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• Why do many medications lack pediatric dosing information in their drug labeling?

  There is a lack of evidence-based literature on the safe and effective use of medications in children.
• Why are Neonates at greater risk for toxicity with highly protein-bound drugs?

  Protein binding is decreased in neonates increasing the amount of free drug available.
• At what age are adult levels of renal function achieved?

  12 months
• How do you help prevent medication errors?

  write out the term "daily"
• In pediatric patients gastric acidity does not reach adult values for

  2 years
• Altered absorption of drugs in the elderly may result in____drug response


  delayed
• You have an elderly patient taking warfarin. You add another protein binding drug. Which of the following statements is correct?

  You will need to decrease dose of warfarin
• In the elderly, the proper index of renal function is____.

  GFR
• what is bioavilability?


  ability of drug to reach the systemic circulation from site of admin

  occurs primarily with oral preps than parenteral
• what is a prodrug?

  compound pharmacologically inactive at admin then converts to active form via metabolism
• what is glucuronidation?


  converts lipid soluble drugs into water soluble by binding to glucuronic acid
• what is the first pass effect?

  rapid hepatic inactivation of drugs
• what does a partial agonist do?

  • moderate intrinsic activity
  • act as agonist and antagonist
• what is an example of a partial agonist?


  pentazocine
• noncompetitive bind irreversibly or reversibly?

  irreversibly
• Nematodes (round worms)


  Mebendazole, Ivermectin, Albendazole (MIA)
• Cestodes (tapeworms)

  Prazinquantel
• Trematodes (flukes)


  Praziquantel, Triclabendazole, albendazole (PAT)
• Ascariasis (giant roundworm)


  most prevalent

  serious complications if migrates - pancratic duct, bile duct, gallbladder, liver

  Albendazole, Mebendazole, Ivermectin
• Pinworms


  children and spreads to family

  whole family needs to be treated

  not washing hands

  Albendazole, Mebendazole, Pyrantel pamoate
• Ancylostomiasis and necatoriasis (hookworm)


  enter by attaching to feet when walking barefoot

  Albendazole, Mebendazole, Pyrantel pamoate
• Trichuriasis (whipworm)


  enter by food grown in soil where they live

  Albendazole
• Strongyloidiasis (threadworm)


  Responds to Ivermectin
• Richinosis (pork round worm)

  eating undercooked pork

  Albendazole
• Wuchereriasis andbrugiasis

  infects from mosquito bites

  Diethylcarbamazine
• Onchocerciasis (river blindness)


  bites of flies

  Ivermectin
• Prazinquantel


  Cestodes - by under cooked meat - Taeniasis (beef/pork tapeworm), diphyllobothriasis (fish tapeworm)

  Trematode - snails - Fascioliasis (liver fluke)

  Fasciolopsiasis (Intestinal fluke)
• Adverse Drug rx definition by WHO

  any noxious, unintended, and undesired effect that occurs at normal drug doses
• Side effect


  a nearly unavoidable secondary drug effect produced at therapeutic doses

  predictable

  intensity dose dependent
• idiosyncratic effect

  uncommon drug reponse resulting from a geneti predisposition

  6GPD deficiency - X link condition in African and Mediterranean ancestry - ASA or sulfonamides can cause hemolysis
• Iatrogenic disease

  disease produced by a physician

  drug-induced disease
• pharmacodynamic tolerance


  long term admin of drugs such as morphine or heroin
• metabolic tolerance 


  accelerated drug metabolism
• Tachyphylaxis


  reduction in drug responsiveness brought by repeated dosing over a short time
• BiDil


  contains two vasodilators: Isosorbide and hydralizine

  in a A-Heft trial for African Americans

  treat HF to decrease mortality
• Monoamine Oxidase Inhibitors trigger what?

  trigger malignant HTN by eating foods with tyramine
• liver maturation in babies

  liver capacity to metabolize drugs increases rapidly about 1 month

  mature level is a few months after

  complete liver maturation is at 1 year
• what is an appropriate treatment for suppressive therapy?

  Valacyclovir 500mg daily x 1 year
• when treating with an antiviral, what lab should you run?

  Bun/cr
• what treats herpes labialis?

  Valacyclovir

  topical - Penciclovir and Docosanol