NPS NPS Pharmacology and Medications 2 — Questions and Answers
Question 1: A 28-week neonate receives vancomycin for suspected sepsis. Which pharmacokinetic parameter is most commonly monitored to guide dosing?
- Peak concentration
- AUC/MIC ratio (Correct answer)
- Half-life
- Volume of distribution
Correct answer: AUC/MIC ratio
AUC/MIC-guided vancomycin monitoring (targeting AUC 400–600) is now preferred over trough-only monitoring in neonates and pediatric patients.
Question 2: Dexamethasone is used postnatally in premature neonates primarily to treat which condition?
- Hypoglycemia
- Bronchopulmonary dysplasia (Correct answer)
- Intraventricular hemorrhage
- Necrotizing enterocolitis
Correct answer: Bronchopulmonary dysplasia
Low-dose postnatal dexamethasone is used to facilitate extubation and manage bronchopulmonary dysplasia in ventilator-dependent preterm neonates.
Question 3: What is the maximum safe concentration of dextrose that should be administered via a peripheral IV in a neonate?
- D5W (5%)
- D10W (10%)
- D12.5W (12.5%) (Correct answer)
- D15W (15%)
Correct answer: D12.5W (12.5%)
Dextrose concentrations up to 12.5% are considered safe for peripheral IV administration in neonates to avoid venous irritation and extravasation injury.
Question 4: A pediatric patient in status asthmaticus fails initial bronchodilator therapy. Which IV medication is administered next?
- Magnesium sulfate (Correct answer)
- Aminophylline
- Terbutaline IV
- Ketamine
Correct answer: Magnesium sulfate
IV magnesium sulfate is recommended as second-line therapy for pediatric status asthmaticus not responding to initial bronchodilators, due to its bronchodilatory effect.
Question 5: Which medication is used to treat neonatal seizures as first-line therapy in the US?
- Levetiracetam
- Phenobarbital (Correct answer)
- Fosphenytoin
- Lorazepam
Correct answer: Phenobarbital
Phenobarbital at 20 mg/kg IV is the established first-line anticonvulsant for neonatal seizures in most US centers.
Question 6: A neonate with persistent pulmonary hypertension (PPHN) fails conventional therapy. Which inhaled medication is indicated?
- Nitric oxide (iNO) (Correct answer)
- Epoprostenol
- Sildenafil
- Bosentan
Correct answer: Nitric oxide (iNO)
Inhaled nitric oxide (iNO) is the only FDA-approved inhaled pulmonary vasodilator for neonates with PPHN, selectively reducing pulmonary vascular resistance.
NPS NPS Pharmacology and Medications 2
A 28-week neonate receives vancomycin for suspected sepsis.
Which pharmacokinetic parameter is most commonly monitored to guide dosing?