Question 1

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 at other times higher than adult doses based on the age of the child.&#10;

Accepted Answer

Prescribing dosages for children must consider the developmental activity of phase I enzymes, which can fluctuate throughout childhood. This means that depending on the child's age, the prescribed dosage may need to be adjusted higher or lower than what would be calculated based purely on weight, to account for these enzymatic activity variations.

Question 2

Education of parents regarding administering oral antibiotics to a 4-month-old infant with otitis media 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 oral drugs to infants can be challenging, and using a medication syringe is a recommended method because it allows for accurate dosing and ensures the medication is directed towards the side of the mouth to avoid choking. Mixing medication with formula can lead to underdosing if the infant doesn't finish the bottle. Discontinuing antibiotics without consulting a healthcare provider can lead to incomplete treatment of the infection. If an infant chokes during administration, it's important to adjust the technique rather than immediately changing the antibiotic.

Question 3

The Pediatric Research Equity Act says that:&#10;A)All children must be given equal access to drug research trials.&#10;B)Children must be included in the planning phase of new drug development.&#10;C)Children of multiple ethnic groups must be included in pediatric drug trials.&#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 mandates that pediatric studies are required for all applications for new active ingredients, new indications, new dosage forms, or new routes of administration, ensuring that drugs are safely and effectively used in the pediatric population.

Question 4

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 lead to hypothalamic-pituitary-adrenal (HPA) axis suppression, especially in young children, due to their more permeable skin and a higher surface area to body weight ratio, which can increase systemic absorption.

Question 5

Treatment for fever in a 5-month-old infant may include:&#10;A)&#9;&#8220;Baby&#8221; aspirin&#10;B)&#9;Acetaminophen suppository&#10;C)&#9;Ibuprofen suppository&#10;D)&#9;Alternating acetaminophen and ibuprofen&#10;

Accepted Answer

Acetaminophen is safe for infants over 3 months old. Aspirin is not recommended due to the risk of Reye's syndrome, and ibuprofen is typically not recommended for infants under 6 months. Alternating medications is not generally recommended without medical advice.

Question 6

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 absolutely contraindicated in lactating women because they can be harmful to the nursing infant due to their effects on rapidly dividing cells.

Question 7

The Best Pharmaceuticals for Children Act:&#10;A)Includes a pediatric exclusivity rule that 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 to specifically develop pediatric formulations&#10;

Accepted Answer

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

Question 8

A woman who is breastfeeding her 2-month-old child 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 factors listed - maternal drug levels, half-life, and lipid-solubility - influence the effect of a drug on the infant through breastfeeding. Higher maternal drug levels can lead to higher levels in breast milk, drugs with longer half-lives may accumulate in the infant's system, and lipid-soluble drugs are more likely to pass into breast milk and be absorbed by the infant.

Question 9

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 six 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

Infants younger than six months have immature renal function, leading to reduced renal excretion of drugs. Therefore, lower doses of renally excreted drugs may be necessary to avoid toxicity.

Question 10

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 three or four times a day&#10;

Accepted Answer

Taste is a significant factor in medication adherence among pediatric patients. A medication that is palatable or tastes better is more likely to be accepted and taken regularly by children, thus increasing adherence.

Deck 53: Pediatric Patients