Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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 |
