Term
|
Definition
>1wk
Spreads beyond diaper area
Signs of infection |
|
|
Term
| Prevention of diaper rash; how to protect skin? |
|
Definition
Zinc oxide
Petrolatum
No powders b/c of aspiration |
|
|
Term
| 4 ways to prevent diaper rash |
|
Definition
1. Freq. changes
2. Cleanse and dry
3. Avoid irritants
4. Protect skin |
|
|
Term
| Prevention of diaper rash; what are irritants |
|
Definition
wet
chemicals
fecal enzymes |
|
|
Term
| Pharm products from prevention of diaper rash |
|
Definition
1. Zinc oxide
2. A&D oint.
3. White petrolatum
4. Aquaphor
5. Various compounds/combos |
|
|
Term
| Pharm compounds for the prevention of diaper rash |
|
Definition
1. Kayra in petrolatum or oint
2. Maalox +/- aquaphor
3. Cholestyrmine in aquaphor
4. Carafate paste in aquaphor
5. Nystatin/HC/Zinc ox. |
|
|
Term
| Coating the bum in Maalox or Mylanta does... |
|
Definition
|
|
Term
| Which agent is best for a non-fungal rash |
|
Definition
|
|
Term
| What is a side effect of HC |
|
Definition
| HPA (hypothalamus pituitary suppression) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Nystatin
Imidazole (ketoconazole Lotrimin) |
|
|
Term
| How to prevent open wounds in babies with eczema? |
|
Definition
socks on hands
short fingernails |
|
|
Term
| In addition to eczema; pts with eczema commonly have |
|
Definition
|
|
Term
|
Definition
Occlusive moisturizers such as
Crisco
Vaseline
Cetaphil
Lubriderm
Aquaphor
Eucerin |
|
|
Term
| Can you grease up eczema kids with olive oil? |
|
Definition
|
|
Term
| When to apply hydrocortisone? |
|
Definition
Post bath
Before moisturizer |
|
|
Term
| Should you use HC for longer than 1-2mo |
|
Definition
| No - looses effectiveness |
|
|
Term
| Are tacrolimus and pimecrolimus used any more to treat eczema? |
|
Definition
| No - skin cancer in animals |
|
|
Term
| Use topical antihistamine to treat eczema |
|
Definition
|
|
Term
|
Definition
AH
Tar
Oral Corticosteroid
Oral AB |
|
|
Term
| Treat STAPH bacterial skin infection orally |
|
Definition
KEFLEX (1rst gen ceph)
Dicloxacillin (PCN) |
|
|
Term
| In the NICU IRT ADME talk about Metabolism and Elimination |
|
Definition
| Both are constantly increasing...Liver reaches adult level functioning by 1yr, and kidney at 6mo. Hard to dose |
|
|
Term
| In the NICU IRT ADME talk about Absorption |
|
Definition
Skin is thin = increased
pH of GI changes = unpredictable
Less muscle mass= IM admin unreliable |
|
|
Term
| In the NICU IRT ADME talk about Distribution |
|
Definition
More % body water = increased Vd for hydrophilic meds
Reduced plasma = increased free protein-bound drug |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
Premenstrual age
Corrected gestational age
post-conceptual age |
|
Definition
| conception to current day |
|
|
Term
| Risk of RDS (Resp Distress Syndrome) |
|
Definition
| <29wk Gestational age ...lungs do not finish developing until 36wks |
|
|
Term
| Treat RDS in the womb with |
|
Definition
steroids giving to mom if expected to deliver early
betamethasone 12mg IM Q24hr |
|
|
Term
|
Definition
| surfactant replacement therapy via endotracheal tube |
|
|
Term
| Define BDP (Broncho pulmonary dysplasia) |
|
Definition
|
|
Term
|
Definition
Thiazide diuretic
Albuterol
Fluticasone
Systemic crticosteroids |
|
|
Term
|
Definition
| systemic corticosteroids - DART protocol |
|
|
Term
