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Peds
P3 Pediatric- Therapeutics
| Question | Answer |
|---|---|
| Vital signs: Heart rate | age dependent, decreases with age |
| Vital signs: respiratory rate | age dependent, decreases with age |
| Vital signs: blood pressure | age, sex and height dependent, increases with age |
| pediatric temperatures | Normal = 37°C (98.6°F) Low-grade fever = 37.8°C – 39°C (100°F – 102°F) High fever = ≥ 40°C (≥ 104°F) |
| Erythromycin in neonates <2 weeks | pyloric stenosis |
| fluoroquinolones in children | risk of cartilage toxicity |
| chloramphenicol in neonates | grey baby syndrome (cyanosis) |
| ceftriaxone in neonates | bliary sludging/kernicerterus |
| sulfonamides in infants <2 months | kernicterus/BMS |
| tetracyclines in children <8 years | dental staining |
| ASA in children <18 years | reye's syndrome |
| CF signs in neonate | meconium ileus, prolonged obstructive juandice |
| CF signs in infants/children | RTI, GI complaints, failure to thrive |
| diagnosis for CF sweat test | >60 mEq/L |
| Most common CF pathogens | S aureus, H influenza, P aeruginosa |
| Less common CF pathogens | Stenotrophomonas maltophilia, Burkholderia cepacia |
| mechanism of Ivacaftor | (Kalydeco) CFTR potentiator |
| what form of CF is Ivacaftor used for | G551D |
| dosage of Ivacaftor | 150 mg BID with fatty food, decrease dose for hepatic dysfunction and co-treatment with CYP3A inhibitors |
| what MVI supplement is used in CF | ADEK |
| how is ADEK dosed | <12 months: 1 ml po QD 1-3 yr: 2 ml po QD 4-10: 1 tab po QD >10 2 tab po QD |
| When is zinc supplement given in CF | for poor weight gain |
| dosage of pancreatic enzymes in CF | infants: 2000-4000 u/120 ml formula <4: 1000 u/kg with meals and 1/2 with snacks >4: 400-500 u/kg with meals and 1/2 with snacks |
| mechanism of dornase alfa | topical mucolytic agent |
| dosage of dornase alfa | 2.5 mg NMT qd to BID |
| Ibuprofen dosage in CF | 20-30 mg/kg BID, adjusted to levels of 50-100 ug/ml |
| Azithromycin maintenance dose in CF | <40 kg: 250 mg po M-W-F >40 kg: 500 mg po M-W-F |
| prophylatic inhaled abx in CF | TOBI (300 mg NMT BID, 28 on/28 off) Aztreonam (75 mg inh tid, 28 on/28 off) Colistin (75 mg NMT BID, save for multi drug resistant) |
| management of CFRD | insulin, po hypoglycemics |
| management of osteopenia/osteoporosis in CF | exercise, vit D, ca, bispohosphonates |
| management of depression in CF | SSRIs, psychotherapy |
| empiric po tx for MSSA | cefuroxime, amox/clav, sulfmethoxazole/trimethoprim |
| empiric po tx for PSA | ciprofloxacin |
| empiric iv tx for MSSA | cefuroxime or oxacillin or cefepime |
| empiric iv tx for MRSA | vanco +/- rifampin |
| empiric iv tx for PSA | double coverage: aminoglycoside (gent, tob, amikacin) + ceftazidime or cefepime, pip/taz or tic/clav, imipenem/cliastatin or meropenem (2nd line), cipro (last line) |
| tx for CF exacerbation with B cepacia and/or S maltophilia | combination of 2-3 drugs: aminoglycosides, B-lactams (pip/tazo, ceftazidime, carpapenem), cloramhenicol, colistatin, fluoroquinolones, sulfamethoxazole/trimethoprim |
| CF exacerbation w/ history of MSSA/no PSA colonization | cefuroxime or nafcillin or oxacillin |
| CF exacerbation w/ history of MSSA and PSA colonization | double PSA coverage: cefepime + aminoglycoside |
| CF exacerbation w/ history of MRSA/no PSA colonization | vanco +/- rifampin |
| CF exacerbation w/ history of MRSA and PSA colonization | vanco +/- rifampin plus double PSA coverage aminoglycoside + B-lactam (ceftazidime) |
| duration of tx for CF exacerbations | 14-21 days |
| monitoring in abx therapy in CF | FEV1, FVC, SCr, UOP, peak and trough |
| goal peak and trough in CF aminoglycoside dosing | peak: 10-12 mcg/ml trough: <1.5 mcg/ml |
| exclusions for ped self tx of fever | <6 months w/ rectal temp >38.3 C >6 months w/ rectal temp >40C hx of febrile seizures or seizures |
| ped dosing of APAP | 10-15 mg/kg/dose q4-6h |
| ped dosing of ibu | 5-10 mg/kg/dose q6-8h |
| exclusions for ped self tx of cough/cold | high fever, SOB, hx of asthma, immunosuppression therapy |
| ped dosing for PSE | Children < 2 years = 1 mg/kg/dose q6h (not recommended) Children 2 – 5 years = 15 mg q6h (max = 60 mg/day) Children 6 – 12 years = 30 mg q6h (max = 120 mg/day) Children > 12 years = 60 mg q6h (max = 240 mg/day) |
| ped dosing for phenylephrine | Children 4 – 6 years = 2.5 mg PO q4-h (max = 15 mg/day) Children 7 – 12 years = 5 mg PO q4-6h (max = 30 mg/day) Children > 12 years = 10 mg PO q4h (max = 60 mg/day) |
| exclusions for ped self tx of allerigic rhinitis | symptoms of AOM, sinusitis, pneumonia, bronchitis hx of asthma |
| ped dosing of loratidine | Children 2 – 5 years = 5 mg PO daily Children ≥ 6 years = 10 mg PO daily |
| ped dosing of fexofenadine | Children 6 – 23 months = 15 mg PO q12h Children 2-11 years = 30 mg PO q12 Children ≥ 12 years = 60 mg PO q12 |
| ped dosing of cetirizine | Children 6-12 months = 2.5 mg PO daily Children 1-5 years 2.5-5 mg per day PO divided q12-24 hours Children ≥ 6 years = 5-10 mg per day PO divided q12-24 hours |
| pathogens of ped D/V | most common: rotavirus others: norwalk like viruses and adenovirus |
| exclusions for self tx of acute gastroenteritis | <6 months, severe dehydration, fever (>38.3 in <3 mon, >40 in infants >3 months), blood or mucus in stool, severe abdominal pain/distress |
| ORT of diarrhea w/out dehydration | ORT 10 mL/kg to replace ongoing stool losses ORT may not be necessary if fluid intake + age appropriate feeding continues |
| ORT for mild dehydration | Correct dehydration: ORT 50 mL/kg over a 4 hour period and reassess q2h Replace ongoing losses: ORT 10 mL/kg/stool; estimate emesis loss and replace |
| ORT for moderate dehydration | Correct dehydration: ORT 100 mL/kg over a 4 hour period and reassess q1h Replace ongoing losses: ORT 10 mL/kg/stool; estimate emesis loss and replace |
| self tx of diaper dermatitis | Products containing ≥ 1 of the following: Allantoin, Cod liver oil, Kaolin, Mineral oil, Zinc oxide, Calamine, Dimethicone, Lanolin, Petrolatum |
Created by:
Kachmiel
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