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 medication if it tastes good. Therefore, being the best tasting of the effective drugs would increase adherence in pediatric patients.

Question 2

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 3

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

Establishes a committee that writes guidelines for pediatric prescribing

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 suppress the hypothalamic-pituitary-adrenal axis, which controls the body's response to stress. This can lead to a variety of side effects, including decreased growth, weight gain, and increased risk of infections. Therefore, caution should be exercised when prescribing these medications to young children.

Question 5

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 drug factors listed (maternal drug levels, half-life, and lipid-solubility) can influence the effect of the drug on the infant. Maternal drug levels determine how much of the drug is in the breast milk, while half-life determines how long the drug stays in the system. Lipid-solubility can affect the drug's ability to cross into breast milk and be absorbed by the infant. It is important to consider all of these factors when choosing an antibiotic for a breastfeeding mother.

Question 6

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) requires that all applications for new active ingredients, new indications, new dosage forms, or new routes of administration include studies to evaluate the safety and efficacy of the drug in pediatric populations. This ensures that children are not left behind in drug research and that drugs are appropriately tested for use in the pediatric population.

Question 7

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

Acetaminophen is safe for infants over 3 months old to reduce fever. Aspirin is not recommended due to the risk of Reye's syndrome, and ibuprofen is not recommended for infants under 6 months. Alternating medications is not typically recommended for infants.

Question 8

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 can impact the metabolism and excretion of drugs. In infants younger than 6 months, the renal function may not be fully developed, leading to slower drug clearance from their system. This requires lower doses of renally excreted drugs to be prescribed to avoid toxicity.

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 safest and most accurate way of ensuring the infant receives the correct dose of the medication. Mixing the medication with formula is not recommended as infants may not drink the entire bottle and may not receive the full dose. Discontinuing the antibiotic if diarrhea occurs is not appropriate as antibiotics may cause diarrhea as a side effect. Calling for an antibiotic change if the infant chokes and sputters during administration is not necessary if the medication is administered using a medication syringe correctly.

Question 10

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 means that pediatric prescribing will vary depending on the activity of each enzyme in the child's body. At times, lower doses may be needed due to low enzyme activity, while other times higher doses may be needed due to higher enzyme activity. Therefore, there is no one-size-fits-all dosage for children and dosage must be adjusted according to the developmental activity of each enzyme.

Deck 50: Children As Patients