Paediatric pharmacology Flashcards
What is off-label prescribing?
Formulation administered via a route not intended
Medicines used for an indication not intended
Medicines used at a different dose to that recommended
Children below stated recommended age limit
How does off-label prescribing affect death rates and ADR?
Off label medicines use gives rise to an increased rate of ADRs and avoidable deaths
Why is extrapolation of adult data not safe?
Pharmacokinetic differences between adults and children
Pharmacodynamic differences in responses
Effects on growth and development not known
Different specific pathologies
Are drugs often prescribed/used off label in the early post natal phase?
Yes
About 98% are
What are some drug-relevant physiological features of the early post natal phase?
Rapid growth
Highly variable alterations in drug metabolism and elimination
Lower tolerance to ADRs
Difficulty in identifying efficacy and toxicity
What are some drug-relevant physiological features of the infancy phase?
Body weight gain and body water composition change rapidly as does the ratio of bodyweight or surface area to organ size and function
What are some drug-relevant physiological features of the toddler phase?
This stage is associated with minor illnesses, leading to multiple short courses of therapy
Problems with compliance
What are some drug-relevant physiological features of the young child phase?
Enhanced metabolism and excretion
Clearance can change significantly during a single dose regimen
What are some drug-relevant physiological features of the adolescent phase?
Sexual development produces major changes in body size and composition which affect drug metabolism
Psychological changes and peer pressure result in behaviour such as smoking, alcohol and elicit drug use which can alter drug metabolism
Can parents/patients report suspected side effects of drugs?
Yes
www.yellowcard.gov.uk
Leaflets in pharmacies
Calling yellow card hotline
