Pediatrics Review

Pediatrics review

Age groups

Neonate (<1 month) Infant (1 month to 2 years) Child (2 years to <12 years) Adolescent (12 years to 21 years) Adult (>18 years)

Pharmacokinetics in Pediatrics

Decrease plasma protein and increased free drug Decreased renal function Decreased enzyme activity Increased skin permeability Increased stomach acid Decreased gastric emptying time Rectal drug administration is same as adults

Dosing

Utilize weight based dosing NOT BSA in children less than 10kg PO <600mOsm/kg otherwise lead to necrotizing enterocolitis IV peripheral < 1000mOsm/L, <D12.5 otherwise lead to intraventricular hemmorrage IV central < D30 otherwise lead to intraventricular hemmorrage

Preservatives to avoid

Sorbiitol à GI upset Sodium benzoate à displace bilirubin Benzyl alcohol à gasping syndrome Propylene glycol à serum hyperosmolarity, lactic acidosis, hypotension, arrhythmias, CNS depression, death

Pregnancy Drug Categories

A – Controlled studies failed to demonstrate a risk to the fetus B – Animal studies failed to demonstrate a risk to the fetus and no controlled studies in pregnant women OR        Animal studies demonstrate a risk and controlled studies in pregnant women have failed to demonstrate a risk C – Studies in animals showed adverse effects on the fetus and no controlled studies in women D – Positive evidence of human fetal risk, but in some cases benefit may outweigh risk X – Contraindicated in pregnancy, risk outweighs any potential benefit

Lactation Drug Categories

L1 – Controlled studies fail to demonstrate a risk L2 – Limited studies without an increase in adverse effects L3 – No controlled studies, risk of untoward effects to a breastfed infant is possible OR          Controlled studies show only minimal non-threatening adverse effects L4 – Evidence of risk L5 – Studies have shown that there is significant and documented risk