NURS 6521, WEEK 11, DISCUSSION 11 (DRAFT).docx - NURS 652`1 WEEK 11 DISCUSSION 11 Pediatrics Children deal with variety of health issues similar to

NURS 6521, WEEK 11, DISCUSSION 11 (DRAFT).docx - NURS 652`1...

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NURS 652`1, WEEK 11, DISCUSSION 11; Pediatrics Children deal with variety of health issues similar to adults, but they also have issues that are more prevalent within their population. One issue that significantly impacts children is the prescription of drugs for off-label use. Consider the case of Rebecca Riley. When she was two years old, Riley was diagnosed with ADHD, and by age three, she was diagnosed with bipolar disorder. In the span of two years, Riley’s doctor prescribed four drugs off-label: Clonidine, Depakote, Zyprexa, and Seroquel. Riley’s doctor also approved 13 increases in drug dosages. Then, at age four, Riley died from pneumonia combined with a toxic level of prescription drugs (Lambert, 2010). Cases such as this have brought attention to the off-label use of drugs in pediatric patients, as well as the importance of monitoring patient reactions to prescribed drugs and evaluating the effects of drug-drug interactions. As an advanced practice nurse, how do you determine the appropriate use of off-label drugs in pediatrics? Are there certain drugs that should be avoided with pediatric patients? This week you examine the practice of prescribing off-label drugs to children. You also explore strategies for making off-label drug use safer for children from infancy to adolescence as it is essential that you are prepared to make drug–related decisions for pediatric patients in clinical settings. Discussion: Off-Label Drug Use in Pediatrics The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children. When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.
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