Introduction to Pediatrics Flashcards
Challenges to pediatric pharmacotherapy
PK/PD differences
Psychosocial influences
Caregiver medication administration hesitance
Dosage formulation selections
Off-label medication uses
PK/PD differences in children affect what?
Dosage and drug selection
Psychosocial influences
Child vs. adolescent/older child
Caregiver medication administration hesitance
Cultural beliefs, socioeconomic status
Dosage formulation selection: parenteral factors to consider
volume of IV fluids, vehicle safety, IV access
Dosage formulation selection: PO factors to consider
manufactured liquid preparations, extemporaneously compounded liquid preparations, volume of PO fluids, chewable tablets, tablets, capsules, granules
Dosage formulation selection: palatability factors to consider
children have different taste preferences
Consequences of poor/nonadherence
delayed/absent clinical improvement, worsening of illness, unnecessary therapy modifications that can lead to adverse clinical outcomes
Reasons for nonadherence
apprehension regarding medication ADEs, caregiver inability or unavailability to administer drugs, caregivers may be overwhelmed/confused, inappropriate measurements of medication dose, missed doses due to resistance from the child
Strategies to improve adherence
caregiver education should be reinforced at several points of healthcare visit, ease of administration (palatable dosage forms, less frequent dosing), decreased child resistance (reward system, positive reinforcement), empowering older children/adolescents
Off-label medication use definition
use of a medication outside its FDA-approved labeled indication(s)
Limitations to off-label drug usage
Potential for denied insurance provider coverage
Liability for ADEs
Limited experience in specific conditions or age groups
Limited available dosage formulations
Evidence considerations for off-label use: adult data
Using adult data isn’t always accurate when determining safe and effective pediatric dosing; use guidelines when available or primary literature
Neonates/infants are more susceptible to…
Volume overload, need more concentrated doses of IV medications
Limit the use of what vehicle in neonates/infants?
Propylene glycol
Something to consider about tablets and capsules in kids
Can they be chewed/crushed/opened?
How to handle palatability in kids
Mix medicine into food, FlavoRx
Why are extemporaneous formulations needed in infants and children sometimes?
Some drugs aren’t commerically available in a formulation the patient can take, so you have to compound it
Pediatric meds are dosed based on weight, so taking a capsule/tablet might not give them the dose they need
A max peds dose of a drug is what?
Adult dose
Peds dosing can be based on what?
mg/kg/dose
mg/kg/day
mg/m^2
gestational age
actual age
patient weight ranges