| Which four antidepressants are approved for kids? |
|
Definition
Fluoxetine - Prozac
Sertraline - zoloft
Fluvoxamine - Luvox
Escitalopram - lexapro |
|
|
Term
| Fluoxetine is approved to treat ______ from what age |
|
Definition
OCD >/= 7yo
MDD >/= 8yo
Initial 5-10mg
Max 60g/day |
|
|
Term
| Are any psychopharmacologi agents approved for anxiety? |
|
Definition
|
|
Term
| Sertraline is approved to treat ______, and from what age? |
|
Definition
OCD >/= 6yo
Intial 6-12yo 25mg
Initial 13-17yo 50mg
Max 200mg/day |
|
|
Term
| Fluvoxamine is approved to treat ______, and from what age? |
|
Definition
OCD >/= 8yo
25mg start
8-11yo incr. to 200
12-17yo increase to 300
BID if >50mg day |
|
|
Term
| Escitalopram is approved to treat ______, and from what age? |
|
Definition
MDD >/= 12 yo
Initial 5-10mg
Max 20mg/day |
|
|
Term
| Which two psychopharmacologics can treat MDD? |
|
Definition
Fluoxetine - proac
Escitalopram - Lexapro |
|
|
Term
| Which of the 4 approved psychopharmacologics is not approved to treat OCD |
|
Definition
|
|
Term
| Modality of psychopharmacologic tx? |
|
Definition
| start low; go slow; new behaviors is a problem |
|
|
Term
| Disruptive Mood Dysregulation Disorder |
|
Definition
Temper update >3/wk
For >1yr
Present in 2 settings
Onset 6-10yo |
|
|
Term
|
Definition
| Depressed/irritable for >1y |
|
|
Term
|
Definition
Depressed mood or irritable + 4or more of the following symptoms
-weight loss
-decrs. appetite
-insomnia
-hypersomnia
-psychomotor agitation/retardation
-fatigue
-lack of energy
-worthlessness
-guilt
-decreased concentration
-indecisiveness
-suicidal thoughts |
|
|
Term
| Due these 3 things to clarify a depression Dx |
|
Definition
1. screen for abuse/neglect
2. Asses learning difficulties
3. Assess risk for mania |
|
|
Term
| TADS - Treatment for adolescents w/ depression study compared |
|
Definition
Placebo
CBT
Fluoxetine (Prozac)
Fluoxetine + CBT |
|
|
Term
| Results of the TADS study |
|
Definition
Prozac + CBT = best outcome
Prozac only = 2nd best
CBT = third
Placebo = fourth but a 34.8% resp. rate |
|
|
Term
| Treatment of SSRI-Resistant Depression in Adolescent (TORDIA)compared: |
|
Definition
| switching to another SSRI or Venlafaxine (Trintellix) w/ or wo/ CBT |
|
|
Term
| Results of the TORDIA Study |
|
Definition
-Med switch + CBT = best outcome
-Switching to venlafaxine over other SSRI had similar outcomes
- |
|
|
Term
| Child anxiety Multimodal study (CAMS) compared |
|
Definition
| CBT v. Sertaline (Zoloft) v. Zoloft+CBT v. Placebo |
|
|
Term
| Results of the CAMS Study |
|
Definition
Sertaline (Zoloft) + CBT = best outcome
CBT only and Zoloft only had similar outcomes
Placebo much lower resp. rate |
|
|
Term
| Key point: SSRI resonse rate is _________, and RCTs show a ____________ placebo effect |
|
Definition
|
|
Term
| Kids + Paroxetine (Paxil) = |
|
Definition
|
|
Term
| Venlafaxine (Effexor) is a |
|
Definition
|
|
Term
| Typical antidepressant onset of action |
|
Definition
|
|
Term
| hen selectinf AD consider these four things |
|
Definition
1. FDA
2. Half-life
3. Once daily dosing
4. DDIs |
|
|
Term
| Best AD for sporadic adherence |
|
Definition
| Fluoxetine (Prozac) longest half-life |
|
|
Term
|
Definition
|
|
Term
| Floxetine did not work try... |
|
Definition
|
|
Term
| Oh know there is a DDI! Which AD is the best choice? |
|
Definition
