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Fall'20 Pharmacology III > Peds & Geri > Flashcards

Flashcards in Peds & Geri Deck (151)
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1

Young children are not simply small adults; they have unique physiology that changes remarkably with age; especially in what?

The first year

2

Neonates and infants have a high percentage of body water. This means what?

Drugs distributed in water have a high volume of distribution

3

In infants, cardiac output is dependent on:

Heart rate!

4

Due to infants/neonates having a high body water percentage what may be enhanced for this population?

Drug toxicity

5

Anesthetic drugs that cause a reduction in heart rate may ________ depress blood pressure and blood flow to tissues.

Disproportionately

6

Name the three common age groups of the pediatric population:

1.) Neonates - less than 4weeks after birth
2.) Infants - between 4 wks and 1 yr
3.) children - greater than 1 yr of age

7

Neonates often have two subdivisions. What are they?

1. Prematurely (before 37 wks gestation)
2. Term (greater than or equal to 37 weeks)

8

The understanding, assessment and management of acute pain in pediatrics has lagged behind that of adults. Pediatric pts often receive....

Less analgesia postoperatively than adults

9

What was the established view of neonates regarding pain?

Neonates were neither capable of perceiving pain NOR able to remember painful stimuli

10

The primary indication for anesthesia once was the prevention of...

Movement during surgery! :(

(Achieved with little more than Controlled ventilation and NMB’s)

11

The behavioral response to standard noxious stimulus in the neonate may be:

Unpredictable

12

The stress response associated with noxious stimuli in the neonate is:

Impressive and CONSISTENT

13

Infants undergoing surgery w/o adequate anesthesia suffer significant ________ and ________ response which adversely affects post op recovery.

Hormonal and metabolic

14

Important developmental changes in the determinants of pharmacoKINETICS occurs during:

Infancy

15

Infantry changes in pharmacokinetics include:

-drug absorption
-distribution
-Binding
-entry into the brain across BBB
-Metabolism

16

The principal site of absorption for drugs given ORALLY is:

The small intestine

17

The rate at which a drug leaves the stomach is the determinant of speed of:

Drug Absorption

18

Oral Drug absorption is determined by:

The rate at which a drug leaves the stomach

19

The rate at which most drugs are absorbed when given orally is SLOWER in neonates and infants than in older children because:

Gastric emptying is delayed

20

Delayed Gastric emptying is more prevalent in what pediatric populations?

Neonates and infants (vs older children)

21

In neonates, the time (Tmax) at which maximum concentration (Cmax) is achieved is ______.

Prolonged

22

Gastric emptying and intestinal motor motility rates reach normal adult rates at what age?

6-8 months

23

In neonates, the gastric pH is:

Elevated.
Greater than 4

24

The increased gastric pH in neonates increases the bioavailability of ___________. And decreases the bioavailability of _______ ______ when given orally.

Increases: acid-labile compounds (PCN G)
Decreases: weak acids (Phenobarbital)

25

Compared to the older child, The infant gut is more permeable to:

Large molecules (proteins, high molecular-weight drugs)

26

Absorption of _______ drugs is increased in neonates due to what 3 reasons?

Topically applied drugs (corticosteroids, LA Creams, antiseptics)

Due to:
1.) Larger relative skin surface area
2.) increased cutaneous perfusion
3.) thinner stratum corneum

27

Neonates have a tendency to form methgb b/c they have reduced levels of :

Methemoglobin reductase

28

B/c fetal hemoglobin is more readily oxidized than adult hgb, and neonates have a reduced level of methgb reductase what tends to happen?

Methemoglobin

29

The reluctance to use EMLA cream in neonates results because of what reasons:

1.) increased epidermis absorption
2.) reduced methemoglobin reductase

30

EMLA has been shown to be safe in neonates when applied as a

One time dose.

Shown to be efficacious for circumcision pain