drug therapy across lifespan- pharm

Were 30 of drugs caused unanticipated side effects

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Unformatted text preview: Patients 20% of drugs were ineffective in children even though they 20% were effective in adults. were 30% of drugs caused unanticipated side effects, some of 30% them potentially lethal. them 20% required dosages different from those that had been 20% extrapolated from dosages used in adults. extrapolated 21 Pediatric Patients 22 Drug Therapy in Children 1. 2. 3. 4. 5. 6. 7. Due to organ immaturity very young patients are highly sensitive to drugs In neonates and young infants drug responses may be intense and prolonged. Protein-binding capacity is limited in young children. BBB not fully developed at birth. Drug metabolizing capacity of neonates is low. Renal excretion is low in neonates. In children 1 year or older most pharmacokinetic parameters are the same as adults. 23 Fig. 10-1. Comparison of plasma drug levels in adults and infants. A, Plasma drug levels following IV injection. Dosage was adjusted for body weight. Note that plasma levels remain above the minimum effective concentration (MEC) much longer in the infant. B, Plasma drug levels following subQ injection. Dosage was adjusted for body weight. Note that both the maximum drug level and the duration of action are greater in the infant. 24 Pharmacokinetics: Children 1 Year of Age and Older Most pharmacokinetic parameters similar to those in adults Drug sensitivity more like that for adults than for children Drug less than 1 year old less One important difference • Metabolize drugs faster than adults Markedly faster until 2 years of age, then a gradual decline Sharp decline at puberty May need to increase dosage or decrease interval between doses 25 26 Drug Administration in Children 1. 2. 3. 4. Parents are sources of information. Avoid putting medications in essential foods. Be aware of child’s reactions. Give cold juices first as it will dull the taste of unpalatable medicines. 5. Sugarless with children who have Diabetes. 6. Jam and syrup for medicines that do not dissolve well in water. 7. Record successful method of admi...
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This document was uploaded on 03/25/2014.

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