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50 Cards in this Set

  • Front
  • Back
what causes gray baby syndrome
chloramphenicol
what does thalidomide cause
phocomelia
what is the estimation of maturity at birth
gestational age
what is the days or weeks of life since birth
postnatal age
what is the postmenstrual/postconceptual age
gestetional age + postnatal age
when does a babies gastric pH reach adult levels
2 years
what is the pH of babies
above 4, they are not able to make gastric acids fully yet (achlorhydria)
what is the acid absorption and basic absorption in babies
acid requires higher dose
base requires lower dose
what drugs are acidic
phenobarbital
phenytoin
what drugs are basic
penicillin
ampicillin
erythromycin
how can necratizing entercolitis occur
this happens if you give too concentrated of a drug to an infant because it causes irritation in the GI tract
how is absorption in neonates vs adults
drugs are better absorbed in neonates due to their long gastric emptying time
what is GI integrety influenced by
osmolarity

(increased osmolarity may compromise GI integrety)
what disease state affects gastric acid secretion (absorption)
removal of small bowel
what disease state affects delayed gastric emptying (absorption)
pyloric stenosis
congenital heart disease
what disease states affect intestinal transit time (absorption)
thyroid disorders (hypo increases hyper decreases)
diarrhea (decreases)
why is IM admin not used
not sure how much will be absorbed due to infants having little muscle tissue
what is the biggest factor in transdermal administration
skin thickness
how does transdermal admin compare in neonates and adults
neonates have a higher skin to weight ratio so only need a little medication topically to have systemic effect

their skin is also very hydrated therefore increased absorption
what drugs are not preferred topically due to increased absorption
corticosteroids
alcohol
diphenhydramine
EMLA
what are the properties of rectal admin in neonates
not for routine use may lead to perforartion of intestinal wall
what are some drugs given rectally to kids
acetomenophen
diazepam
how does the Vd of neonates compare and how does it effect their dose
neonates have a high Vd

they require a higher dose of hydrophilic drugs and lower dose of lipophilic drugs
what are some drugs that are highly hydrophilic
aminoglycosides
antibiotics
when do neonates reach adult levels of protein
10-12 months
what binds basic drugs
alpha 1 acid glycoprotein
what binds acidic drugs
albumin
what is the protein levels in neonates vs adults
low
how does a decrease in protein effect neonates
decreased binding sites
therefore increased free drugs
how does a decrease in albumin effect neonates
that means more drug/endogenous compounds are displaced such as bilirubin which can lead to jaundice or keratenous
what drugs bind to albumin
ceftriaxone
sulfamethazole and trimethoprim
if a drug has high tissue penetration what does that mean
it has a high Vd and will require a higher dose
what disease states increase Vd
cystic fibrosis
malignancies
liver failure w/ ascites
septic shock
what disease state decreases Vd
dehydration
what is the major site od drug metabolism in neonates
hepatic metabolism but neonates have a

decreased cellular uptake of drugs, hepatic enzyme capacity, biliary excretion
what are the phase 1 reactions
alchohol dehydrogenase
demethylation
hydroxylation
what is the significance of alcohol dehydrogenase
converts benzyl alcohol which is a drug preservative
what is the effect of benzyl alcohol
decreases blood viscosity leading to hemmorrhage and brain damage
what drugs undergo demethylation
meperidine
diazepam
theophyline
what drugs undergo hydroxylation
diazepam
phenytoin
phenobarbital
what can result from benzyl alcohol poisoning
neonatal gasping syndrome
what are the phase 2 reactions
sulfation
acetylation
glucoronidation
conjugation
how can neonates metabolize acetaminophen w/o glucorinidation
they do so via sulfation
how long does it take for glucorinidation metabolism to occur
3-4 years
what disease state increases hepatic clearance
cystic fibrosis

therefore things metabolized quickly
what disease state decreases hepatic clearance
congenital heart disease
birth asphyxia
sepsis

therefore things metabolized slowly
how is the GFR in neonates
initially at birth their SCr is like that of their mother but after all of it has been secreted their GFR drops

therefore neonates have decreased secretion and reabsorption
what is the renal clearance of neonates
decreased therefore increased drug half life and decreased dosing interval
what disease state has increased renal clearance
cystic fibrosis
what disease state has decreased renal clearance
congenital heart disease
sepsis
renal failure