| Escitalopram (Lexapro) CYP450 |
|
|
Term
| Dose increase interval for ADs is |
|
Definition
| every 4-7days until desired effect |
|
|
Term
|
Definition
| To the family's behavior goal. |
|
|
Term
| Which surveys are used to monitor therapeutic effect of ADs |
|
Definition
|
|
Term
| T/F dose changes as kids grow |
|
Definition
|
|
Term
| T/F When switching ADs do so abruptly |
|
Definition
| F - taper/increase over a few weeks with the EXCEPTION of Fluoxetine b/c of long half-life. |
|
|
Term
| AD Dose adjustments are made how often? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| T/F Fluoxetine (Prozac) can be discontinued abruptly |
|
Definition
|
|
Term
| Bupropion (Wellbutrin) is choice 5 of 4 ADs for kids |
|
Definition
| True; 5 of 4 b/c not FDA approved |
|
|
Term
| T/F One problematic side effect of bupropion (Wellbutrin) is seizures? |
|
Definition
|
|
Term
| Wellbutrin is a powerhouse combo b/c it treats what two thngs |
|
Definition
Depression + ADHD
Not FDA approved in peds |
|
|
Term
| T/F Escitalopram (Lexapro) is more effective than Citalopram (Celexa) |
|
Definition
| F equal...both SSRI... Celexa not FDA approved in peds |
|
|
Term
| Venalfaxine offers similar efficacy to the approved four ADs, but has_______ |
|
Definition
Increased side effect profile
not fda approved in peds |
|
|
Term
| Mirtazapine (Remeron) most bothersome side effect is |
|
Definition
Weight gain
Not FDA approved for peds |
|
|
Term
| T/F CBT has a specified 16wk path? |
|
Definition
|
|
Term
| 4 prescribing principles of ADs |
|
Definition
1. prescribe only if Dx
2. Evidence based (FDA approved); avoid outlier Rx-ing (no resp. coul be adherence)
3. Plan to track benefit/side effects
4. Monitor for adherence
5. Always screen for trauma |
|
|
Term
| FDA recommended monitoring plan for ADs |
|
Definition
Week 1-4: weekly
Week 5-8: biweekly
Week9-forever: every 12wks |
|
|
Term
| 6 approved antipsychotics: |
|
Definition
| risperidone, aripipazole, paliperidone, olanzapine, asenapine, quetiapine |
|
|
Term
| Side effect of Antipsychotics |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Describe absence seizures |
|
Definition
| spells of staring into space; pts commonly have tonic-clonic seizures as well |
|
|
Term
|
Definition
Siezure when temp exceeds 100.4F
FH common
No epilepsy |
|
|
Term
|
Definition
Alternate Tylenol/Ibuprofren
Aggessive dosing (15mg/kg Tylenol | 10mg/kg Ibuprofren) |
|
|
Term
| Define tonic-clonic seizures |
|
Definition
| onset 1-2hrs after wakening |
|
|
Term
| Treat tonic-clonic non-pharm |
|
Definition
Lifetime pharm treatment req. and also
Maintain low stress
consistent sleep
avoid alcohol
be wary of hormonal changes |
|
|
Term
| Treat tonic-cloinc seizures |
|
Definition
Carbamezapine (Carbatrol; Tegretol) (self-inducer)
Phenobarbital (neonate choice; b/c drowsy)
Phenytoin (Dilantin) (satruable; jiggling eye balls; lots of gums)
Topiramide (Topamax) (renal stones; no monitoring) |
|
|
Term
|
Definition
Levetiracetam (Keppra)(dose aggressively; no monitoring)
Clobazam (Onfi)(benzo; sedation; 1rst 2nd line tx)
Gabapentin(Neurontin)(sedation)
Zoniamide (Zonegran)(Sulfonamide) |
|
|
Term
| Treat epilepsy; INFINTILE SPASMS |
|
Definition
| Vigabatrin (sabril)(vision probs) |
|
|
Term
| Worried about DDIs with which seizure agents |
|
Definition
Crbamazepine
Oxycarb...
