Medicines use in children and others Flashcards
Children dosage and administration
Dose sizes are not one size fits all, dosed by age and/or body weight, high risk of errors
Carefully consider administration: age appropriate formulation, palatability, who/where
Dosages
Calculated by age and/or weight
Always try to check the actual weight of a child- use guide in back of BNFc, be aware child may not always fit bracket
Always double check dosages- more difficult to spot errors
Label in a way the patient/ carer can relate to e.g. mls vs mgs
Administration considerations
Developmental milestones- all children develop at different rates, normal is a broad descriptor
Administration increasingly occurs outside the home, nanny/ childminder authorised by parents to use certain medication, can encounter difficulties when giving medicines during the school day
Community and hospital pharmacies need to be able to advise parents and children on basic methods of administration of medicines
Successful administration
Positive attitude Involve the whole family Be honest Empower the child Masking Seek advice Use incentives
Information provision
Important that age appropriate and relevant information is provided to the parent and patient
Consider safe storage within the home
It is a legal requirement for all dispensed medicines to be supplied with a PIL
Illness in childhood
Acute infection Congenital disease Childhood conditions Mental health Obesity
Licensing
Medicines must be tested in a specific patient group to be granted a marketing authorisation for use in that patient group
No license does not mean medicines are ineffective
Unethical to test new medicines on children
Paediatric specialists will use unlicensed medicines on children in practice
BNFc allows us to utilise these practical experiences
Developmental issues
Doses of medication and administration issues will need regular review as the child develops
Encourage and support children on long term medication to take responsibility for their medication
Opportunities available for health education
Vaccination
Community pharmacists are an important resource for parents
Childhood vaccination schedule
Education and advice
General recommendations
Know differences in appropriate treatments and licensed medications in children
Ensure adverse events are given due consideration
Review recommendations as the child grows
Be able to provide general health advice
Elderly poopulations
Proportion of older people in the UK continues to rise
Anticipated that social factors will drive health and social care arrangements
Current approach must be modified to ensure that care of elderly patients is patient centred and outcome focused
Medicines optimisation to support: patient capability, independence, re-ablement
Interventions
Medication review to avoid unnecessary polypharmacy Simplify medication regimes Medication counselling Compliance charts MAR charts Pictogram labels Large print labels Reminder alarms Multi compartment compliance aids
Compliance aids
Consider suitability of individual medication: dosage regime stability storage requirements other medication
Practical considerations of compliance aids
Repackaging of medicines out of the manufacturer’s original packaging makes them unlicensed- stability, expiry date, PIL
Consider accountability- risk vs benefit, liability
Document discussions with patient/ carer/ prescriber
Dysphagia
Difficulty with the act of swallowing- unable to swallow, sensation of sticking, choking episodes, aspiration of food and/or liquids
Some children born with swallowing difficulties: cerebral palsy, cleft lip/ palate, GORD