Pediatric Meds. Physiologic differences make children more sensitive to drugs and more at risk for adverse drug reactions Pharmacokinetics and pharmacodynamics are affected by changes in body fluid composition, differences in the cardiovasc, GI, renal, and neurological systems.
Physiologic differences make children more sensitive to drugs and more at risk for adverse drug reactions
Pharmacokinetics and pharmacodynamics are affected by changes in body fluid composition, differences in the cardiovasc, GI, renal, and neurological systems.
Infants:developing trust. Involve parents in deliv. meds when possible.
Toddlers:developing autonomy. Follow routines, give choice betw 2 things, involve parents.
Preschoolers: developing initiative. Play with safe equipment, be positive, keep choices limited and possible in reality, involve parents.
Schoolagers: developing industry. Give explanations, involve them in their care, reward system as needed to instill cooperation (usually cooperative), use therapeutic play to help with coping, involve parents as appropriate to their relationship.
Adolescents: developing identity. Give explanations at adult level (as applic).
use the 5 rights: pt,drug, dose, route, time.
discrepancies must be determined
lab results or levels may need to be consulted before administration.
preferred mechanism: unit of medic per Kg of body weight.
BSA primarily used for calc. Chemotherapy (ht and wt accd to West nomogram)
mg/kg/day (24 hrs) divided by a certain amt of hrs or
mg/kg/dose with a defined interval.
adult dose may be used for > 50 or 60 Kg (per protocol).
D/H x V
algebraic ratio equation A/B=C/D
Give Tylenol 325mg po Q 4hrs to a 5yr old who weighs 25Kg.
Tylenol Susp. Comes 160mg/teaspoon; 1tsp=5ml
How much will you give?
Tylenol SDR is 10-15mg/kg/dose not to exceed the daily max dose.
What is the SDR for this child of 25 Kg?
What is the daily max dose if it is not to exceed 5 doses/24hrs?
Give Amoxicillin 450mg po TID to a 2.5yr old who weighs 15kg for an ear infection.
Amoxicillin comes 250mg/5ml
SDR is 90mg/kg/day for Otitis Media
Is it within SDR?
How much will you give per dose?
Age 3yrs: Wt 9.8 Kg
SDR Cefazolin = 50-100mg/kg/24hrs Q 8 hr.
Calc recomm dose for this child, compare it to ordered dose, action needed?
SDR for this child :
child receives 900mg/day (300mg Q 8hr=300x3=900) OR
490/3= 163mg/dose up to 980/3=326mg/dose (300mg/dose)
child’s dose is within SDR (either per dose or per day); safe to give.
Cefazolin 300mg comes in a multi-dose syringe labeled 900mg/30ml.
How many ml’s will you deliver to give the correct dose of 300mg?
900X=30(300): X= 300(30)/900
D/H X V : 300/900 X 30 = 10ml.
Ranitidine comes in a multidose syringe of 150mg/30ml
SDR for infants/children is 2-4mg/kg/24hr divided Q 6-8hrs
What is the SDR? Action needed?
72/3=24mg per dose.
Dose ordered is 50mg Q 8hr which exceeds the SDR so would notify the physician.
Use micro drippers in pedi
Ml/hr = gtts/min
A rate of 100ml/hr would be set at 100ml/hr (which is the same as 100gtts/min)
The maintenance IV fluid of D5 ½ 20 KCL/L is supposed to run at a rate of 60ml/hr. What would be the IV pump rate?