SS_PA 1.79 Describe the maximum safe doses of local anaesthetic agents in different age groups

TRUE/FALSE  Neonates are more prone to develop methaemogolbinaemia with prilocaine administration due to the presence of foetal haemoglobin

TRUE/FALSE  Transfer of local anaesthetics across the placenta is inversely proportional to drug lipophilicity

TRUE/FALSE  Methaemoglobin reductase requres NADH as an electron donor

TRUE/FALSE  Methaemoglobin reductase is functionally deficient in the neonate

TRUE/FALSE  Children are more prone to cocaine toxicity due to reduced cholinesterase activity

SS_PA 1.51 : paediatric pharmacokinetics

As promised…

SS_PA 1.51  : Describe how the pharmacokinetics of drugs commonly used in anaesthesia in neonates and children differ from adults and the implications for anaesthesia

Neonates require larger doses of neuromuscular blockers per kg than adults   TRUE/FALSE

Neonates require larger doses of remifentanil per kg than adults   TRUE/FALSE

Neonates require a larger induction dose of thiopentone per kg than adults   TRUE/FALSE

Higher doses of EMLA can be more safely used in neonates than older children   TRUE/FALSE

Surgical stress decreases the concentration of alpha 1 acid glycoprotein   TRUE/FALSE

SS_PA 1.51 : paediatric pharmacokinetics

Staying on the theme of routes of administration today..

SS_PA 1.51  : Describe how the pharmacokinetics of drugs commonly used in anaesthesia in neonates and children differ from adults and the implications for anaesthesia

Oral medications are absorbed slowly in infants due to decreased gastric emptying and intestinal motility  TRUE/FALSE

Nasal midazolam tastes good  TRUE/FALSE

Gastric pH is lower in infants than in adults  TRUE/FALSE

The solubility coefficients of an inhaled anaesthetic will determine its volume of distribution  TRUE/FALSE

In Evers & Maze the author states  ‘Other factors causing a more rapid “wash-in” of inhalational anesthetics include the greater fraction of cardiac output distributed to the vessel-rich tissue group (e.g., the lungs)’ What do you think of this comment?

(hint – keep reading this chapter on paediatric pharmacology – you might even be able to spend the rest of the week testing your retention of the material)