Advanced Pharmacology Walden 6521 Peds with Verified Solutions

Advanced Pharmacology Walden 6521 Peds with Verified Solutions Drug sensitivity variation in the very young results largely from Organ System Immaturity What are the five stages of pediatrics premature (less than 36wks), full-term (36-40wks), neonates(first 4 post-natal wks), infants (5- 52wks), children(1-12years), adolescents (12-16 years) What considerations have to be made for the pharmacokinetics in children? -organ immaturity -delayed drug elimination gastric emptying time in infancy is both _____and _____ prolonged, and irregular during the neonatal phase, intramuscular administration of medications is slow and erratic ** by infancy, absorption becomes more rapid than in neonates and adults during infancy transdermal absorption is greater than in adolescence and adulthood (skin is thinner, more vascular) **infants are at a greater risk for toxicity from topical drugs Describe why there is more "free" concentrations of drug in infants verses adults, intensifying the effects infants do not have as much albumin, therefore there is less protein binding - dosages for infants should be reduced Describe the blood-brain barrier after birth it is not fully developed, therefore drugs have relatively easy access to the CNS, therefore drugs should be given at a reduced dose. Newborns have a lower drug-metabolizing capacity,...which organ is this associated with an how the liver, lower hepatic metabolism, doses of drugs metabolized by the liver must be reduced. complete maturation of the liver does not occur until 1 year of age Renal capacity of newborns is also less....considerations??? medications primarily excreted through the kidneys dosage should be reduced....adult levels of renal function are achieved by 1 year. by 1 year of age most pharmacokinetic parameters in children are.... similar to those in adults Children (1 year and older) generally metabolize drugs .... faster than adults ***drug metabolizing capacity in children tends to peak at 2 years of age, and then gradually declines there is another rapid decline at puberty where metabolism is near equal with that of an adult changes in drug metabolism would require.... a change of dose, or a change of dose interval what are some of the adverse effects specific drugs can have on developing children *glucocorticoids - growth suppression *discoloration of developing teeth - tetracyclines *Kernicterus (a bile-induced brain dysfunction) - caused by sulfonamides Pediatric dosage formula [child's BSA x Adult dosage] / 1.73m2 = ***metabolizing factors and medication reactions should still be monitored closely to adjust dose accordingly pediatric dosages have been established for .... few drugs adherence and education: what issues should be addressed for the caregiver and/or the child *dosage size and timing