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25 Cards in this Set

  • Front
  • Back
How much circulating blood volume is in an infant?
80 cc/kg
Max. amount of blood that can be taken?
<5% or circulating blood volume
8 lb newborn- how much blood can you draw?
8 lbs * (1 kg/ 2.2lbs) = 3.6 kg

3.6 kg * (80cc/kg) *0.05 = 14.5 cc
If we needed to gather 8 samples @ 5cc/sample how much should the child weigh?
5cc/sample * 8 samples = 40cc

80cc/kg * X kg *0.05= 40cc

X = 10 kg, child should weigh > 10 kg.
Definition of preterm infant
23-34 weeks gestation
Treament and side effects of NRDS
1) Mechanical ventilation, O2, surfactant

2) Can lead to inflammation, treat with corticosteroids
Did a double-blind study find an increased risk of cerebral palsy in low birth weight infants exposed to dexamethasone?
Is absorption of wk acids slower or faster in children? Why?
Slower until 3-7 years

Due to higher gastric pH
Name 2 acid-labile compounds that have increased bioavailability in kids?
Penicillin G
Is intestinal transit time increased or decreased in kids?
*Know slophyllin gyrocaps for this (oral med for bronchial asthma)
Dose and Vd
Dose = concentration * Vd
% total body H2O in infants
Increased, consider aminoglycosides
% total body fat in infants and children
Protein [albumin] in children < 1 year
Protein binding affinity in infants? How does this affect sulfonamides?

Sulfonamides compete w/bilirubin for albumin
Age related physiologic changes
Clearance (hepatic and renal)
Schwartz equation for baby? For child?
Creatinine Clearance = 0.45 * length (cm)/Crs

Creatinine clearance = 0.55 * length(cm)/Crs
% clearance of these P450 cytochromes: 3A4, 2D6, 2C9
3A4- 50%
2D6- 20%
2C9- 15%
Total = 60%
Gray baby syndrome
Chloramphenicol toxicity
(when a baby is given chloramphenicol for bacterial meningitis -> can't metabolize the drug properly -> toxicity)
Some times infants produce weird metabolites. Give an example.
Theophylline--> caffeine
What is p-glycoprotein
Multidrug efflux pump for lipophilic compounds that is expressed in many tissues including BBB
Examples of drugs affected by p-glycoprotein
Why do pts. get kernicterus
Slow intestinal transit time

Decreased albumin binding of bilirubin

Immature glucoronidation pathway

BBB lacks sufficient p-glycoprotein
Bilirubin encephalopathy affecting CNS esp. basal ganglia

Results in neuro damage, deafness, and cerebral palsy.
Dangerous side effects of:
S- increased risk of suicide
D- sedation/hyperactivity
L- Steven's Johnson syndrome