Phenobarbital
Phenytoin
Vigabatrin
Valproic Acid |
|
|
Term
| Seizure meds renally eliminated |
|
Definition
Gaba
Levetiraceetam
Topiramate |
|
|
Term
| What is unique about phenytoin metabolism? |
|
Definition
|
|
Term
| Which Bacterial skin infection impetigo is most common |
|
Definition
Impetigo most common, but
Bullous most common in neonate ( |
|
|
Term
| Treat bacterial skin infection; strep |
|
Definition
|
|
Term
| Treat Strep and Staph bacterial skin infections with |
|
Definition
Vanco (MRSA)
Clindamycin (MRSA sometimes) |
|
|
Term
| When to treat bacterial skin infection systemically? |
|
Definition
Family/daycare outbreak
Deep tissue penetration |
|
|
Term
| Treat Seborrheic Dermatitis |
|
Definition
Dandruff shampoo
Scrub scalp with tooth brush
Be careful of EYEs |
|
|
Term
| Topical v. Systemic treatment of ring worm |
|
Definition
| If on head systemic otherwise topical |
|
|
Term
| Which agent to treat ringworm systemically |
|
Definition
Griseofulvin - with a FATTY meal
2nd line = Fluconazole |
|
|
Term
| Lice treatment Nix or rid |
|
Definition
|
|
Term
| Rid is used in ______ hair; while Nix is used in _ wet hair |
|
Definition
|
|
Term
| IRT age; Rid can be used on _______ while Nix is used on __________ |
|
Definition
|
|
Term
| T/F Nix/Rid requires to tx to be effective? |
|
Definition
|
|
Term
| New Lice treatments (Sklice, Ovide, Natroba) can kill lice and nits; AKA one tx |
|
Definition
|
|
Term
| IRT scabies; treat all family members or individuals? |
|
Definition
|
|
Term
| T/F scabies is the gift that keeps giving for 7 additional days after tx |
|
Definition
|
|
Term
|
Definition
Pernetherin
Lindane (No infants)
Crotalmiton
Sulfur (pregnant/< 2mo old) |
|
|
Term
| t/F If there is a scabies outbreak wash sheets bag stuffed animals... |
|
Definition
|
|
Term
| Preemie/Neonate skin lesions that are not treated |
|
Definition
Neonatal acne (gift from mom)
Milia (white spots)
Mongollian spots (blue) |
|
|
Term
| Back to the NICU; Define AOP Apnea of Prematurity |
|
Definition
Common if birth weight <1kg
Stop breathing for 20secs
Resolves at 36wk PMA |
|
|
Term
| T/F AOP is a Dx of exclusion |
|
Definition
| T - Rule out brain stem prob and obstructions |
|
|
Term
|
Definition
By touching baby (no joke)
Caffeine (goal 8-20; 50 is tox) |
|
|
Term
| Define PDA (patent Ductus Arteriosus |
|
Definition
| Passage connectin pulmonary artery to descending aorta does not close |
|
|
Term
|
Definition
1. Fluid restriction (reduce pressure)
2. Prophylactic expose all to NSAID
3. Presymptomatic ECHO
4. Symptomatic/resue (MOST COMMON)
5. Surgically |
|
|
Term
|
Definition
IV indomethacin
IV Ibuprofren
IV Acetaminophen (maybe) |
|
|
Term
| Define NAS Neonatal Abstinence Syndrome) |
|
Definition
| Intrauterine exposure to opioids |
|
|
Term
|
Definition
| Urine/meconium/hair/umbilical cord |
|
|
Term
|
Definition
Sneezing/congestion
Excessive sucking, poor feeding, _VD
Tremor; high pitched cry poor sleep |
|
|
Term
| You can score NAS using what survey |
|
Definition
|
|
Term
|
Definition
Kanagroo care (baby on chest)
Pharm varies by institution
-Morphine taper
-clonidine if weening is not woking |
|
|
