ionized drugs
- poorly absorbed in stomach of infants
- water-soluble medication
___ will produce slower absorption
- cardiovascular shock
- vasoconstriction due to sympathomimetic agents
- heart failure
- sick preterms with little muscle mass
acid secretion in full term vs preterm
- full term: soon after birth
- preterm: more slowly
t/f weakly acidic, ionized drugs better absorbed in stomach of infants
false, UNIONIZED DRUGS are absorbed better
weak acidic + unionized = good
strong acidic + ionized = bad
t/f drugs that are absorbed primarily in the stomach may be absorbed more completely than annticipated
true
- gastric emptying time is prolonged (6-8 hrs)
t/f for drugs absorbed in small intestine, the therapeutic effect will be faster in babies
false
- drug stays longer in stomach = delayed transmission to intestines = delayed absorption and effect
peristalsis in the neonate is __
irregular and slow
t/f absorption of lipid soluble drugs is decreased
true
- lower gi enzymes
- low concentrations of bile acids and lipase
t/f the neonate has higher percentage of water of body weight
true, 70-75 in neonate, 50-60 in adult
- younger = more water
- extracellular water 40% in neonate, 20% in adult
preterm infants have ___ body fat than full term
less
- less fat = cannot accumulate as much lipid soluble drugs
effect of lower levels of total plasma protein in babies
higher concentration of free/active drug
effects of drugs in neonatal jaundice
- drugs given to neonate with jaundice can displace bilirubin from albumin
- free bilirubin can go to the brain and cause kernicterus
effects of lower cytochrome p450 and conjugating enzymes
- slower clearance rate
- longer half life of drugs
- can predispose to ades
effects of lower gfr in newborns
- drugs that depend on renal function are cleared slower
life saving drugs
- indomethacin = rapid closure of pda
- prostaglandin e1 = keep pda open (for totga or tof)
