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14 Cards in this Set
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- Back
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What are pharmacokinetics?
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How the body affects the drug
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What are some physiologic differences in neonates that lead to changes in absorption?
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Uncoordinated / unpredicable gastric persistalsis
Short intestinal transit time Variable Tmax Variable magnitude of absorption |
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How do reduced albumin, a-1 acid glycoprotein and interfering substances like FFA and BR affect [unbound drug] in neonates?
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Increase
Babies are not small adults! |
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What % H20 are babies versus adults?
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75% vs 60%
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What does the combination of increased unbound drug and increased body water mean for neonates in terms of dosing?
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May need either less drug / kg or more (especially if drug H2O soluble)
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What is the volume of distribution?
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The theoretical volume of fluid into which drug must be administered to reach concentration in plasma
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Describe what happens to kidney function, from 34 weeks GA to 40 weeks GA to 2-3 months to 1-6 years?
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34 weeks: <25%
40 weeks (EDC):25% 2-3 months: ~50% 1-6 years: > 100% |
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How should caffeine (for apnea) and gentamycin (for UTIs) be dosed for neonates?
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Less / kg than adult dose.
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Compare clearance, T1/2 and Vd of gentamycin in neonates vs adults?
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Vd: 150%
T1/2: 200% Clearance: 25% Therefore give lower dose. |
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Rank in dose / kg of digoxin the following groups: 2-5, 5-10, neonates, adults
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1. 2-5
2. 5-10 3. adults 4. neonates |
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What are some classes of drugs that can kill babies with one wrong dose?
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TCAs
antipsychotics quinine calcium channel blockers opioids and oral hypoglycemics |
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What is the causative drug for these iatrogenic syndromes?
Reye's Gasping Syndrome Gray Baby Syndrome |
Reye's: ASA with VZV
Gasping Syndrome: benzyl alcohol causing metabolic acidosis Gray Baby Syndrome: hypotension due to chlorophenylol Abx |
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What can these drugs cause in infants?
EtOH Sulfonamide Tetracylcine |
EtOH: hypoglycemia
Sulfonamide: kernicterus due to displaced BR Tetracycline: teeth discoloration of pre-erupted teeth Valproic Acid: liver failure in young children |
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What is a good algorithm for predicting weight for children?
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Weight = 2 x age in years + 8
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