children?

low water content

Vancomycin dosing in obese children is typically based on ______ body weight.

actual Signup and view all the answers

For complicated infections in obese children, the initial vancomycin dosing frequency of every 8 hours may be increased. What is the subsequent dosing frequency?

Every 6 hours (B) Signup and view all the answers

Why are some drugs diluted from adult concentrations for pediatric patients?

To achieve suitable pediatric dosage forms (D) Signup and view all the answers

Mixing medications with palatable substances will always improve drug absorption in pediatric patients.

False (B) Signup and view all the answers

When dosing antineoplastic agents based on BSA in adolescents, what precaution should be taken regarding the daily dose?

do not exceed the maximum adult dose Signup and view all the answers

Why are insulin requirements typically higher during adolescence compared to other age groups?

Due to rapid growth spurts. (A) Signup and view all the answers

Infants require a lower maintenance dose of digoxin compared to adults due to immature myocardium.

False (B) Signup and view all the answers

Why is promethazine not recommended for children under 2 years old?

risk of severe respiratory depression Signup and view all the answers

The use of _______________ is contraindicated in children under 8 because of the risk of dental staining and enamelization defects.

tetracyclines Signup and view all the answers

Match the following medications with their respective pediatric considerations:

Chloramphenicol = Increased toxicity in newborns due to immature metabolism Promethazine = Risk of severe respiratory depression in young children Tetracyclines = Risk of dental staining and enamelization defects in children Digoxin = Infants require higher maintenance doses compared to adults Signup and view all the answers

What is a primary concern regarding the use of ethanol and sorbitol as excipients in oral medications for pediatric patients?

Safe levels for infants and children are undetermined. (C) Signup and view all the answers

Cough and cold remedies containing antihistamines and decongestants are generally recommended for children under 6 years old.

False (B) Signup and view all the answers

Why do aminoglycosides appear to be less toxic in infants compared to adults?

Neonatal tissue compartments resemble those in adults with similar renal function, leading to a lower incidence of nephrotoxicity. (B) Signup and view all the answers

Which factor primarily contributes to the neutral gastric pH observed in newborns?

Presence of amniotic fluid in the stomach (B) Signup and view all the answers

Infants are less susceptible to medication toxicity due to a less permeable blood-brain barrier.

False (B) Signup and view all the answers

What is one physiological change that can increase the risk of medication toxicity in sick, dehydrated children?

Increased water loss and decreased oral fluid intake Signup and view all the answers

Which age group typically exhibits the highest percentage of total body water relative to body weight?

Preterm infants (A) Signup and view all the answers

Lipophilic drugs, such as diazepam, exhibit a smaller volume of distribution in infants because infants have lower ______ stores.

fat Signup and view all the answers

After the newborn period, drug metabolism tends to slow down, requiring smaller, less frequent doses.

False (B) Signup and view all the answers

Match the age groups to their approximate total body water percentage:

Adults = 55% Infants = 70-75% Preterm Infants = 85% Signup and view all the answers

Reduced liver enzyme activity in neonates leads to which effect on drug metabolism?

Decreased drug clearance and prolonged drug effects (C) Signup and view all the answers

What factor apart from amniotic fluid contributes to a higher gastric pH in premature neonates, affecting drug absorption?

Immature acid secretion Signup and view all the answers

What effect does diminished protein binding have on drug availability and activity in children?

Increases the amount of 'free,' active drug, potentially increasing drug effects (C) Signup and view all the answers

Why is percutaneous absorption of topical medications significantly increased in neonates?

Due to an immature epidermis and increased skin hydration. (A) Signup and view all the answers

Cutting suppositories to achieve a precise dose is recommended when the required dose is unavailable.

False (B) Signup and view all the answers

List three side effects that can be caused by administering steroids via nebulization or inhalation.

Oral thrush, contact dermatitis, cataracts Signup and view all the answers

Variable IM absorption has been demonstrated for ________, gentamicin, phenobarbital, and diazepam in neonates.

digoxin Signup and view all the answers

What must caregivers be in order to ensure accurate medication administration via a Metered Dose Inhaler (MDI)?

Well-educated and confident. (B) Signup and view all the answers

Administering rectal medications to children should be the first choice due to its ease and non-invasive nature.

False (B) Signup and view all the answers

What type of lubricant should always be used to aid insertion during rectal medication administration?

water soluble lubricant Signup and view all the answers

Match the consideration with administration route

Intramuscular = Unpredictable absorption Topical = Increased absorption in neonates Nebulized/Inhaled = Can cause oral thrush Rectal = Use water soluble lubricant Signup and view all the answers

Why are infants more sensitive to drugs affecting the Central Nervous System (CNS)?

Their blood-brain barrier is not fully developed, allowing easier drug entry. (B) Signup and view all the answers

Topically applied medications are safe to use liberally on infants due to their lower absorption rate.

False (B) Signup and view all the answers

Why might adolescents be particularly susceptible to drug interactions?

Adolescents might concurrently use alcohol, recreational drugs, or other medications without informing their healthcare provider. (D) Signup and view all the answers

Besides age and weight, what other factor is crucial for determining medication doses in children?

Body surface area (BSA) Signup and view all the answers

The instillation of otic medications can cause an unpleasant sensation for a child if the medication is too ______.

cold Signup and view all the answers

The recommended daily drug dose for a pediatric patient must always exceed the maximum dose approved for adults in similar conditions.

False (B) Signup and view all the answers

Why is hyperextension of the head recommended when administering nasal drops?

To prevent an unpleasant sensation by stopping the medication from trickling down the throat. (D) Signup and view all the answers

Why is promethazine contraindicated for use in children younger than 2 years?

risk of severe respiratory depression Signup and view all the answers

Administering eye drops is generally a painless procedure for children and does not require special techniques.

False (B) Signup and view all the answers

The maintenance dose of digoxin is substantially higher in infants than in adults due to a lower binding affinity of receptors in the ______ for digoxin.

myocardium Signup and view all the answers

Name one potential adverse drug reaction (ADR) unique to children due to their ongoing growth and development.

Growth Suppression Signup and view all the answers

Match the following drugs with the reasons for their toxicity or dosage adjustments in specific pediatric populations:

Chloramphenicol = Increased toxicity in newborns due to immature metabolism Digoxin = Higher maintenance dose in infants due to lower receptor binding affinity Insulin = Higher requirements during adolescence due to rapid growth Promethazine = Contraindicated in young children due to risk of respiratory depression Signup and view all the answers

Match each medication with its common intranasal application in pediatric care:

Midazolam = Seizure management Fentanyl = Pain management Morphine = Severe pain management Signup and view all the answers

Which of the following factors contributes to increased chloramphenicol toxicity in newborns?

Immature metabolism and enhanced bioavailability. (D) Signup and view all the answers

Ethanol and sorbitol, commonly found in some liquid medications, pose no significant risk to infants and children, even when they are taking multiple medications concurrently.

False (B) Signup and view all the answers

Why are insulin requirements highest during adolescence?

rapid growth Signup and view all the answers

Adolescent substance use

Adolescents may use substances, requiring careful monitoring to prevent drug interactions.

Digoxin dosage difference

Infants need a higher digoxin dose than adults due to binding differences.