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25 Cards in this Set
- Front
- Back
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How much circulating blood volume is in an infant?
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80 cc/kg
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Max. amount of blood that can be taken?
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<5% or circulating blood volume
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8 lb newborn- how much blood can you draw?
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8 lbs * (1 kg/ 2.2lbs) = 3.6 kg
3.6 kg * (80cc/kg) *0.05 = 14.5 cc |
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If we needed to gather 8 samples @ 5cc/sample how much should the child weigh?
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5cc/sample * 8 samples = 40cc
80cc/kg * X kg *0.05= 40cc X = 10 kg, child should weigh > 10 kg. |
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Definition of preterm infant
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23-34 weeks gestation
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Treament and side effects of NRDS
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1) Mechanical ventilation, O2, surfactant
2) Can lead to inflammation, treat with corticosteroids |
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Did a double-blind study find an increased risk of cerebral palsy in low birth weight infants exposed to dexamethasone?
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Yes
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Is absorption of wk acids slower or faster in children? Why?
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Slower until 3-7 years
Due to higher gastric pH |
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Name 2 acid-labile compounds that have increased bioavailability in kids?
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Penicillin G
Ampicillin |
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Is intestinal transit time increased or decreased in kids?
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Decreased
*Know slophyllin gyrocaps for this (oral med for bronchial asthma) |
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Dose and Vd
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Dose = concentration * Vd
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% total body H2O in infants
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Increased, consider aminoglycosides
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% total body fat in infants and children
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decreased
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Protein [albumin] in children < 1 year
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Decreased
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Protein binding affinity in infants? How does this affect sulfonamides?
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Decreased
Sulfonamides compete w/bilirubin for albumin |
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Age related physiologic changes
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Absorption
Vd Clearance (hepatic and renal) |
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Schwartz equation for baby? For child?
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Creatinine Clearance = 0.45 * length (cm)/Crs
Creatinine clearance = 0.55 * length(cm)/Crs |
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% clearance of these P450 cytochromes: 3A4, 2D6, 2C9
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3A4- 50%
2D6- 20% 2C9- 15% Total = 60% |
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Gray baby syndrome
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Chloramphenicol toxicity
(when a baby is given chloramphenicol for bacterial meningitis -> can't metabolize the drug properly -> toxicity) |
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Some times infants produce weird metabolites. Give an example.
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Theophylline--> caffeine
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What is p-glycoprotein
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Multidrug efflux pump for lipophilic compounds that is expressed in many tissues including BBB
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Examples of drugs affected by p-glycoprotein
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Bilirubin
Cyclosporin Methotrexate |
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Why do pts. get kernicterus
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Slow intestinal transit time
Decreased albumin binding of bilirubin Immature glucoronidation pathway BBB lacks sufficient p-glycoprotein |
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Kernicterus
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Bilirubin encephalopathy affecting CNS esp. basal ganglia
Results in neuro damage, deafness, and cerebral palsy. |
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Dangerous side effects of:
SSRIs Diphenhydramine Lamotrigine |
S- increased risk of suicide
D- sedation/hyperactivity L- Steven's Johnson syndrome |
