neonatal and newborn/pediatric considerations

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Pharmacology
Chapters 5-51
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1

surfactant

  • MOA
  • decrease surface tension of alveoli
  • can be used for rescue or prophylaxis
  • monitor vital signs, maintain patent airway\
2

expected finding after surfactant administration

crackles and moist breath sounds

3

erythromycin

  • ADMIN
  • USE
  • AE
  • to eyes within an hour of delivery
  • prevent eye infection
  • chemical conjunctivitis
4

vitamin K (Phytonadione)

  • MOA
  • USE
  • AE
  • ADMIN
  • anticoagulant antagonist
  • prevent bleeding
  • pain \/edema at injection site, urticaria, rash
5

hep B vaccine

  • MOA
  • USE
  • AE
  • ADMIN
  • stimulate immune system to produce anti-HBsAg antibodies
  • protect hep B infection
  • pain/edema at injection site
  • IM injection within 12hrs after birth
6

neonatal body is about how many percent of water compared to adults?

75% compared to 60%

7

PREA

requires drug manufacturers to study pediatric drug use and offer incentives for pediatric pharmacology research

8

what's the best method to administer drugs to neonates?

oral syringe

9

define off label

using a drug for a different purpose than it is intended to for.

10

the degree and absorption of drugs in based on

age, health status, weight, and route

11

less absorption in neonates and infants due to

  • immature organs
  • lack of maturation in GI tract
  • alkaline gastric pH at birth (acid at 2-3yrs of age)
12

distribution of drugs is affected by

  • body fluid and tissue composition
  • protein binding capacity
  • barriers to drug transport
13

effects of decreased protein concentration in neonates

  • affect protein binding of drugs
  • increased risk of toxicity
  • immature BBB
14

metabolism of drugs in neonates depends on

maturation level of patient and it varies from child to child

15

primary organ for metabolism

liver. infants have reduced hepatic flow and reduced drug-metabolizing enzymes. reaches adult levels by age 1

monitor therapeutic levels

16

primary organ for excretion

primarily renal. reduced GFR. reaches adult levels by 12mnths.

monitor renal function, urine output, and drug effectiveness