Question 1

To increase adherence in pediatric patients a prescription medication should:&#10;A) Have a short half-life&#10;B) Be the best tasting of the effective drugs&#10;C) Be the least concentrated form of the medication&#10;D) Be administered 3 or 4 times a day&#10;

Accepted Answer

Pediatric patients are more likely to take medications that taste good. Therefore, choosing a medication that is the best tasting among the effective drugs can increase adherence.

Question 2

The Pediatric Research Equity Acts requires:&#10;A) All children be provided equal access to drug research trials&#10;B) Children to be included in the planning phase of new drug development&#10;C) That pediatric drug trials guarantee children of multiple ethnic groups are included&#10;D) All applications for new active ingredients, new indications, new dosage forms, or new routes of administration require pediatric studies&#10;

Accepted Answer

The Pediatric Research Equity Act (PREA) of 2003 requires that all applications for new active ingredients, new indications, new dosage forms, or new routes of administration require pediatric studies. This aims to ensure that drugs are safe and effective for children, as they often have different responses and needs compared to adults. A, B, and C are not accurate descriptions of PREA. While children should have access to drug research trials, PREA specifically focuses on requiring research for new drugs. While involving children in the planning phase may be beneficial, it is not a requirement under PREA. Additionally, while ensuring diversity in research is important, PREA does not specifically require multiple ethnic groups to be included in pediatric drug trials.

Question 3

Drugs that are absolutely contraindicated in lactating women include:&#10;A) Selective serotonin reuptake inhibitors&#10;B) Antiepileptic drugs such as carbamazepine&#10;C) Antineoplastic drugs such as methotrexate&#10;D) All of the above&#10;

Accepted Answer

Antineoplastic drugs such as methotrexate are highly toxic and can be harmful to both the nursing baby and the lactating woman. These drugs are known to cause severe birth defects, so they must be avoided during lactation.

Question 4

The developmental variation in Phase I enzymes has what impact on pediatric prescribing?&#10;A) None, Phase I enzymes are stable throughout childhood.&#10;B) Children should always be prescribed lower than adult doses per weight due to low enzyme activity until puberty.&#10;C) Children should always be prescribed higher than adult doses per weight due to high enzyme activity.&#10;D) Prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and other times higher than adult doses based on the age of the child.&#10;

Accepted Answer

The developmental variation in Phase I enzymes can have a significant impact on pediatric prescribing. Depending on the age of the child and the developmental activity of each enzyme, dosages may need to be adjusted. This can result in both lower and higher than adult doses per weight. Therefore, the best answer is D, prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and other times higher than adult doses based on the age of the child.

Question 5

The Best Pharmaceuticals for Children Act:&#10;A) Includes a pediatric exclusivity rule which extends the patent on drugs studied in children&#10;B) Establishes a committee that writes guidelines for pediatric prescribing&#10;C) Provides funding for new drug development aimed at children&#10;D) Encourages manufacturers specifically to develop pediatric formulations&#10;

Accepted Answer

The answer of The Best Pharmaceuticals for Children Act:&#10;A) Includes...

Question 6

Developmental variation in renal function has what impact on prescribing for infants and children?&#10;A) Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months.&#10;B) Higher doses of water soluble drugs may need to be prescribed because of increased renal excretion.&#10;C) Renal excretion rates have no impact on prescribing.&#10;D) Parents need to be instructed on whether drugs are renally excreted or not.&#10;

Accepted Answer

Developmental variation in renal function means that infants younger than 6 months may have lower renal excretion rates, which can lead to accumulation of renally excreted drugs if higher doses are prescribed. Therefore, lower doses are recommended for this age group.

Question 7

Liza is breastfeeding her 2-month-old son and has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant?&#10;A) Maternal drug levels&#10;B) Half-life&#10;C) Lipid-solubility&#10;D) All of the above&#10;

Accepted Answer

All of the listed drug factors (maternal drug levels, half-life, lipid-solubility) can influence the effect of the antibiotic on the breastfed infant. Maternal drug levels determine the amount of drug that is transferred to the infant through breastmilk. Half-life determines how long the drug will stay in both the maternal and infant's system, impacting how often the drug needs to be taken. Lipid-solubility is a factor in how much of the drug can pass into breastmilk, potentially affecting the infant's exposure to the medication.

Question 8

Topical corticosteroids are prescribed cautiously in young children because:&#10;A) They may cause an intense hypersensitivity reaction&#10;B) Of hypothalamic-pituitary-adrenal axis suppression&#10;C) Corticosteroids are less effective in young children&#10;D) Young children may accumulate corticosteroids, leading to toxic levels&#10;

Accepted Answer

Topical corticosteroids can cause hypothalamic-pituitary-adrenal axis suppression, particularly with prolonged use, and young children may be more susceptible to this effect. This can result in adrenal insufficiency and growth retardation. As such, they should be used cautiously in this population.

Question 9

Zia is a 4-month-old patient with otitis media. Education of his parents regarding administering oral antibiotics to an infant includes:&#10;A) How to administer an oral drug using a medication syringe&#10;B) Mixing the medication with a couple of ounces of formula and putting it in a bottle&#10;C) Discontinuing the antibiotic if diarrhea occurs&#10;D) Calling for an antibiotic change if the infant chokes and sputters during administration&#10;

Accepted Answer

Administering an oral drug using a medication syringe is the most accurate way to ensure the infant receives the correct dose of the medication. Mixing the medication with formula can be inaccurate and may not deliver the full dose. Discontinuing the antibiotic if diarrhea occurs is not necessarily appropriate and should be discussed with the healthcare provider. Choking and sputtering during administration may be a sign of aspiration, which is a medical emergency and requires immediate attention. It is not appropriate to simply call for an antibiotic change in this situation.

Question 10

Janie is a 5-month-old breastfed infant with a fever. Treatment for her fever may include:&#10;A) &#34;Baby&#34; aspirin&#10;B) Acetaminophen suppository&#10;C) Ibuprofen suppository&#10;D) Alternating acetaminophen and ibuprofen&#10;

Accepted Answer

The answer of Janie is a 5-month-old breastfed infant with...

Deck 50: Children As Patients